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1. During active labor, there is a gush of clear fluid and the fetal heart rate drops to 100
bpm. A vaginal examination reveals a loop of umbilical cord in the vagina. The nurse
places the client in which position?
A) Trendelenburg abirb.com/test
B) Lithotomy
C) Hands and knees
D) Left-side lying abirb.com/test

2. The charge nurse in Labor and Delivery hears the cord prolapse protocol activated, then
promptly directs the staff to do which of the following activities first?
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A) Open the operating room for a cesarean birth

B) Obtain 2 units of blood from the blood bank
C) Administer pitocin to augment the client's contractions
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D) Arrange to transfer the client to ICU

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3. A client is diagnosed with a missed abortion. Which explanation by the nurse is the best
description of this diagnosis?
A) There is no bleeding or cramping, but the pregnancy has stopped developing and is
no longer viable. abirb.com/test
B) There is bleeding and cramping and the cervix is dilated. The pregnancy will soon
be lost.
C) There is vaginal bleeding but the cervix is closed. Pregnancy is developing but
long-term viability is uncertain. abirb.com/test

D) There is no sign of a pregnancy or gestational sac in the uterus. The uterus is

inflamed and client is febrile.
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4. A client comes to the clinic complaining of being tired, nauseated, having to urinate
"once an hour" and that her breasts are extremely tender. An ultrasound examination
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confirms she is 6 weeks pregnant. Four weeks later the client returns for a follow-up
appointment, reporting that she "feels great" and that all the symptoms she had last
month have disappeared. She denies having any vaginal bleeding or cramping. The
provider wants to perform an ultrasound examination, believing that the client has
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experienced which condition?
A) Missed abortion
B) Threatened abortion
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C) Septic abortion
D) Incomplete abortion

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5. A client at 8 weeks' gestation comes to the clinic with vaginal bleeding and cramps. An
ultrasound examination shows the cervix is dilated. What is the client experiencing?
A) Inevitable abortion
B) Threatened abortion abirb.com/test
C) Missed abortion
D) Complete abortion
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6. A client experiencing vaginal bleeding and cramping is diagnosed with a threatened

abortion. The nurse anticipates the provider will prescribe which medication for this
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A) Misoprostol with methotrexate

B) Penicillin and ketorolac
C) Methylergonovine maleate and oxytocin abirb.com/test
D) Progesterone and folate

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7. A client asks the nurse what causes a spontaneous abortion in the first trimester of the
pregnancy. What is the best response by the nurse?
A) "Many happen because something is genetically wrong with the pregnancy and the
fetus cannot continue to survive.” abirb.com/test
B) "Many times it is because the pregnancy was exposed to a teratogenic substance
before the time of conception."
C) "Sometimes the lifestyle of the pregnant woman causes the pregnancy to implant in
the abdominal cavity." abirb.com/test

D) "Sometimes the structure of the reproductive organs or the hormone levels cause
the embryo to implant in the fallopian tube."
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8. A client in early pregnancy presents to the clinic with vaginal bleeding and cramping.
She says she passed clots when she got out of bed. During the examination, the provider
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finds the cervix is dilated but products of conception remain in the uterus. How would
the nurse document these findings?
A) Incomplete abortion
B) Missed abortion abirb.com/test
C) Septic abortion
D) Threatened abortion
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9. The nurse assesses the late preterm infant for which problems during the 12 hours
immediately following birth? Select all that apply.
A) Hypoglycemia
B) Hypothermia abirb.com/test
C) Respiratory distress
D) Hyperbilirubinemia
E) Congenital hearing loss abirb.com/test

10. The nurses assesses a neonate born at 36 weeks' gestation. The neonate is grunting, has
nasal flaring, and subcostal retractions. Respiratory rate is 82 breaths/min, and on
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auscultations there are crackles in the lungs. What is the nurse's assessment of the
neonate's condition?
A) Transient tachypnea abirb.com/test
B) Surfactant deficiency
C) Persistent pulmonary hypertension
D) Apnea
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11. A primigravida client learns she is Rh negative and the father of her baby is Rh positive.
What is the potential risk to the woman during this pregnancy?
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A) Formation of antibodies to Rh-positive blood
B) Hemolysis of the maternal red blood cells
C) Decreased oxygen carrying capacity of the red blood cells
D) Immune reaction against the fetus abirb.com/test

12. A primigravida client learns she is Rh negative and the father of her baby is Rh positive.
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At 10 weeks' gestation, the client experiences an incomplete abortion and has dilation
and curettage (D & C). What medication will the nurse administer following the
procedure?
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A) Rho (D) immune globulin
B) Gamma globulin
C) Oxytocin
D) Misoprostol abirb.com/test

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13. A woman who is Rh negative gives birth to an Rh positive infant. When the nurse is
preparing to administer Rho(D) immune globulin, the client states, "My religious beliefs
prohibit the use of blood products." How does the nurse respond in this situation? Select
all that apply. abirb.com/test
A) Educate the client about the risk to future pregnancies.
B) Respect the client's beliefs.
C) Ask the client to sign a refusal of treatment form. abirb.com/test
D) Tell the client Rho(D) immune globulin is not a blood product.
E) Enlist a family member to get the client to accept the medication.

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14. An infant born at 35 weeks' gestation is being screened for hypoglycemia. During the
first 24 hours of life, when will the nurse screen this infant?
A) Before feedings abirb.com/test
B) Only if the infant is jittery
C) Every 8 hours
D) After feedings
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15. The nurse is assessing a 3-day-old infant. The infant's sclerae have a yellow tinge as
does the infant's forehead and nose. What would the nurse do next?
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A) Obtain a transcutaneous bilirubin level.
B) Draw blood for a metabolic panel.
C) Prepare the infant for an exchange transfusion.
D) Initiate phototherapy. abirb.com/test

16. One hour after birth the nurse is assessing a neonate in the nursery. The nurse begins by
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assessing which parameters?
A) Inspecting posture, color, and respiratory effort
B) Checking for identifying birthmarks or skin injuries
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C) Auscultating bowel sounds, and measuring urine output
D) Determining chest and head circumference

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17. When performing an assessment on a neonate, which assessment finding is suggestive
of hypothermia?
A) Bradycardia
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B) Hyperglycemia
C) Metabolic alkalosis
D) Shivering
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18. Rho(D) immune globulin is administered to which clients? Select all that apply.
A) A client who is Rh-positive and gave birth to a 7-pound baby
B) A newborn with type O-negative blood and a negative Coombs test
C) An Rh-negative woman who had a spontaneous abortion yesterday
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D) An Rh-negative woman following an ectopic pregnancy
E) A Rh negative woman who gives birth at 32 weeks gestation to a baby with A+
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19. The nurse is conducting a car seat challenge test for an infant born at 35 weeks'
gestation. For which finding would the nurse delay the infant's discharge?
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A) An episode of desaturation to 90% lasting for 15 seconds

B) An episode of apnea lasting 15 seconds
C) An episode of tachycardia to 180 beats per minute for 15 seconds
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D) An episode of hypoglycemia with symptoms and a blood glucose of 35 mg/dL (2
mmol/L)

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20. The nurse is teaching a preconception class. A participant asks how long after ovulation
can the egg be fertilized. What is the best response by the nurse?
A) An egg can only be fertilized for about 24 hours after release from the ovary.
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B) An egg can only be fertilized for about 48 hours after release from the ovary.
C) An egg can only be fertilized for about 3 days after release from the ovary.
D) An egg can only be fertilized for about 12 hours after release from the ovary.
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Answer Key
1. A
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2. A
3. A
4. A
5. A abirb.com/test
6. A
7. A
8. A
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9. A, B, C
10. A
11. A
12. A abirb.com/test
13. A, B, C
14. A
15. A
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16. A
17. A
18. C, D, E
19. A abirb.com/test
20. A

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