College of Nursing

All India Instutite of Medical Sciences, Rishikesh (Uttarakhand)

B.Sc. (Hons) Nursing 3rd year Batch – 2016
End Term Examination – 2019
Subject – Maternal Health Nursing

Note: All questions are compulsory. Each carries 1 mark MM-200

1. This refers to systems of health care delivery that focus on reducing the cost of health care by closely
monitoring the cost of personnel, use and brands of supplies, length of hospital stays, number of procedures
carried out, and number of referrals requested:
a) Competency
b) Autonomy
c) Decision making
d) Privacy
2. In Indian scenario we see that maternal morbidity and mortality is high, what is the main reason of maternal
mortality during pregnancy and labour?
a) Hypertensive Diseases
b) Obstetric Haemorrhage
c) Postpartum Depression
d) Anaemia
3. The medical termination of pregnancy act which is formed to protect pregnancies under legal guidelines, does
not protect act of termination of pregnancies after:
a) 20 weeks
b) 24 weeks
c) 28 weeks
d) 32 weeks
4. (Number of Fetal Deaths of 28 or more weeks gestation + Number of Newborn death under 7 days of age)
/(Number of Live Births + Fetal Deaths of 28 or more weeks gestation) per 1000 live births is known as:
a) Neonatal mortality rate
b) Maternal mortality rate
c) Perinatal mortality rate
d) Infant mortality rate
5. The provision of biomedical, behavioural and social health interventions to women and couples before
conception denote:
a) Preconception care
b) Antenatal care
c) Health education
d) Postnatal care
6. Bhore committee laid the foundation for public health planning in India laid great stress on the need for
qualified midwives and health visitors in the year:
a) 1942
b) 1944
c) 1946
d) 1948
7. This refers to systems of health care delivery that focus on reducing the cost of health care by closely
monitoring the cost of personnel, use and brands of supplies, length of hospital stays, number of procedures
carried out, and number of referrals requested:
a) Extended Roles
b) Expanded Roles
c) Change in social structure
d) Cost containment
8. What should the nurse do when planning nursing care for a Antenatal client who is admitted for antenatal care
with a different cultural background? The nurse should:
a) Allow the family to provide care during the hospital stay so no rituals or customs are broken
b) Identify how these cultural variables affect the health problem
c) Speak slowly and show pictures to make sure the client always understands
d) Explain how the client must adapt to hospital routines to be effectively cared for while in the hospital
9. One evening you are in the supermarket when you see a patient who was discharged a couple of weeks ago
following a caesarean section with still birth of a baby boy. Do you:
a) Introduce yourself to the patient
b) Ask about her health and family
c) Ask about her shopping
d) Leave her alone. Don’t risk embarrassing her and breaching her confidentiality by discussing her
treatment in public.
10. A nursing teacher is teaching about female pelvis and its types to the students, which type of pelvis has the
below given features? Heart shaped brim with prominent ischial spines:
a) Gynecoid
b) Android
c) Anthropoid
d) Platypelloid
11. During the class of gametogenesis students have doubt like the maximum number of oogonia is formed at
what age of the female life?
a) One month intrauterine life
b) Five month intrauterine life
c) At birth
d) At Puberty
12. After describing anatomy of female reproductive system tutor asks to students which among the following is
the constricted part that connects body of the uterus and cervix?
a) Ampulla
b) Infundibulum
c) Cornua
d) Isthmus
13. In labour room a placenta is given to students and asked them to explain what is the amount of fetal blood
flow through the placenta?
a) 100ml/min
b) 250ml/min
c) 330 ml/min
d) 400ml/min
14. A term gravid mother had done her ultrasound and the report stated that her amniotic fluid is normal. What is
her expected level of amniotic fluid?
a) 300 ml
b) 500 ml
c) 700 ml
d) 1100 ml
15. While a nurse performing amniotomy the nurse noted that the colour of the fluid was golden coloured. What
would be the nurse’s interpretation?
a) post maturity
b) meconium stained
c) Rh incompatibility
d) Intra Uterine Death
16. After the class of fetal development teacher asks students that From which germ layer does the cardiovascular
system originates during organogenesis?
a) Ectoderm
b) Mesoderm
c) Endoderm
d) Bilaminar layer
17. A student while demonstrating the fetal skull, the teacher asks her to explain the anatomical location of the
bregma. Which among the following may be correct response by the student?
a) at the junction of the sagittal, coronal and frontal sutures
b) at the junction of lambdoidal and sagittal sutures
c) between the two halves of the frontal bones
d) between the frontal and parietal bones
18. After the delivery of the placenta the nurse writes the report in the case file as placenta and membranes
complete and small sized placenta with the weight of 350 g. what is the normal weight of the placenta at term?
a) 300 g
b) 500 g
c) 700 g
d) 900
19. A healthy antenatal mother at 37 gestational week had her monthly weight checked by the community health
nurse and reported as to have a normal weight gain. What is the total weight gain during the course of a single
ton pregnancy in a healthy woman?
a) 9 kg
b) 11 kg
c) 13 kg
d) 15 kg
20. During per vaginal examination of a 6 week antenatal mother, midwife found the cervix to be softened as the
lip of the mouth. What should be the midwife’s interpretation for this finding?
a) Jacquemier’s sign
b) Goodell’s sign
c) Chadwick’s sign
d) Hegar’s sign
21. During a group discussion on umbilical cord features the teacher told the students that Wharton’s jelly acts as
a protective barrier. What does Wharton’s jelly refers to?
a) A whitish cheesy hard substance
b) A gelatinous fluid or jelly like substance
c) Fine hair follicles
d) None of the above
22. In an antenatal clinic doctor asked the nursing student to calculate the EDD of the antenatal mother with
Naegele’s formula. How will the student calculate the EDD using this formula?
a) 9 days and 9 months to the last menstrual period
b) 7 days and 9 months to the last menstrual period
c) 9 days and 9 months from the ovulation day
d) 7 days and 9 months from the ovulation day
23. A nurse can best describe the collection of fluid in between the layers of scalp with which term given below?
a) Hematoma
b) Cephalhematoma
c) Caput succedaneum
d) Hydrocephalus
24. While performing a newborn assessment the student identifies that the anterior fontanel is depressed. What
may be the students’ interpretation on this finding?
a) Hydrocephalus
b) Increased intracranial pressure
c) Caput succedaneum
d) Dehydration
25. A student nurse while performing placental examination found a knot in the umbilical cord and which is
unable to open. How can the student state this finding?
a) True knot present
b) False knot present
c) It’s a long cord
d) Its due to the short length of the cord
26. The nurse explains to the student nurse regarding the transformation of abnormal structure in the fetal
circulation. Which among the following is a correct transformation?
a) Ductus arteriosus to ligamentum arteriosum
b) Umbilical vein to ligamentum venosum
c) Ductus venosus to ligamentum teres
d) Distal part of umbilical arteries to superior vesicle arteries
27. After delivery of placenta a nurse examines the placenta and find out, the following layers form the placental
barrier?
a) Syncyto tropoblast, cytotrophoblast, connective tissue
b) Ectoderm, mesoderm and endoderm
c) Superficial compact layer, intermediate spongy layer, thin basal layer
d) Amniotic membrane, chorionic plate, basal plate
28. A nurse is assessing an antenatal mother in the clinic and has checked the FHR with the help of a fetoscope
for the first time during the current pregnancy period. What may be the mothers expected gestation age?
a) 16 weeks
b) 20 weeks
c) 24 weeks
d) 28 weeks
29. While teaching the students regarding the the fetal circulation the teacher asked the student regarding the
pressure in the umbilical artery. What is the correct answer expected from the student?
a) 20 mm Hg
b) 40 mm Hg
c) 60 mm Hg
d) 80 mm Hg
30. In a prenatal class discussion on foetal development and amniotic fluid. The client asks the nurse to explain
the purpose of amniotic fluid. Which response by the nurse is most appropriate regarding the purpose of
amniotic fluid?
a) It generates foetal antibodies from the mother
b) It helps to protect the foetus from external injury
c) It provides oxygen for the developing foetus
d) It helps support the enlarging maternal uterus
31. The physician determines that the client is in the 15th week of pregnancy. The client asks if it is too early to
hear the baby’s heartbeat. How early in a pregnancy can the nurse expect to hear the foetal heart beat using a
Doppler device?
a) 4- 6 weeks
b) 10-12 weeks
c) 16-18 weeks
d) 20-24 weeks
32. Clinical instructor while explaining the placental examination pointed out on the different fetal membrane and
its differentiation criteria. How can the students identify the chorion based on the class teaching?
a) A inner thin shiny layer of membrane
b) Discoid and spongy in structure
c) It is a trilaminar embryonic disc
d) Outer thick membrane and shaggy in nature
33. After delivery stretch marks on the abdomen contracts and become glistening white in appearance and what is
its particular name?
a) Pink lines
b) Striae gravidarum
c) Light stretch marks
 d) Striae albicans
34. A patient Roshini, who is multipara came for antenatal checkup at 28th weeks of gestation. How will you
assess that she is a multipara and not the primigravida from the following options?
a) Roshini is having loose and lax abdominal wall
b) Sign of old scarring from previous perineal lacerations
c) Both a and b
d) Rigid uterine wall
35. Maternal serum alphafeto protein (MSAFP) investigation of a patient who is having a history of congenital
deformed still birth has been sent to lab. MSAFP is sent to detect which of the following option?
a) haemoglobin level
b) neural tube defect
c) blood sugar level
d) Both a & c.
36. A patient Sunita, 22nd weeks pregnant, is worry about the Haemorrhoids problem that she is facing during
pregnancy. What would be the best advice you will give, if haemorrhoids are not bothering her too much?
a) Immediately go for haemorrhoidectomy
b) Sit and relax.
c) The problem mostly disappears after pregnancy
d) There is nothing to worry
37. The nurse is preparing a client at 16 weeks’ gestation for an amniocentesis. Which of the following nursing
actions has priority?
a) Ensure the client has a full bladder.
b) Ensure that lab results are on the chart.
c) Ensure that the client empties her bladder.
d) Ensure that the client has remained NPO.
38. A client at 28 weeks’ gestation was seen for a routine clinic appointment. She complained about frequent
heartburn. She asked the clinic nurse why this occurs. Which of the following replies by the nurse is most
accurate?
a) “Heartburn means your baby has a lot of hair.”
b) “Heartburn means you are carrying a boy.”
c) “Heartburn is caused by pregnancy hormones.”
d) “Heartburn is caused by carrying your baby high.”
39. During pregnancy in first trimester many skin changes are seen among them one sign is Chadwick’s sign,
another name for this sign is?
a) palmer's sign
b) jacquemier's sign
c) Osiander's sign
d) Goodell's sign
40. When antenatal assessment is done on a mother, over the forehead and cheeks skin discolouration is seen,
what is the name of this type of skin change during pregnancy?
a) Chloasma
b) Linea nigra
c) Striae gravidarum
d) Cushing syndrome
41. In antenatal abdominal examination if you find fundus at the level of umbilicus then what is the gestation
period in weeks?
a) 16 weeks
b) 20 weeks
c) 24 weeks
d) 28 weeks
42. Geeta came for antenatal check-up in OPD, Her LMP was 22 February 2018. Calculate the EDD of Geeta?
a) 25th August. 2018
b) 26th Sept. 2018
c) 26th Oct 2018
d) 29th Nov. 2018
43. When abdominal examination is done on a antenatal woman, What is the presentation of fetus in utero if
buttocks of fetus are felt in fundal grip?
a) Podalic
b) Cephalic
c) Breech
d) Oblique
44. A pregnant woman came in antenatal clinic she has queries regarding TT administration. What is the correct
answer by the nurse about TT administration in pregnancy?
a) Give first dose then gap of 4 weeks then 2nd dose
b) Give first dose then gap of 1 weeks then 2nd dose
c) Give first dose then gap of 2 weeks then 2nd dose
d) Give first dose then gap of 3 weeks then 2nd dose
45. Which of the following option is incorrect regarding perineal hygiene and prevention of vaginal infection in
pregnancy?
a) local cleanliness
b) wearing loose panties
c) use of fragrant perineal washes
d) using anti-microbial agents
46. A nurse is demonstrating kegel exercises to a mother and she teaches that these muscles are strengthened by
this exercise:
a) abdominal muscles
b) leg and arm muscles
c) pelvic floor muscles
d) both a & b
47. A non – pregnant uterus is having 5 – 10 ml of capacity. How much times the capacity of uterus increased
when it is at term?
a) 50-100 times
b) 100-500 times
c) 500-1000 times
d) 1000-1500 times
48. A 30 years old working woman who got divorced 2 years back, living with her 3 years old son and raising her
son own without any support so she considered which type of parent?
a) Single parent
b) Unwed mother
c) Divorced
d) Both b & c
49. Tripple screening is to be done on a antenatal woman which measures blood protein, screens for spina bifida,
Down syndrome and other severe abnormalities, which of the following test is needed for this screening:
a) Maternal blood sampling
b) Amniocentesis
c) Urine examination
d) fetal blood sampling
50. A clinical examination is done on a woman to detect a number of clinical conditions such as anatomical
abnormalities and sexually transmitted infections, to evaluate the size of a woman’s pelvis (pelvimetry) and to
assess the uterine cervix so as to be able to detect signs of cervical incompetency, this examination is referred
as:
a) Breast examination
b) Per Vaginal examination
c) Blood screening
d) Systemic examination
51. When taking an obstetrical history on a pregnant client who states, I had a son born at 38 weeks gestation, a
daughter born at 37weeks gestation and I lost a baby at about 8 weeks, the nurse should record her obstetrical
history as which of the following?
a) G3P2A0L2
b) G2P2A1L2
 c) G4P2A1L2
d) G2P1A0L2
52. Which of the following is used by the nurse when preparing to listen to the fetal heart rate at 12 weeks
gestation?
a) Stethoscope placed midline at the umbilicus
b) Doppler placed midline at the suprapubic region
c) Fetoscope placed midway between the umbilicus and the xiphoid process
d) An external electronic fetal monitor placed at the umbilicus
53. When developing a plan of care for a client newly diagnosed with gestational diabetes, which of the following
instructions would be the priority?
a) Dietary intake
b) Medication
c) Exercise
d) Glucose monitoring
54. A client at 8 weeks gestation calls complaining of slight nausea in the morning hours. Which of the following
client interventions should the nurse question?
a) Taking 1 teaspoon of bicarbonate of soda in an 8-ounce glass of water
b) Eating a few low-sodium crackers before getting out of bed
c) Avoiding the intake of liquids in the morning hours
d) Eating six small meals a day instead of thee large meals
55. The nurse documents positive ballottement in the client’s prenatal record. The nurse understands that this
indicates which of the following?
a) Palpable contractions on the abdomen
b) Passive movement of the unengaged fetus
c) Fetal kicking felt by the client
d) Enlargement and softening of the uterus
56. When performing a pelvic examination, the nurse observes a red swollen area on the right side of the vaginal
orifice. The nurse would document this as enlargement of which of the following?
a) Clitoris
b) Parotid glands
c) Skene’s gland
d) Bartholin’s gland
57. After 4 hours of active labor, the nurse notes that the contractions of a primigravida client are not strong
enough to dilate the cervix. Which of the following would the nurse anticipate doing?
a) Obtaining an order to begin IV oxytocin infusion
b) Administering a light sedative to allow the patient to rest for several hour
c) Preparing for a cesarean section for failure to progress
d) Increasing the encouragement to the patient when pushing begins
58. The nurse hears a mother telling a friend on the telephone about umbilical cord care. Which of the following
statements by the mother indicates effective teaching?
a) Respiratory problems
b) Gastrointestinal problems
c) Integumentary problems
d) Elimination problems
59. When longitudinal axis of the fetus is in relation to the long axis of maternal uterus assessed by abdominal
examination prior to delivery, that condition is known as:
a) Presentation
b) Attitude
c) Lie
d) Position
60. During abdominal examination part of fetus which comes in relation to right or left side of maternal pelvis and
is engaged during labour is known as:
a) Presentation
b) Attitude
c) Lie
 d) Position
61. Normal labour is the process by which contractions of the gravid uterus expel the fetus and the other products
of conception:
a) between 37 and 42 weeks from the last menstrual period
b) After 42 weeks gestation
c) between 28 and 37 weeks from the last menstrual period
d) Before 28 weeks gestation
62. The labouring client is experiencing contractions every 2–3 minutes lasting 90 seconds. The client’s fetal
heart rate is ranging from 130–140 beats per minute (BPM) with variability of 6–10 beats per minute. Which
action by the nurse is most appropriate?
a) Discontinue the IV fluid containing Pitocin (oxytocin)
b) Document the finding in the client’s medical record
c) Contact the doctor at once and reposition the client
d) Insert an internal fetal scalp electrode monitor
63. During stage 3 of labor, a gush of blood is noted and the uterus changes shape from an oval shape to globular
shape. This indicates?
a) Postpartum haemorrhage
b) Imminent delivery of baby
c) Signs of placental separation
d) Both b &c
64. The client is found to be at +4 station. Which action is most appropriate for the nurse to take?
a) Prepare for delivery
b) Chart the finding
c) Administer pain medication
d) Increase the oxytocin
65. A patient who is in labour has transitioned to stage 2 of labor. What changes in the perineum indicate the birth
of the baby is imminent?
a) Increase in meconium-stained fluid and retracting perineum
b) Retracting perineum and anus with an increase of bloody show
c) Rapid and intense contractions
d) Bulging perineum and rectum with an increase in bloody show
66. The nurse observes the client’s amniotic fluid and decides that it appears normal. What are the normal features
of amniotic fluid that made the nurse to reach the conclusion?
a) Clear and dark amber in colour
b) Milky, greenish yellow, containing shreds of mucus
c) Clear, almost colourless, and containing little white specks
d) Cloudy, greenish yellow and containing little white specks
67. Why should the client nurse teach pregnant women the importance of conserving the "spurt of energy" before
labour?
a) energy helps to increase the progesterone level
b) fatigue may increase the need of pain medication
c) energy is needed to push during the first stage of labour
d) fatigue will increase the intensity of contractions
68. A primigravida with 40 weeks of gestation arrives at the labour room with abdominal cramping and a bloody
show. Her membranes ruptured 30 minutes before arrival. Vaginal examination reveals 1 cm dilatation and -1
station. After obtaining the FHR and maternal vital signs, what should the nurse do next?
a) teach the client how to push with each contraction
b) encourage the client to perform pattern paced breathing
c) provide the client with comfort measures
d) prepare for client blood grouping and Rh typing
69. Why the nurse should with hold the food and oral fluids as a labouring client approaches the second stage of
labour?
a) the mechanical and chemical digestive process require energy that is needed for the labour process
b) undigested food and fluid may cause nausea and vomiting
c) the gastric phase of digestion stimulates the release HCL and may cause dyspepsia
 d) food and fluid will further aggravate gastric peristalsis
70. A nurse is caring for a primigravida during labour. What does the nurse observe that indicates birth is about to
happen?
a) bloody discharge from the vagina increases
b) client become more irritable
c) perineum begins to bulge with each contractions
d) contraction becomes more stronger and last longer
71. The cervix of a client in labour is fully dilated and effaced. The head of the fetus is at +2 station. What should
the nurse encourage the client to do during contractions?
a) relax by closing her eyes
b) push with her glottis open
c) blow to slow the birth process
d) pant to prevent the cervical edema
72. A client was being taken care by her partner/ attendant during the labour. The client's cervix is now dilated 7
cm, and the presenting part in the mid pelvis. What should the nurse instruct the partner to do that will
alleviate the client's discomfort during contraction?
a) deep breathing slowly
b) perform pelvic rocking
c) use the panting technique
d) begin pattern paced breathing
73. When monitoring the FHR of a client in labour, the nurse identifies an elevation of 15 beats more than the
baseline lasting for 15 seconds. How should the nurse document this finding?
a) an acceleration
b) an early elevation
c) a sonographic motion
d) a tachycardic heart rate
74. A client is admitted in the delivery area in active phase of labour. What should the nurse expect after an
amniotomy is performed?
a) Diminished blood flow
b) increased and more variable FHR
c) less discomfort with contractions
d) progressive dilation and effacement
75. A pregnant women at 39 weeks gestation arrives in the triaging area of the labour ward, stating that, “her bag
of water has been broken." What should be the nurse's next?
a) auscultate the fetal heart rate to determine the feat well being
b) perform abdominal palpation to rule out the presentation
c) check the vaginal introitus for the presence of umbilical cord
d) do a nitrazine test on the vaginal fluid for verification
76. A client's membrane spontaneously rupture during active labour. The nurse inspects the perineum and
determine that the umbilical cord is not visible. What is the next nursing action?
a) auscultate the FHR
b) monitor the contractions
c) call the health care provider
d) obtain the maternal vital signs
77. A client's membrane rupture while her labour is being augmented with oxytocin infusion. A nurse observes
variable deceleration in the fetal heart rate on the fetal monitoring strip. What action should the nurse take
immediately?
a) change the client's position
b) take the client's blood pressure
c) stop the oxytocin infusion
d) prepare the client for an immediate delivery
78. A primigravida is admitted to the delivery room in early labour. A pelvic examination reveals that her cervix
is 100% effaced and the 3 cm dilated. The fetal head is at+1 station. In what area of the maternal pelvis is the
fetal occiput?
a) not yet engaged
 b) below the ischial spine
c) entering the pelvic inlet
d) visible at the vaginal introitus
79. What is the most common problem that confronts the client in labour when an external fetal monitor has been
applied on to her abdomen?
a) intrusion on movement
b) inability to take sedative
c) interference with breathing technique
d) increased frequency of vaginal examination
80. A patient is on labour and the baby's head becomes visible at the opening of the vagina and becomes fixed
there. What is the movement which is seen during this period?
a) Engagement
b) Crowning
c) Dystocia
d) Rotation
81. A labour room nurse is performing an assessment on a client in labour and notes that the fetal heart rate is 158
beats per min and regular. The client’s contraction is every 5 minutes with a duration of 40 seconds and of
moderate intensity. On the basis of these assessment findings what would be the appropriate nursing action?
a) Contact the obstetrician
b) Report the FHR to the anaesthesiologist
c) Continue to monitor the client
d) Prepare for the imminent delivery of the fetus
82. A nurse is caring for a client in the second stage of labour. The client is experiencing uterine contractions
every 2 minutes and cries out in pain with each contraction. How should the nurse recognise this behaviour?
a) Exhaustion
b) Involuntary grunting
c) Valsalva maneuver
d) Fear of losing control
83. The nurse is monitoring a client in labour and suspects umbilical cord compression if which is noted in the
external monitor tracing during contraction?
a) Variability
b) Acceleration
c) Early deceleration
d) Variable deceleration
84. The nurse is caring for a client in labour. Which assessment finding indicates that the client has entered the
second stage of labour?
a) The contractions are regular
b) The membranes have ruptured
c) The cervix is dilated completely
d) The client begins to expels the clear vaginal fluid
85. A client in labour is transported to the delivery room and prepared for the caesarean delivery. After the client
is transferred to the delivery room table, the nurse would place the client in which position?
a) Supine position with the wedge under the right hip
b) Trendelenburg’s position with the leg’s stir ups
c) Prone position with the legs in separated and elevated
d) Semi fowler’s position with pillow under the knee
86. The nurse monitoring a mother in labour and notes that she has been pushing hardly for last 1 hour. What is
the client’s primary physiological need at this time? The nurse monitoring a mother in labour and notes that
she has been pushing hardly for last 1 hour. What is the client’s primary physiological need at this time?
a) Ambulation
b) Rest between the contractions
c) Change positions frequently
d) Consume oral fluids and foods
87. A nurse has been encouraging the intake of oral fluids for a client in labour to improve the hydration. Which
of the following indicates a successful outcome of this action?
 a) Ketones in the urine
b) A urine specific gravity of 1.020
c) A blood pressure of 150/90mm Hg
d) The continued leaking of amniotic fluid during labour
88. To correctly assess the duration of a contraction, the nurse counts the time between which intervals?
a) The beginning of one contraction to the end of the same contraction
b) The end of one contraction and the beginning of the next contraction
c) The beginning of one contraction and the end of next contraction
d) The beginning of one contraction and the beginning of the next contraction
89. After the vaginal examination the physician indicates that the client is in the latent phase of labour. A progress
note is written in the client’s admission record. Which assessment finding is most reliable indicator that the
client is in true labour?
a) Contractions are regular and increasing in duration and intensity
b) Contraction radiate from the lower back to the lower abdomen
c) Bloody show is present
d) The cervix is dilating
90. During the evaluation of the client’s contractions during the active phase of the first stage of labour, when is it
important for the nurse to notify the physician?
a) When the contractions occur every 3-5 minutes
b) When the contractions last longer than 45 seconds
c) When the uterus relaxes between the contractions
d) When the fetal heart rate drops after the acme of a contraction
91. Labour has progressed and the client enters the transition phase of the first stage of labour. Which assessment
finding can the nurse expect to observe during this phase?
a) Cervix dilated up to 10cm
b) Crowning of the presenting part
c) Contractions lasting up to 60 seconds
d) Increased bloody show
92. A gravida 2 para 1 has just delivered a full term infant. Which finding indicates the separation of the placenta?
a) Wave like relaxation of the abdomen
b) Increased length of cord
c) Decreased vaginal bleeding
d) Inability to palpate the uterus
93. Fundal height is to be taken of a postnatal mother on her second day of labour. The fundus of the uterus is
expected to go down normally postpartally about __ cm per day.
a) 1 cm
b) 2 cm
c) 3 cm
d) 4 cm
94. Which among the following is the correct in explaining the process by which the cervical muscle fibres are
pulled upward and mixes with the fibres of the lower uterine segment?
a) Retraction
b) Effacement
c) Quickening
d) Lightening
95. A client is gravida 4 para 3 and is in labour room. After the vaginal examination it is determined that the
presenting part is at station +3. The appropriate nursing intervention is to:
a) continue to observe the client's contraction
b) check the fetal heart rate for the prolapsed cord
c) prepare to move the client quickly to the delivery room
d) check with the physician to see if an oxytocin drip is warranted
96. An antenatal mother admitted to the labour room in the first stage of labour with intact membranes. The
mother is asked to ambulate. How this be best explained from the following statements?
a) It increases the descent of the fetal head
b) This reduces the chance of APH
 c) This reduces the chances of eclampsia
d) It decreases the chances of abortion
97. A client entered to the third stage of labour presented with sudden gush of blood and cord insertion site at the
introitus with shiny surface. Which type of placental separation is happened in this client?
a) Mathew Duncan method
b) Schultz method
c) Marginal separation
d) Premature separation
98. A primigravida is on continuous cadiotocography monitoring. At a point of time the nurse starts noting that
the graph was showing late deceleration. What may be the nurse's interpretation from this finding?
a) normal finding
b) fetal head compression
c) umbilical cord compression
d) fetal hypoxia
99. A woman came to antenatal ward with amenorrhea 9 months and lower abdominal pain since two hours.
Which among the following is not a feature of true labour pains?
a) Painful contractions at regular intervals
b) Braxton’s kicks contractions
c) Gradual increase in intensity and duration
d) Progressive effacement
100. A prenatal mother is said to be in transition phase of labour. What does the term transition phase
refers to?
a) Period of 8cm-10cm dilatation
b) Period of up to 4 cm dilatation
c) Period of 4-7 cm dilatation
d) Period where the mother presents with frequency of micturition or constipation
101. A primigravida in active labour is about 9 days post-term. The client desires a bilateral pudendal
block anaesthesia before delivery. After the nurse explains this type of anaesthesia to the client, which of the
following locations identified by the client as the area of relief would indicate to the nurse that the teaching
was effective?
a) Back
b) Abdomen
c) Fundus
d) Perineum
102. At term prenatal mother is admitted to the delivery room in active stage of labour. What would be the
nurse’s priority action while receiving the client?
a) Check for fetal heart rate
b) Take a brief obstetric history
c) Confirm the timing of last meal
d) Check for the membrane status
103. A nurse while assessing a client in the fourth stage of labour noted that the bleeding was heavy and
reported immediately the physician. When does it is said to be having normal bleeding status?
a) blood loss of 100 ml
b) blood loss of 300 ml
c) blood loss of 500 ml
d) blood loss of 700 ml
104. A multigravida mother is on labour from 2.30 am and while plotting the findings of monitoring at
8.15am in the partograph the nurse noted that the mother had achieved full dilatation. What would be the
nurse's immediate action?
a) inform the physician
b) continue monitoring & conduct the delivery
c) administer 5 unit oxytocin
d) stop the oxytocin infusion
105. On the third postpartum day, a client complains that she is urinating more than when she was
pregnant. Which is the primary cause of urinary output post-delivery?
 a) Puerperal diuresis
b) Renal malfunctioning
c) Increased postpartum fluid intake
d) Breastfeeding
106. Implementing anti – D immunoglobulin prophylaxis in Rh-D negative women during pregnancy,
which of the following statement is considered?
a) It is given in all the pregnant women
b) It is given only in primigravida
c) It is given during last trimester in Rh negative mother
d) It is given during last trimester in Rh positive mother
107. On assessment of the postpartum client the nurse notes that the uterus feels soft and boggy. Which
initial action can be taken by the nurse?
a) Elevate the client’s leg
b) Document the findings
c) Massage the fundus until it is firm
d) Push on the uterus to assist in expressing clots
108. While mother is feeding her child first time, the discharge from the breasts following birth of the
baby for the first three days is known as:
a) Breast milk
b) Colostrum
c) Both a and b
d) None of these
109. Mrs Moni, 35 years old postnatal mother admitted in obstetrics ward, complains that she is having
severe pain on episiotomy site, on observation hematoma found at suture site, what will be the initial action by
nurse?
a) Clean the wound and advise her to use ice packs at suture site
b) Application of infrared heat at suture site
c) Hot fomentation at suture site
d) Antibiotics
110. Mrs Sheela admitted in postnatal ward. She has 2nd postnatal day and she complains of infrequent,
spasmodic pain in her lower abdomen, what is the indication?
a) Flatulent
b) Constipation
c) Hypertonic contractions due to retained bits of placenta
d) Paralytic ileus
111. A primiparous mother who is admitted to postnatal ward, is conscious about time period of involution
of her genital organs and is frequently asking questions. What will be the best answer by the nurse?
a) 4 weeks
b) 6 weeks
c) 8 weeks
d) 10 weeks
112. The process of growth and development of the mammary gland in preparation for milk production.
This process begins when the mammary gland is exposed to estrogen at puberty and is completed during the
third trimester of pregnancy:
a) Lactation
b) Lactogenesis
c) Galactokinesis
d) Mammogenesis
113. The nurse is providing instructions about measures to prevent postpartum mastitis to a client who is
breastfeeding her newborn, which client statement indicates need for further instructions?
a) I should feed after 2-3 hours
b) I should change the breast pads frequently
c) I should exclusively breastfeed the baby
d) I should wash my nipples daily with soap and water
114. A client in a postpartum unit complaints of sudden sharp pain and dyspnea. The nurse notes that client
is tachycardiac and the respiratory rate is elevated. Which should be the initial nursing action?
a) Initiate IV line
b) Assess the client BP
c) Prepare to administer morphine sulphate
d) Administer oxygen 8-10 ml by face mask
115. A postpartum nurse is preparing to care for a woman who has just delivered a healthy newborn infant.
In the immediate postpartum period the nurse plans to take the woman’s vital signs:
a) Every 30 minutes during the first hour and then every hour for the next two hours.
b) Every 15 minutes during the first hour and then every 30 minutes for the next two hours.
c) Every hour for the first 2 hours and then every 4 hours
d) Every 5 minutes for the first 30 minutes and then every hour for the next 4 hours.
116. A postpartum nurse is taking the vital signs of a woman who delivered a healthy newborn infant 4
hours ago. The nurse notes that the mother’s temperature is 100.2*. Which of the following action would be
most appropriate?
a) Retake the temperature in 15 minutes
b) Notify the physician
c) Document the findings
d) Increase hydration by encouraging oral fluids
117. A nurse is preparing to perform a fundal assessment on a postpartum client. Which of the following is
the initial nursing action in performing this assessment?
a) Ask the client to turn on her side
b) Ask the client to lie flat on her back with the knees and legs flat and straight.
c) Ask the mother to urinate and empty her bladder
d) Massage the fundus gently before determining the level of the fundus.
118. The nurse is assessing the lochia on a 1 day postpartum patient. The nurse notes that the lochia is red
and has a foul-smelling odour. The nurse determines that this assessment finding is:
a) Normal
b) Indicates the presence of infection
c) Indicates the need for increasing oral fluids
d) Indicates the need for increasing ambulation
119. When performing a postpartum assessment on a client. The nurse notes the presence of clots in the
lochia. The nurse examines the clots and notes that they are larger than 1 cm. Which of the following nursing
actions is most appropriate?
a) Show
b) Notify the physician
c) Reassess the client in 2 hours
d) Encourage increased intake of fluids.
120. A nurse in a postpartum unit is instructing a mother regarding lochia and the amount of expected
lochia drainage. The nurse instructs the mother that the normal amount of lochia may vary but should never
exceed the need for:
a) One peripad per day
b) Two peripads per day
c) Three peripads per day
d) Eight peripads per day
121. A nurse is caring for a postpartum woman who has received epidural anaesthesia and is monitoring
the woman for the presence of a vulval hematoma. Which of the following assessment findings would best
indicate the presence of a hematoma?
a) Complaints of a tearing sensation
b) Complaints of intense pain
c) Changes in vital signs
d) Signs of heavy bruising
122. A Postpartum nurse is providing instructions to a woman after delivery of a healthy newborn infant.
The nurse instructs the mother that she should expect normal bowel elimination to return by:
a) First day of postpartum
 b) 3 days Postpartum
c) 7 days Postpartum
d) Within 2 weeks Postpartum
123. A nurse in a delivery room is assisting with the delivery of a newborn infant. After the delivery which
of the following method is used by the nurse to prevent heat loss in the newborn resulting from evaporation?
a) Warming the crib pad
b) Turning on the overhead radiant warmer
c) Closing the doors to the room
d) Drying the infant in a warm blanket
124. A nurse in a newborn nursery is performing an assessment of a newborn infant. What would the nurse
do to appropriately measure the head circumference of the infant?
a) Wrap the tape measure around the infant’s head and measure just above the eyebrows.
b) Place the tape measure under the infants head at the base of the skull and wrap around to the front just
above the eyes
c) Place the tape measure under the infants head. Wrap around the occiput. and measure just above the eyes
d) Place the tape measure at the back of the infant’s head. Wrap around across the ears and measure across
the infant’s mouth.
125. A nurse prepares to administer a vitamin K injection to a newborn infant. The mother asks the nurse
why her newborn infant needs the injection. The best response by the nurse would be:
a) Your infant needs vitamin K to develop immunity.
b) The vitamin K will protect your infant from being jaundiced.
c) Newborn infants are deficient in vitamin K. and this injection prevents your infant from abnormal
bleeding.
d) Newborn infants have sterile bowels and vitamin K promotes the growth of bacteria in the bowel.
126. A nurse is educating a postnatal mother regarding proper newborn care. The newborn should always
be kept close to the mother for effective:
a) Attachment
b) Parenting
c) Caring
d) Bonding
127. A NICU nurse is taking care of a newborn what action should a nurse take if the respiratory rate of an
infant is 35 breaths/minute?
a) administer oxygen
b) document findings
c) notify physician
d) reassess after 15 minutes
128. At 10 hours of age an infant has a large amount of mucus and become cyanotic. What should the
nurse do first?
a) administer oxygen
b) suction
c) insert nasogastric tube
d) record the incident
129. When the object touches the baby's cheek, baby turns his head towards the side touched, opens his
mouth and begins to suck -this is an:
a) rooting reflex
b) gag reflex
c) sucking reflex
d) grasp reflex
130. A preterm neonate admitted to the neonatal intensive care unit has muscle twitching, seizures,
cyanosis, abnormal respirations and a short, shrill cry. What complication is to be suspected?
a) brachial palsy
b) dislocate hip
c) intracranial haemorrhage
d) fractured hip
131. When performing a physical assessment of a newborn with down syndrome, the nurse suspects that
the infant may have:
a) bulging fontanels
b) stiff lower extremities
c) abnormal heart sound
d) unusual papillary reaction
132. A new-born’s respiratory rate is irregular ,heart rate less than 100,extremities are blue ,flaccid muscles
and reflexes are absent ,his total Apgar score is:
a) 0
b) 3
c) 6
d) 9
133. A 10 days old baby is admitted with 5% dehydration. The nurse is most likely to note which of the
following sign?
a) Tachycardia
b) Bradycardia
c) Hypothermia
d) Hyperthermia
134. A weeks old child who has diarrhoea for 14 days but has no sign of dehydration, is classified as:
a) persistent diarrhoea
b) dysentery
c) severe dysentery
d) severe persistent diarrhoea
135. A newborn with cleft palate was admitted in paediatric surgery ward, what appropriate feeding
method for the nurse to use with this infant?
a) suction infant before feeding
b) feeding in sitting position
c) hold feed of an infant during hospitalization
d) bubble the infant after feed to reduce risk for aspiration
136. A newborn with 32 gestational age and 1500 g weight is to be shifted to Nursery who has
physiological immaturity and needs feeding and mechanical ventilation which level of care to be provided to
that infant?
a) Level I
b) Level II
c) Level III
d) Level IV
137. A nurse in a newborn nursery receives a phone call to prepare for the admission of a 43-week-
gestation newborn with Apgar scores of 1 and 4. In planning for the admission of this infant. the nurse’s
highest priority should be to:
a) Connect the resuscitation bag to the oxygen outlet
b) Turn on the apnea and cardiorespiratory monitors
c) Set up the intravenous line with 5% dextrose in water
d) Set the radiant warmer control temperature at 36.5* C (97.6*F)
138. A nurse is assessing a newborn infant who was born to a mother who is addicted to drugs. Which of
the following assessment findings would the nurse expect to note during the assessment of this newborn?
a) Sleepiness
b) Cuddles when being held
c) Lethargy
d) Incessant crying
139. How would the nurse prepare to administer this therapy? A nurse on the newborn nursery floor is
caring for a neonate. On assessment, the infant is exhibiting signs of cyanosis, tachypnea, nasal flaring, and
grunting. Respiratory distress syndrome is diagnosed and the physician prescribes surfactant replacement
therapy.
a) Subcutaneous injection
b) Intravenous injection
 c) Instillation of the preparation into the lungs through an endotracheal tube
d) Intramuscular injection
140. A postpartum nurse is providing instructions to the mother of a newborn infant with
hyperbilirubinemia who is being breastfed. The nurse provides which most appropriate instructions to the
mother?
a) Switch to bottle feeding the baby for 2 weeks
b) Stop the breast feedings and switch to bottle-feeding permanently
c) Feed the new-born infant less frequently
d) Continue to breast-feed every 2-4 hours
141. The nurse is assessing a client who is 6 hours postpartum after delivering a full-term healthy infant.
The client complains to the nurse of feelings of faintness and dizziness. Which of the following nursing
actions would be most appropriate?
a) Obtain haemoglobin and haematocrit levels
b) Instruct the mother to request help when getting out of bed
c) Elevate the mother's legs
d) Inform the nursery room nurse to avoid bringing the newborn infant to the mother until the feelings of
light-headedness and dizziness have subsided.
142. Four hours after a difficult labour and birth, a primiparous woman refuses to feed her baby, stating
that she is too tired and just wants to sleep. The nurse should:
a) Tell the woman she can rest after she feeds her baby
b) Recognize this as a behaviour of the taking-hold stage
c) Record the behaviour as ineffective maternal-newborn attachment
d) Take the baby back to the nursery, reassuring the woman that her rest is a priority at this time
143. As part of the postpartum assessment, the nurse examines the breasts of a primiparous breastfeeding
woman who is one day postpartum. An expected finding would be:
a) A soft, non-tender colostrum is present
b) Leakage of milk at let down
c) Swollen, warm, and tender upon palpation
d) A few blisters and a bruise on each areola
144. Following the birth of her baby, a woman expresses concern about the weight she
gained during pregnancy and how quickly she can lose it now that the baby is born. The nurse,
in describing the expected pattern of weight loss, should begin by telling this woman that:
a) Return to pre pregnant weight is usually achieved by the end of the postpartum period
b) Fluid loss from diuresis, diaphoresis, and bleeding accounts for about a 3 pound weight loss
c) The expected weight loss immediately after birth averages about 11-13 pounds.
d) Lactation will inhibit weight loss since caloric intake must increase to support milk
production
145. After expulsion of the placenta in a client who has six living children, an infusion of
lactated ringer’s solution with 10 units of oxytocin is ordered. The nurse understands that this is
indicated for this client because:
a) She had a precipitate birth
b) This was an extramural birth
c) Retained placental fragments must be expelled
d) Multigravidas are at high risk of uterine atony
146. Perineal care is an important infection control measure. When evaluating a postpartum
woman’s perineal care technique, the nurse would recognize the need for further instruction if
the woman:
a) Uses warm water and soap to wash the vulva and perineum
b) Washes from symphysis pubis back to episiotomy
c) Changes her perineal every 2-3 hours
d) Uses peribottle to rinse upward into her vagina
147. Oxytocin is prescribed for a woman to treat postpartum haemorrhage. Before
administration of this medication, the priority nursing assessment is to check the:
a) Amount of lochia
b) Blood pressure
 c) Deep tendon reflexes
d) Uterine tone
148. Which of the following interventions would be helpful to a breastfeeding mother who is
experiencing engorged breasts?
a) Apply ice
b) Apply breast binder
c) Teach how to express her breast with hot compression or hot shower
d) Administer medicine
149. Which of the following findings would be a source of concern if noted during the
assessment of a woman who is 12 hours postpartum?
a) Postural hypotension
b) Temperature of 101*F
c) Bradycardia
d) Pain in calf muscles on dorsiflexion
150. The primary health care provider prescribes betamethasone for a 34-year-old
multigravida client at 32 weeks' gestation who is experiencing preterm labour. Previously, the
client has experienced one infant death due to preterm birth at 28 weeks' gestation. The nurse
explains that this drug is given for which of the following reasons?
a) To enhance fetal lung maturity.
b) To counter the effects of tocolytic therapy.
c) To treat chorioamnionitis.
d) To decrease neonatal production of surfactant.
151. A client at 4 weeks postpartum tells the nurse that she can't cope any longer and is
overwhelmed by her new-born. The baby has old formula on her clothes and under her neck.
The mother does not remember when she last bathed the baby and states she does not want to
care for the infant. The nurse should encourage the client and her husband to call their health
care provider because the mother should be evaluated further for:
a) Postpartum blues.
b) Postpartum depression.
c) Poor bonding.
d) Infant abuse.
152. A primiparous client who was diagnosed with hydramnios. While in early labour is
diagnosed with early postpartum haemorrhage at 1 hour after a caesarean birth. The client asks,
“Why am I bleeding so much?” The nurse responds based on the understanding that the most
likely cause of uterine atony in this client is which of the following?
a) Trauma during labour and birth.
b) Moderate fundal massage after birth.
c) Lengthy and prolonged second stage of labour
d) Over distention of the uterus from hydramnios
153. A postpartum client is diagnosed with cystitis. The nurse plans for which priority
nursing intervention in the care of the client?
a) Providing sitz bath
b) Encouraging fluid intake
c) Placing ice on the perineum
d) Monitoring haemoglobin and haematocrit levels
154. A nurse is monitoring a client in the immediate postpartum period for signs of
haemorrhage. Which of the following signs, if noted, would be an early sign of excessive blood
loss?
a) A temperature of 100.4 F
b) A blood pressure change from 130/88 to 124/ 80 mm Hg
c) An increase in the pulse rate more than 100 beats/min
d) An increase in the respiratory rate from 18 to 22 breaths/min
155. A nurse is monitoring a client in labour. The nurse suspects umbilical cord compression
if which of the following is noted on the external monitor tracing during a contraction?
a) Variability
 b) Accelerations
c) Early decelerations
d) Variable decelerations
156. When assessing a client 1 hour after vaginal delivery, the nurse notes blood gushing
from the vagina, pallor and a rapid, thready pulse. What do these findings suggest?
a) Uterine involution
b) Cervical laceration
c) Placental separation
d) Postpartum haemorrhage
157. While the nurse is caring for a primiparous client with cephalopelvic disproportion 4
hours after a caesarean birth, the client requests assistance in breast-feeding. To promote
maximum maternal comfort, which of the following would be most appropriate for the nurse to
suggest?
a) Football hold
b) Scissors hold.
c) Cross-cradle hold.
d) Cradle hold.
158. A primigravida client at 8 weeks' gestation tells the nurse that since 2 days she has
vaginal bleeding, discharge of clusters of vesicles on her vagina with variable degree of
abdominal pain. The nurse refers the client to a health care provider because the nurse suspects
which of the following?
a) Hydatidiform mole
b) Gonorrhoea
c) Syphilis
d) Herpes
159. Three hours postpartum, a primiparous client’s fundus is firm and midline. On perineal
inspection, the nurse observes a small, constant trickle of blood. Which condition should the nurse
assess further?
a) uterine inversion
b) perineal lacerations
c) retained placental tissue
d) bladder distention
160. A primiparous client who gave birth vaginally 8 hours ago desires to take a shower. The
nurse anticipates remaining nearby the client to assess for which problem?
a. hygiene needs
b. fatigue
b) fainting
c) diuresis
161. During a home visit with a primipara who gave birth 7 days ago, the client tells the nurse
that her lochia serosa has been profuse and foul-smelling and she has had chills. During palpation
of the uterus, the client indicates that she is very sore. The nurse should further assess the client
for:
a) Normal uterine involution.
b) Retained placental fragments.
c) Puerperal infection.
d) Uterine atony.
162. When assessing a postpartum client, the nurse notes a continuous flow of bright red blood
from the vagina. The uterus is firm and no clots can be expressed. Which action should the nurse
take?
a) Massage the uterus every 15 minutes.
b) Assure the client that such bleeding is normal.
c) Apply an ice pack to the perineum.
d) Notify the physician.
163. A multigravid client gave birth vaginally 2 hours ago. A family member notifies the nurse
that the client is pale and shaky. Which are the priority assessments for the nurse to make?
 a) blood glucose level and vital signs
b) uterine infection and pain
c) fundus and lochia
d) temperature and level of consciousness
164. A nurse is providing care for a postpartum client. Which condition increases this client's
risk for a postpartum haemorrhage?
a) Placenta previa
b) Hypertension
c) Severe pain
d) Uterine infection
165. A postpartum nurse is assessing a client who delivered a healthy infant by caesarean
section for signs and symptoms of superficial venous thrombosis. Which of the following signs or
symptoms would the nurse note if superficial venous thrombosis were present?
a) Paleness of the calf area
b) Coolness of the calf area
c) Enlarged, hardened veins
d) Palpable dorsalis pedis pulses
166. A nurse is developing a plan of care for a postpartum client with a small vulvar
hematoma. The nurse includes which specific intervention in the plan during the first 12 hours
after delivery?
a) Assess vital signs every 4 hours.
b) Measure fundal height every 4 hours.
c) Prepare an ice pack for application to the area.
d) Inform the health care provider of assessment findings.
167. A nurse is reviewing a client’s history. What two predisposing causes of puerperal
(postpartum) infection should alert the nurse to monitor this client?
a) Malnutrition and anaemia
b) Haemorrhage and trauma during labour
c) Preeclampsia and retention of placental fragments
d) Organisms in the birth canal and trauma during
168. A postpartum client is being treated for DVT. The nurse understands that the client's
response to treatment will be evaluated by regularly assessing the client for:
a) Dysuria, ecchymosis and vertigo
b) Epistaxis, haematuria and dysuria
c) Haematuria, ecchymosis and epistaxis
d) Haematuria, ecchymosis and vertigo
169. After a dilatation and curettage (D&C) to evacuate a molar pregnancy, assessing the client
for signs and symptoms of which of the following would be most important?
a) Urinary tract infection.
b) Chorioamnionitis.
c) Abdominal distention.
d) Haemorrhage.
170. When preparing a multigravid client who has undergone evacuation of a hydatidiform
mole for discharge, the nurse explains the need for follow-up care. The nurse determines that the
client understands the instruction when she says that she is at risk for developing which of the
following?
a) Ectopic pregnancy
b) Choriocarcinoma.
c) Multifetal pregnancies
d) Infertility.
171. A client presents to the obstetrics triage unit with no prenatal care and painless bright red
vaginal bleeding. Which interventions are most indicated?
a) Applying external fetal monitor and complete physical assessment.
b) Applying external fetal monitor and perform sterile vaginal exam.
c) Obtaining a fundal height physical assessment on the patient.
 d) Obtaining fundal height and a sterile vaginal exam.
172. When assessing a 34-year-old multigravid client at 34 weeks' gestation experiencing
moderate vaginal bleeding, which of the following would most likely alert the nurse that placenta
previa is present?
a) Painless vaginal bleeding
b) Uterine tetany.
c) Intermittent pain with spotting.
d) Dull lower back pain.
173. The primary health care provider prescribes whole blood replacement for a multigravid
client with abruptio placentae. Before administering the intravenous blood product, the nurse
should first:
a) Validate client information and the blood product with another nurse.
b) Check the vital signs before transfusing over 5 to 6 hours.
c) Ask the client if she has ever had any allergies.
d) Administer 100 mL of 5% dextrose solution intravenously.
174. An ultrasound is performed on a client at term gestation who is experiencing moderate
vaginal bleeding. The results of the ultrasound indicate that abruptio placentae is present. Based
on these findings, the nurse would prepare the client for:
a) Delivery of the fetus
b) Strict monitoring of intake and output
c) Complete bed rest for the remainder of the pregnancy
d) The need for weekly monitoring of coagulation studies until the time of delivery
175. what is the most likely cause of abortion in a 27 year old woman with the past history of
two abortions in 10 wks and one in 15 wks with normal karyotype conceptus?
a) Endocrine
b) Immunological
c) Anatomic
d) Infectious
176. what is the most likely cause of abortion in a 27 year old woman with the past history of
two abortions in 10 weeks and one in 15 weeks with normal karyotype conceptus?
a) Bowel perforation
b) Electrolyte imbalance
c) Miscarriage
d) Pregnancy induced hypertension (PIH)
177. In the 12th week of gestation a client completely expels the products of conception.
Because the client is Rh negative the nurse must:
a) Administer RhoGAM within 72 hours
b) Make certain she receives RhoGAM on her first clinic visit
c) Not give RhoGAM since it is not used with the birth of a stillborn
d) Make certain the client does not receive RhoGAM since the gestation only lasted 12 weeks.
178. A 24 years old G2 P1 A0 had last menstrual period 9 weeks ago. She presents with
bleeding and passage of tissues per vaginum. Bleeding is associated with lower abdominal pain.
The most likely diagnosis is :
a) Threatened abortion
b) Inevitable abortion
c) Incomplete abortion
d) Twin pregnancy
179. A 24 years primigravida comes for a routine antenatal visit. She is currently 16 weeks
pregnant. Which of the following gestational age-specific prenatal laboratory test should be
performed?
a) Hepatitis B surface antigen
b) Syphilis serology
c) Maternal serum alfa fetoprotein
d) Urine culture
180. A 28 years old primigavida at 37 weeks gestation is admitted with BP more than 160/110
mmHg, proteinuria 5 gm on 24 hours urine collection, headache, visual disturbances, epigastric
pain, which of the condition is indicated by above symptoms?
a) Mild preeclampsia
b) Moderate preeclampsia
c) Severe preeclampsia
d) Eclampsia
181. Seema at 24 weeks period of gestation comes to ANC with complaining of edema in the
legs, on examination her BP found to be 145/95 mmHg and urine suggestive of proteinuria,
what will be the probable diagnosis?
a) Pregnancy- induced hypertension
b) Eclampsia
c) Pre-eclampsia
d) Malignant hypertension
182. Kavita w/o Mahesh is admitted in ANC ward. She is on magnesium sulphate therapy
for the repeated dose administration. The nurse need to check which of the following :
a) Knee jerk reflex are present
b) Urine output >30 mL/hr.
c) Respiration is more than 12 bpm
d) All of the above
183. The nurse is reviewing the lab tests of four prenatal clients. Which lab finding would
support the diagnosis of hyperemesis gravidarum?
a) Hypercalcemia
b) Hyperkalemia
c) Hypokalemia
d) Hypocalcemia
184. A client at 30 weeks gestation is admitted to the maternity unit with vaginal bleeding.
What should be the nurse's initial nursing action?
a) Assess blood pressure and pulse.
b) Count and weigh peripads.
c) Observe for pallor, clammy skin, and perspiration.
d) Start an intravenous infusion drip.
185. Client is diagnosed with gestational hypertension and is receiving magnesium sulphate.
Which finding would the nurse interpret as indicating a therapeutic level of medication?
a) Urinary output of 20 mL per hour
b) Respiratory rate of 10 breaths/minute
c) Deep tendons reflexes 2+
d) Difficulty in arousing
186. Which of the following would the nurse have readily available for a client who is
receiving magnesium sulfate to treat severe preeclampsia?
a) Calcium gluconate
b) Potassium chloride
c) Ferrous sulfate
d) Calcium carbonate
187. A nursing student was collecting history of a patient with preterm premature rupture of
membranes. Which of the following the student would NOT expect to find as factor placing a
woman at high risk for this condition?
a) High body mass index
b) Urinary tract infection
c) Low socioeconomic status
d) Smoking
188. A 14-year-old pregnant adolescent arrives at the hospital in early labor. The nurse
should recognize that the adolescent is at a greater risk for which problem?
a) Calcium deficit
b) Cephalopelvic disproportion
 c) Bleeding tendency
d) Low hemoglobin levels
189. A patient with hyperemesis gravidarum asks the nurse what would have happened if she
had not come to the hospital. What result is the best response by the nurse?
a) large for gestational age infant
b) Anorexia nervosa
c) Preterm delivery
d) Maternal or fetal death
190. A patient is admitted to the hospital with signs of an ectopic pregnancy. What should
the plan of care include for the patient?
a) Long-term bed rest
b) Episodes of extreme hypertension
c) Surgery to remove the embryo/fetus Commented [H1]:
d) Treatment for dehydration
191. A patient is admitted to the hospital with hyperemesis gravidarum. The patient is
malnourished and severely dehydrated. The care plan should be altered to include which
interventions?
a) Hyper alimentation
b) IV fluids and electrolyte replacement
c) Hormone replacement therapy
d) Vitamin supplements
192. The nurse is developing a plan of care for a woman who is pregnant with twins. The
nurse includes interventions focusing on which of the following because of the woman's
increased risk?
a) Oligohydramnios
b) Preeclampsia
c) Post-term labor
d) Chorioamnionitis
193. A client with eclampsia begins to experience a seizure. Which of the following would
the nurse in charge do first?
a) Pad the side rails
b) Place a pillow under the left buttock
c) Insert a padded tongue blade into the mouth
d) Maintain a patent airway
194. When evaluating a client’s knowledge of symptoms to report during her pregnancy,
which statement would indicate to the nurse in charge that the client understands the
information given to her?
a) “I’ll report increased frequency of urination.”
b) “If I have blurred or double vision, I should call the clinic immediately.”
c) “If I feel tired after resting, I should report it immediately.”
d) “Nausea should be reported immediately.”
195. Binita is an insulin-dependent diabetic multigravida who visits the clinic at 28 weeks’
gestation. The nurse should instruct Binita that for most pregnant patients like her:
a) Weekly fetal movement counts are made by the mother
b) Contraction stress testing is performed weekly
c) Induction of labor is begun at 34 weeks’ gestation
d) Nonstress testing is performed weekly until 32 weeks’ gestation
196. At 32 weeks' gestation, a 15-year-old primigravid client who is 5 feet, 2 inches (151.7
cm) has gained a total of 20 lb (9.1 kg), with a 1-lb (0.45-kg) gain in the last 2 weeks. Urinalysis
reveals negative glucose and a trace of protein. The nurse should advise the client that which of
the following factors increases her risk for preeclampsia?
a) Proteinuria
b) Total weight gain
c) Short stature
d) Adolescent age group

a) proteinuria
b) Total weight gain
c) Short stature
d) Adolescent age group
197. On arrival at the emergency department, a client tells the nurse that she suspects that she may be
pregnant but has been having a small amount of bleeding and has severe pain in the lower abdomen. The
client's blood pressure is 70/50 mm Hg and her pulse rate is 120 bpm. The nurse notifies the primary health
care provider immediately because of the possibility of:
a) Ectopic pregnancy.
b) Abruptio placentae
c) Gestational trophoblastic disease.
d) Complete abortion.
198. A multigravid client diagnosed with a probable ruptured ectopic pregnancy is scheduled for
emergency surgery. In addition to monitoring the client's blood pressure before surgery, which of the
following would the nurse assess?
a) Uterine cramping.
b) Abdominal distention.
c) Haemoglobin and haematocrit.
d) Pulse rate.
199. The nurse has completed discharge instructions for a primigravida woman who is 29 weeks gestation
and hospitalized for treatment of deep vein thrombosis. Which of the following statements, if made by the
patient to the nurse, indicates that teaching has been successful?
a) "I should check my leg once a week."´
b) "I will message my leg nightly"
c) "I can take Pepto-Bismol for diarrhoea."
d) "I will take prescribed heparin every day."´
200. Most adolescents eating habits are very imbalanced, what are some complications can poor nutrition
cause during pregnancy?
a) Weight loss
b) Premature births
c) Urinary tract infections
d) Obesity