Question 1

Which time is the most difficult to control diabetes during the maternity cycle?

Accepted Answer

Answer reason: Insulin resistance increases progressively due to placental hormones and peaks in late pregnancy, making glycemic control hardest in the last trimester.

Question 2

At 24 weeks of gestation, the fundal height is approximately at which anatomical level?

Accepted Answer

Answer reason: Fundal height landmarks: ~20 weeks at the umbilicus and remains near/slightly above it around 24 weeks; among options, the best match is at the level of the umbilicus.

Question 3

After a non-stress test, the nurse observes a non-reactive result. What is the most appropriate follow-up action?

Accepted Answer

Answer reason: A nonreactive NST may indicate fetal compromise or requires additional evaluation (e.g., BPP/CST). The nurse should promptly notify/discuss with the provider for further actions, not delay, reassure, or only document.

Question 4

When does a pregnant woman with diabetes mellitus need to increase her insulin dose?

Accepted Answer

Answer reason: Insulin resistance rises in late pregnancy due to placental hormones (e.g., hPL, progesterone, cortisol), so insulin requirements increase in the third trimester; they decrease postpartum.

Question 5

When measuring the fundal height in a client in the second trimester of pregnancy, what should the nurse note regarding gestational age?

Accepted Answer

Answer reason: Between approximately 18–32 weeks, fundal height in centimeters closely equals gestational age in weeks (±2), so it correlates with gestational age.

Question 6

Which actions should the nurse take when caring for a pregnant client experiencing late decelerations?

Accepted Answer

Answer reason: Late decelerations indicate uteroplacental insufficiency. The priority initial intervention is to improve uterine perfusion by turning the client to the left lateral position. Magnesium sulfate is not indicated; oxygen and stopping oxytocin are appropriate subsequent measures. Amnioinfusion treats variable decelerations.

Question 7

What is the primary goal of nursing care in a client with threatened abortion?

Accepted Answer

Answer reason: In threatened abortion the pregnancy may still be viable; nursing priority is to preserve the pregnancy and prevent miscarriage. Surgical evacuation or induction are not indicated, and monitoring uterine size is secondary.

Question 8

A pregnant client reports feeling wetness and the nurse finds clear fluid and the presence of the umbilical cord at the perineum; what is the immediate nursing action?

Accepted Answer

Answer reason: Visible cord at the perineum indicates a prolapsed umbilical cord. The priority is to relieve cord compression immediately by positioning the client in Trendelenburg (or knee-chest). Monitoring, notifying the provider, or transferring can follow.

Question 9

Which of the following screening tests is correctly matched with the gestational age?

Accepted Answer

Answer reason: Routine GBS screening is performed at 35–37 weeks’ gestation. Other listed timings are incorrect (e.g., glucose screening 24–28 weeks, anatomy scan 18–22 weeks, chlamydia at initial visit, rubella serology at initial visit).

Question 10

Which of the following screening tests is correctly matched with the gestational age?

Accepted Answer

Answer reason: GBS screening is performed at 35–37 weeks to guide intrapartum prophylaxis. Other timings are incorrect: glucose screening typically 24–28 weeks (unless high risk early), fetal anatomy scan 18–22 weeks, chlamydia screening at first visit and again in third trimester if at risk, and rubella serology at first prenatal visit with postpartum vaccination if nonimmune.

Question 11

A 24-year-old G2P1 at 36 weeks' gestation in active labor with unknown GBS culture status presents; what is the most appropriate management?

Accepted Answer

Answer reason: CDC guidelines recommend empirical intrapartum antibiotic prophylaxis (penicillin or ampicillin) if GBS culture results are unavailable at labor onset to prevent neonatal sepsis. Delay for cultures or previous records risks fetal infection.

Question 12

A client at 30 weeks gestation is admitted with preterm labor; which intervention should the nurse prioritize?

Accepted Answer

Answer reason: At 30 weeks with preterm labor, priority is antenatal corticosteroids (e.g., betamethasone) to accelerate fetal lung maturity and reduce neonatal morbidity. Ambulation may worsen labor, frequent vaginal exams increase infection risk, and immediate delivery is not indicated unless there is maternal/fetal compromise.

Question 13

Which statement by the prenatal client with heartburn indicates a need for further instruction?

Accepted Answer

Answer reason: Lying down after meals promotes gastroesophageal reflux and worsens pregnancy-related heartburn. Education is to remain upright after eating, eat small frequent meals, avoid fatty/spicy foods, and maintain adequate fluids.

Question 14

Which of the following is a feature of false labour pain?

Accepted Answer

Answer reason: False labour (Braxton Hicks) is characterized by irregular contractions without progressive cervical change, no show, and no increasing frequency or intensity. Options B–D describe true labour; thus A best fits features of false labour.

Question 15

In left occiput anterior fetal position, where is the fetal heart sound located?

Accepted Answer

Answer reason: In LOA position the fetal back lies in the mother’s left anterior quadrant; fetal heart tones are heard best over the fetal back, toward the maternal left flank and below the umbilicus.

Question 16

What is the nurse’s priority action for a 38-week pregnant woman presenting with severe abdominal pain, rigid uterus, and fetal heart tones?

Accepted Answer

Answer reason: Severe abdominal pain with a rigid, boardlike uterus in late pregnancy suggests placental abruption, an obstetric emergency. The priority is to notify the provider immediately to initiate urgent evaluation and possible delivery; ambulation, ice, or simple reassurance are inappropriate.

Question 17

The nurse knows that a non-stress test is most commonly used for which of the following reasons?

Accepted Answer

Answer reason: A non-stress test (NST) assesses fetal well-being by monitoring fetal heart rate accelerations in response to fetal movement, i.e., evaluating fetal heart rate patterns. It does not assess lung maturity, detect anomalies, or primarily measure contractions.

Question 18

Which of the following findings indicates incomplete abortion?

Accepted Answer

Answer reason: Incomplete abortion presents with ongoing vaginal bleeding and cramping with a dilated cervix and retention of some products of conception.

Question 19

What fetal heart rate pattern is most likely to be observed in a client in labor experiencing a prolapsed umbilical cord?

Accepted Answer

Answer reason: A prolapsed umbilical cord causes intermittent cord compression, producing abrupt decreases in FHR—variable decelerations. Early decels are from head compression; late decels indicate uteroplacental insufficiency.

Question 20

What is the typical birth size for a baby born to a pregnant female client with diabetes mellitus?

Accepted Answer

Answer reason: Infants of diabetic mothers are typically LGA due to maternal hyperglycemia causing fetal hyperinsulinemia, which promotes increased growth and fat deposition.

Question 21

Which finding in a postpartum patient who has just delivered her placenta is most concerning and requires immediate intervention?

Accepted Answer

Answer reason: Retained placental fragments prevent adequate uterine contraction and can cause postpartum hemorrhage, requiring immediate intervention. The other findings are expected/normal after placental delivery.

Question 22

Where is the best location to hear the fetal heartbeat (PMI) when a breech presentation with the fetal back on the right side of the mother is found using Leopold's maneuver?

Accepted Answer

Answer reason: FHR PMI is best heard over the fetal back. In breech presentation the PMI is above the umbilicus; with the back on the mother’s right side, it is in the right upper quadrant.

Question 23

What does a boggy uterus indicate during postpartum assessment?

Accepted Answer

Answer reason: A boggy (soft) uterus postpartum signifies inadequate uterine tone—uterine atony—often due to retained placental fragments. A normally contracting uterus is firm; infection presents with fever/tenderness, and bladder fullness displaces the uterus rather than making it boggy.

Question 24

Which fundal height indicates less than 12 weeks gestation when the date of the LMP is unknown?

Accepted Answer

Answer reason: Before 12 weeks the uterus remains a pelvic organ; it becomes palpable above the symphysis after 12 weeks, at the umbilicus around 20 weeks, and near the xiphoid at term.

Question 25

A client expresses worry about how to care for her firstborn child; which priority problem should the nurse identify?

Accepted Answer

Answer reason: Expressing worry about caring for a newborn indicates a knowledge deficit about infant care. There is no evidence of grieving, impaired coping, or lowered self-esteem.

Question 26

Which of the following is NOT a characteristic of an ideal candidate for copper-T insertion?

Accepted Answer

Answer reason: A prior ectopic pregnancy is a risk factor and generally makes a person a less suitable candidate for an IUD; the other choices reflect favorable characteristics for copper-T use.

Question 27

Which term should the nurse expect to see in the pregnant client's chart notation to most accurately describe the condition of vaginal bleeding, increasing cramping, and an open cervical os?

Accepted Answer

Answer reason: Vaginal bleeding with increasing cramping and an open cervical os indicates inevitable (imminent) abortion.

Question 28

What is a common complication associated with breech presentation during delivery?

Accepted Answer

Answer reason: In breech, especially footling, the presenting part does not fill the pelvis, so after membrane rupture the cord can slip past it, leading to cord prolapse.

Question 29

You are in a client's home to attend to a delivery. Which of the following will you do first?

Accepted Answer

Answer reason: Use the nursing process: first assess. Determining contraction pattern establishes the stage and urgency of labor before preparing supplies or performing hygiene.

Question 30

A pregnant patient arrives at the community health center with moderate bloody discharge; what should the nurse do first?

Accepted Answer

Answer reason: Moderate vaginal bleeding in pregnancy may indicate placenta previa or abruptio placenta. Digital/speculum exams can worsen bleeding and should be avoided until location of placenta is known. The priority is to urgently notify the provider for emergency evaluation and management.

Question 31

During which trimester is a mother most likely to contract viral infections related to congenital syndromes?

Accepted Answer

Answer reason: Organogenesis occurs in the first trimester; maternal viral infections (e.g., rubella, CMV) during this period have the highest risk of teratogenic effects and congenital syndromes.

Question 32

At what gestational age is vacuum aspiration typically performed during pregnancy termination?

Accepted Answer

Answer reason: Vacuum (suction) aspiration is the standard method for first-trimester abortion and is typically performed up to about 12 weeks of gestation; beyond this, D&E is preferred.

Question 33

When can fetal movement typically be felt by the mother?

Accepted Answer

Answer reason: Quickening is typically perceived by nulliparous women around 18–20 weeks and by multiparous women around 16–18 weeks, so the expected range is 16–20 weeks.

Question 34

When is magnesium seizure prophylaxis typically given to try to prevent eclamptic convulsions?

Accepted Answer

Answer reason: Magnesium sulfate is administered during labor and continued for about 24 hours postpartum to prevent eclamptic seizures; not antepartum alone or weeks after delivery.

Question 35

What is the best time to have intercourse to achieve pregnancy according to fertility health teaching?

Accepted Answer

Answer reason: Ovulation typically occurs about 14 days before the next menses; intercourse around ovulation maximizes chances of conception.

Question 36

In which phase of the first stage of labor does cervical dilation most rapidly occur when a client has progressed from 4 to 7 cm?

Accepted Answer

Answer reason: During the first stage of labor, dilation from 4 to 7 cm occurs in the active phase, which is characterized by the most rapid cervical dilation.

Question 37

Which sign should the nurse suspect indicates endometritis in a postpartum client?

Accepted Answer

Answer reason: Postpartum endometritis commonly presents with fever >38°C after the first 24 hours postpartum. Leukocytosis, lochia rubra on day 2, and breast engorgement can be normal postpartum findings.

Question 38

What is the brownish black pigmented line in the midline area of the abdomen of a pregnant woman extending from the xiphisternum to the symphysis pubis called?

Accepted Answer

Answer reason: Linea nigra is the hyperpigmented midline that appears on the abdomen during pregnancy from the xiphoid to the pubis; striae are stretch marks, chloasma affects the face, and linea alba is the non-pigmented midline.

Question 39

When is magnesium given as seizure prophylaxis to try to prevent an eclamptic convulsion?

Accepted Answer

Answer reason: Magnesium sulfate is used for seizure prophylaxis in preeclampsia during labor and continued for about 24 hours postpartum to prevent eclamptic seizures; it is not routinely given weeks postpartum.

Question 40

In most labors, the fetal head most commonly enters the pelvis in which position?

Accepted Answer

Answer reason: At engagement, the fetal head typically enters the pelvic inlet with the sagittal suture in the transverse diameter, i.e., in an occipito-transverse position, and later rotates to occipito-anterior for delivery.

Question 41

During which trimester can fetal parts be palpated for the first time?

Accepted Answer

Answer reason: By about 20 weeks the uterus reaches the level of the umbilicus and fetal parts become distinguishable on abdominal palpation; earlier in pregnancy the uterus is still largely pelvic, and later trimesters are not the first time.

Question 42

What is the name of the process by which the cervix becomes thin and indistinct from the body of the uterus?

Accepted Answer

Answer reason: Effacement is the thinning and shortening of the cervix, making it blend with the uterine segment; dilation is opening of the cervix, attitude is fetal posture, and transition is a phase of labor.

Question 43

In hypothyroid patients well controlled on thyroid hormone replacement, how often should thyroid function tests be performed during pregnancy?

Accepted Answer

Answer reason: During pregnancy, TSH and thyroid function are typically monitored about every 4–6 weeks (first half of pregnancy, with periodic checks later), which corresponds to every 1–2 months.

Question 44

Using Nagele’s rule, what is the estimated date of birth for a patient whose last menstrual period began on October 10, 2009?

Accepted Answer

Answer reason: Naegele’s rule: add 7 days and subtract 3 months from the LMP, then adjust year if needed. Oct 10, 2009 + 7 days = Oct 17, 2009; minus 3 months = July 17, 2009; +1 year = July 17, 2010.

Question 45

What is the primary goal of diagnosing and treating gestational diabetes?

Accepted Answer

Answer reason: Gestational diabetes develops after organogenesis, so treatment primarily aims to control maternal hyperglycemia to prevent fetal overgrowth and related complications such as macrosomia and shoulder dystocia. Preventing congenital malformations or miscarriage is not the primary goal.

Question 46

A client with a history of phenylketonuria (PKU) is seen in the local family planning clinic. While completing the intake history, the nurse provides information for a healthy pregnancy. Which statement indicates that the client needs further teaching?

Accepted Answer

Answer reason: Aspartame, a common artificial sweetener, contains phenylalanine and must be avoided by clients with PKU, especially before and during pregnancy. The other statements reflect correct understanding: resume a low-phenylalanine diet, choose fruits/vegetables as snacks, and recognize fetal neurodevelopmental risk if the diet is not followed.

Question 47

What is the period after childbirth called?

Accepted Answer

Answer reason: Postnatal refers to the period after birth. Antenatal/prenatal are before birth, and gestation is the pregnancy period.

Question 48

A pregnant client comes to the clinic for a first visit. The nurse gathers data about her obstetric history, which includes: she has 3 year-old twins at home and had a miscarriage at 12 weeks gestation ten years ago. The nurse would accurately document?

Accepted Answer

Answer reason: Gravida counts all pregnancies: current pregnancy + prior twin pregnancy + prior miscarriage = 3. Parity counts pregnancies reaching viability, not number of infants: only the twin birth reached viability = 1.

Question 49

The most cost effective method of preventing maternal mortality is?

Accepted Answer

Answer reason: Family planning reduces unintended and high-risk pregnancies, thereby preventing exposure to pregnancy-related risks; it is more cost-effective than interventions that manage complications after conception.

Question 50

Which of the following is not indication of induction of labour?

Accepted Answer

Answer reason: Induction is indicated for chorioamnionitis, postterm pregnancy, and preeclampsia. Major placenta previa is a contraindication to labor/induction and requires cesarean delivery.

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Which time is the most difficult to control diabetes during the maternity cycle?

At 24 weeks of gestation, the fundal height is approximately at which anatomical level?

After a non-stress test, the nurse observes a non-reactive result. What is the most appropriate follow-up action?

When does a pregnant woman with diabetes mellitus need to increase her insulin dose?

When measuring the fundal height in a client in the second trimester of pregnancy, what should the nurse note regarding gestational age?

Which actions should the nurse take when caring for a pregnant client experiencing late decelerations?

What is the primary goal of nursing care in a client with threatened abortion?

A pregnant client reports feeling wetness and the nurse finds clear fluid and the presence of the umbilical cord at the perineum; what is the immediate nursing action?

Which of the following screening tests is correctly matched with the gestational age?

Which of the following screening tests is correctly matched with the gestational age?

A 24-year-old G2P1 at 36 weeks' gestation in active labor with unknown GBS culture status presents; what is the most appropriate management?

A client at 30 weeks gestation is admitted with preterm labor; which intervention should the nurse prioritize?

Which statement by the prenatal client with heartburn indicates a need for further instruction?

Which of the following is a feature of false labour pain?

In left occiput anterior fetal position, where is the fetal heart sound located?

What is the nurse’s priority action for a 38-week pregnant woman presenting with severe abdominal pain, rigid uterus, and fetal heart tones?

The nurse knows that a non-stress test is most commonly used for which of the following reasons?

Which of the following findings indicates incomplete abortion?

What fetal heart rate pattern is most likely to be observed in a client in labor experiencing a prolapsed umbilical cord?

What is the typical birth size for a baby born to a pregnant female client with diabetes mellitus?

Which finding in a postpartum patient who has just delivered her placenta is most concerning and requires immediate intervention?

Where is the best location to hear the fetal heartbeat (PMI) when a breech presentation with the fetal back on the right side of the mother is found using Leopold's maneuver?

What does a boggy uterus indicate during postpartum assessment?

Which fundal height indicates less than 12 weeks gestation when the date of the LMP is unknown?

A client expresses worry about how to care for her firstborn child; which priority problem should the nurse identify?

Which of the following is NOT a characteristic of an ideal candidate for copper-T insertion?

Which term should the nurse expect to see in the pregnant client's chart notation to most accurately describe the condition of vaginal bleeding, increasing cramping, and an open cervical os?

What is a common complication associated with breech presentation during delivery?

You are in a client's home to attend to a delivery. Which of the following will you do first?

A pregnant patient arrives at the community health center with moderate bloody discharge; what should the nurse do first?

During which trimester is a mother most likely to contract viral infections related to congenital syndromes?

At what gestational age is vacuum aspiration typically performed during pregnancy termination?

When can fetal movement typically be felt by the mother?

When is magnesium seizure prophylaxis typically given to try to prevent eclamptic convulsions?

What is the best time to have intercourse to achieve pregnancy according to fertility health teaching?

In which phase of the first stage of labor does cervical dilation most rapidly occur when a client has progressed from 4 to 7 cm?

Which sign should the nurse suspect indicates endometritis in a postpartum client?

What is the brownish black pigmented line in the midline area of the abdomen of a pregnant woman extending from the xiphisternum to the symphysis pubis called?

When is magnesium given as seizure prophylaxis to try to prevent an eclamptic convulsion?

In most labors, the fetal head most commonly enters the pelvis in which position?

During which trimester can fetal parts be palpated for the first time?

What is the name of the process by which the cervix becomes thin and indistinct from the body of the uterus?

In hypothyroid patients well controlled on thyroid hormone replacement, how often should thyroid function tests be performed during pregnancy?

Using Nagele’s rule, what is the estimated date of birth for a patient whose last menstrual period began on October 10, 2009?

What is the primary goal of diagnosing and treating gestational diabetes?

A client with a history of phenylketonuria (PKU) is seen in the local family planning clinic. While completing the intake history, the nurse provides information for a healthy pregnancy. Which statement indicates that the client needs further teaching?

What is the period after childbirth called?

A pregnant client comes to the clinic for a first visit. The nurse gathers data about her obstetric history, which includes: she has 3 year-old twins at home and had a miscarriage at 12 weeks gestation ten years ago. The nurse would accurately document?

The most cost effective method of preventing maternal mortality is?

Which of the following is not indication of induction of labour?

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