Question 1

During which stage of labour does the nurse assess 'crowning'?

Accepted Answer

Answer reason: Crowning—the fetal head visible and not receding at the perineum—occurs during the second (expulsive) stage of labor.

Question 2

The charge nurse is formulating a discharge teaching plan for a client with mild preeclampsia. The nurse should give priority to?

Accepted Answer

Answer reason: Home care for mild preeclampsia prioritizes rest (lateral bed rest) to reduce blood pressure and improve uteroplacental perfusion. Pedal edema is common and not an urgent sign; sodium restriction is not recommended; nosebleeds are not typical indicators of worsening preeclampsia.

Question 3

Which obstetrical client is most likely to have an infant with respiratory distress syndrome?

Accepted Answer

Answer reason: Infants of diabetic mothers have delayed pulmonary maturity and decreased surfactant production, markedly increasing risk of neonatal RDS. Alcohol and smoking are linked to low birth weight and other complications, and pregnancy-induced hypertension is not as specifically associated with RDS as maternal diabetes.

Question 4

When performing Leopold maneuvers on a client at 32 weeks gestation, the nurse would expect to find?

Accepted Answer

Answer reason: At around 32 weeks the fetus typically exhibits active movements; decreased movement is more typical near term or with compromise. Therefore active fetal movement is expected on palpation.

Question 5

An obstetrical client calls the clinic with complaints of morning sickness. The nurse should tell the client to?

Accepted Answer

Answer reason: Eating dry crackers before getting out of bed helps settle the stomach and prevent hypoglycemia, reducing morning sickness. Skipping meals is inappropriate; milk or acidic/sugary juice may worsen nausea.

Question 6

Which client is at greatest risk for a caesarean section due to cephalopelvic disproportion (CPD)?

Accepted Answer

Answer reason: Adolescent primigravidas have a higher risk of CPD due to an immature, smaller pelvis. Prior successful vaginal births (multiparas) indicate adequate pelvic capacity, lowering CPD risk; a 32-year-old primigravida has a mature pelvis.

Question 7

Which stage is considered the most difficult: pregnancy, birth, breastfeeding, or sleep?

Accepted Answer

Answer reason: Labor and delivery are the most acutely strenuous and risky part of the childbearing process, typically considered more difficult than pregnancy, breastfeeding, or sleep.

Question 8

What is the first milk produced by the mother called?

Accepted Answer

Answer reason: The first milk produced after delivery is colostrum, a thick, antibody-rich secretion that provides initial immunity and nutrition to the newborn.

Question 9

What is the term for the first fetal movement felt by the mother?

Accepted Answer

Answer reason: Quickening is the term for the first maternal perception of fetal movement, typically around 16–20 weeks.

Question 10

If the color of the amniotic fluid is green, what does it indicate?

Accepted Answer

Answer reason: Green amniotic fluid indicates meconium staining from fetal passage of stool, most commonly due to hypoxia and thus a sign of fetal distress (though it may occur in post-term).

Question 11

Which of the following can lead to greenish discoloration of the amniotic fluid?

Accepted Answer

Answer reason: Meconium passage into amniotic fluid stains it green. Hydramnios is excess fluid volume, lanugo is fetal hair, and vernix is a white cheesy coating—none cause green discoloration.

Question 12

At which stage is the placenta delivered?

Accepted Answer

Answer reason: Labor has four stages: dilation, delivery of the fetus, delivery of the placenta, and postpartum recovery. The placenta is expelled during the third stage.

Question 13

When is the best time to achieve pregnancy?

Accepted Answer

Answer reason: Ovulation typically occurs about 14 days before the next menstrual period. Conception is most likely around ovulation, making 14 days before the expected menses the best time.

Question 14

Operative delivery?

Accepted Answer

Answer reason: Operative delivery encompasses cesarean section and instrument-assisted vaginal delivery, which carry higher maternal and perinatal trauma risk than spontaneous vaginal birth. It does not include minor routine maneuvers such as episiotomy, head extension assistance, lateral flexion, or controlled cord traction; therefore A and B are true, C is false.

Question 15

Hanna gave birth to her first Son through Episiotomy before one day after labouring for 11 hours. Now, she is in the Post natal unit of Hospital A. One of the following is not part of your care as a professional Nurse working in the unit?

Accepted Answer

Answer reason: On postpartum day 1 in a stable patient, routine monitoring is appropriate; increasing the frequency of vital sign checks is unnecessary. Supporting normal feeding, assessing the newborn, and involving the family are standard postnatal care activities.

Question 16

Post abortion care does not involve,?

Accepted Answer

Answer reason: Postabortion care includes emergency treatment of complications, postabortion family planning counseling/services, and linkages to comprehensive reproductive health care. Emergency contraception is for preventing pregnancy after intercourse and is not a core PAC component.

Question 17

What is the minimum total number of antenatal visits a pregnant lady should have?

Accepted Answer

Answer reason: WHO 2016 ANC model recommends a minimum of 8 antenatal contacts to improve maternal-fetal outcomes, replacing the older 4-visit model.

Question 18

What is the name of the bluish discoloration of the cervix during pregnancy?

Accepted Answer

Answer reason: Chadwick’s sign is the bluish or purplish discoloration of the cervix and vaginal mucosa in early pregnancy due to increased vascularity. Hegar’s is softening of the lower uterine segment; Goodell’s is softening of the cervix.

Question 19

Which of the following leads to greenish discoloration of the amniotic fluid?

Accepted Answer

Answer reason: Passage of meconium into the amniotic fluid stains it green. Lanugo and vernix may make fluid cloudy/whitish, and hydramnios refers to excess volume, not discoloration.

Question 20

A client who has chosen to breastfeed tells the nurse that her nipples became very sore while she was breastfeeding her older child. Which measure will help her to avoid soreness of the nipples?

Accepted Answer

Answer reason: Breaking suction before removing the infant prevents nipple trauma and soreness. Hot moist soaks and a support bra address engorgement/comfort, and simply feeding during the first 48 hours does not prevent nipple soreness.

Question 21

Shortly after the client was admitted to the postpartum unit, the nurse notes heavy lochia rubra with large clots. The nurse should anticipate an order for?

Accepted Answer

Answer reason: Heavy lochia rubra with large clots indicates postpartum uterine atony/hemorrhage. Methergine (methylergonovine) is a uterotonic that increases uterine tone to reduce bleeding. The other options are for pain, seizures, or nausea.

Question 22

The client delivered a 9-pound infant two days ago. An effective means of managing discomfort from an episiotomy is?

Accepted Answer

Answer reason: At 48 hours postpartum, warm sitz baths promote circulation, reduce edema, and relieve episiotomy discomfort. Ice packs are recommended only during the first 24 hours; showers and medicated suppositories are not preferred for episiotomy pain relief.

Question 23

The client is admitted to the unit. A vaginal exam reveals that she is 3cm dilated. Which of the following statements would the nurse expect her to make?

Accepted Answer

Answer reason: At 3 cm the client is in the latent phase of labor, typically excited, talkative, and focused on the baby, not on pushing or intense concentration. Statements about pushing occur near complete dilation; irritability and intense focus are common in active/transition phases.

Question 24

A vaginal exam reveals a breech presentation in a newly admitted client. The nurse should take which of the following actions at this time?

Accepted Answer

Answer reason: On discovering breech presentation, the immediate nursing priority is to assess fetal status; initiate continuous fetal heart monitoring. Breech alone does not mandate immediate cesarean, Trendelenburg is not indicated without cord prolapse, and ultrasound requires a provider order.

Question 25

The following are all nursing diagnoses appropriate for a gravida 4 para 3 in labor. Which one would be most appropriate for the client as she completes the latent phase of labor?

Accepted Answer

Answer reason: Near the end of the latent phase the client is generally stable and often on external fetal monitoring, which restricts movement—an actual problem. Hyperventilation is more typical of the transition phase; placental perfusion issues relate to supine positioning; fluid volume deficit is only a potential risk.

Question 26

The nurse is assessing a pregnant client in her third trimester. The parents are informed that the ultrasound suggests that the baby is small for gestational age (SGA). An earlier ultrasound indicated normal growth. The nurse understands that this change is MOST likely due to?

Accepted Answer

Answer reason: Late-onset SGA after previously normal growth is most consistent with uteroplacental insufficiency from maternal hypertension, where vasoconstriction reduces placental oxygen and nutrient delivery. Infections, teratogens, and chromosomal abnormalities typically cause earlier, symmetric growth restriction or congenital anomalies.

Question 27

At a routine health assessment, a client tells the nurse that she is planning a pregnancy in the near future. She asks about pre-conception diet changes. Which of the statements made by the nurse is BEST?

Accepted Answer

Answer reason: Preconception counseling emphasizes folic acid to prevent neural tube defects. Green leafy vegetables are rich in folate, making this the best advice; the other choices are not specific to preconception folate needs and fish may pose mercury concerns.

Question 28

The nurse is explaining the effects of cocaine abuse to a pregnant client. Which of the following MUST the nurse understand as a basis for teaching?

Accepted Answer

Answer reason: Cocaine causes maternal and placental vasoconstriction leading to fetal hypoxia and intrauterine growth restriction. It is not specifically linked to neural tube defects, neonatal withdrawal is variable and not typically immediate, and ongoing cocaine use contraindicates breastfeeding despite its bonding benefits.

Question 29

A woman comes to the antepartum clinic for a routine prenatal examination. She is 12 weeks pregnant with her second child. The nurse would document?

Accepted Answer

Answer reason: Gravida counts total pregnancies, including the current one; being pregnant with her second child makes her G2. Para counts births beyond the age of viability; with one prior child she is P1.

Question 30

While caring for the client during the first hour after delivery, the nurse determines that the uterus is boggy and there is vaginal bleeding. The nurse's FIRST action should be to?

Accepted Answer

Answer reason: A boggy uterus with postpartum bleeding indicates uterine atony. The priority immediate intervention is to massage the fundus to stimulate uterine contraction and reduce bleeding before further assessments or actions.

Question 31

A 23 year-old single client is in the 33rd week of her first pregnancy. She tells the nurse that she has everything ready for the baby and has made plans for the first weeks together at home. Which normal emotional reaction does the nurse recognize?

Accepted Answer

Answer reason: At 33 weeks, preparing the home and planning for the newborn reflects third-trimester task of anticipating birth and assuming the parental role. Acceptance of pregnancy and ambivalence are earlier responses; focus on fetal development is more typical of the second trimester.

Question 32

What is the earliest sign of pregnancy-induced hypertension?

Accepted Answer

Answer reason: Early PIH often presents with fluid retention leading to sudden weight gain before overt hypertension or proteinuria become evident; edema may not yet be obvious.

Question 33

If the last menstrual period (LMP) is June 25, 2018, what is the estimated date of delivery (EDD)?

Accepted Answer

Answer reason: Apply Naegele’s rule: LMP + 7 days − 3 months + 1 year. June 25, 2018 → July 2, 2018 → April 2, 2019.

Question 34

The nurse is caring for a client with abruptio placenta. Which of the following nursing interventions would be MOST beneficial to the fetus?

Accepted Answer

Answer reason: Abruptio placenta reduces placental perfusion; providing maternal oxygen maximizes fetal oxygenation. Ambulation can worsen bleeding, turning has limited benefit, and pain medication does not improve fetal oxygen delivery.

Question 35

A woman in her third trimester complains of severe heartburn. The nurse would appropriately teach the client to?

Accepted Answer

Answer reason: Heartburn in late pregnancy is due to reflux; elevating the head during sleep reduces regurgitation. Eating just before bed worsens reflux; sodium bicarbonate is not recommended in pregnancy; fluid advice is not the primary intervention for heartburn.

Question 36

The nurse has been teaching an apprehensive primipara who has difficulty in initial nursing of the newborn. What observation at the time of discharge suggests that initial breast feeding is effective?

Accepted Answer

Answer reason: Maternal calmness and positive interaction indicate confidence and comfort with breastfeeding, reflecting an effective latch and early success. The other options do not confirm effective breastfeeding and may suggest poor feeding or are unrelated.

Question 37

During a prenatal visit, a client states: "I have been very nauseated during my first trimester, and I don't understand the reason." Which of the following responses by the nurse is BEST?

Accepted Answer

Answer reason: First-trimester nausea (morning sickness) is primarily due to hormonal changes, especially increased hCG and progesterone. Option 3 reflects this cause; the others are incorrect or nontherapeutic.

Question 38

In pregnancy, what is the name of the pigmented line that runs from the pubis to the umbilicus?

Accepted Answer

Answer reason: The darkened line from the symphysis pubis to the umbilicus during pregnancy is called the linea nigra. Striae gravidarum are stretch marks, chloasma is facial hyperpigmentation, and lochia is postpartum vaginal discharge.

Question 39

How many extra kilocalories are required for energy in a pregnant mother?

Accepted Answer

Answer reason: During pregnancy, energy needs increase by about 300 kcal/day (roughly +340 in 2nd trimester and +452 in 3rd); the standard guidance is an additional ~300 kcal.

Question 40

Which denominator is used to identify face presentation during labor?

Accepted Answer

Answer reason: In face presentation, the presenting part is the face and the fetal chin (mentum) is the denominator used to describe position.

Question 41

Which of the following is the primary component of Suraksha Yojana?

Accepted Answer

Answer reason: Janani Suraksha Yojana’s primary focus is to promote institutional deliveries to reduce maternal and neonatal mortality; other elements support this goal.

Question 42

The clinic nurse is counseling a substance-abusing post partum client on the risks of continued cocaine use. In order to provide continuity of care, which of the following is a PRIORITY nursing diagnosis?

Accepted Answer

Answer reason: In a postpartum client with ongoing cocaine use, the highest-priority concern is the infant’s safety and care. Substance abuse directly impairs the ability to bond with and safely care for the newborn, making altered/impaired parenting the priority diagnosis over broader issues like social isolation or coping.

Question 43

The nurse is teaching a smoking cessation class and notices there are two pregnant women in the group. Which information is a PRIORITY for these women?

Accepted Answer

Answer reason: Pregnancy teaching should stress fetal risks of smoking; nicotine and carbon monoxide cause vasoconstriction and hypoxia leading to low birth weight. Other statements are false or irrelevant to pregnancy.

Question 44

A nurse is doing preconceptual counseling with a woman who is planning a pregnancy. Which of the following statements suggests that the client understands the connection between alcohol consumption and fetal alcohol syndrome?

Accepted Answer

Answer reason: Acknowledges that alcohol is teratogenic early in pregnancy, even before recognition; therefore abstinence is necessary when planning pregnancy.

Question 45

In taking the history of a pregnant woman, which of the following would the nurse recognize as the PRIMARY contraindication for breast feeding?

Accepted Answer

Answer reason: Maternal cocaine use is an absolute contraindication to breastfeeding because the drug is excreted into breast milk and can harm the infant. Maternal age, lactose intolerance, or a family history of breast cancer do not preclude breastfeeding.

Question 46

The nurse is monitoring the contractions of a woman in labor. A contraction is recorded as beginning at 10:00 A.M. and ending at 10:01 A.M. Another begins at 10:15 A.M. The nurse recognizes that the frequency of the contractions is?

Accepted Answer

Answer reason: Contraction frequency is measured from the start of one contraction to the start of the next; 10:00 A.M. to 10:15 A.M. equals 15 minutes.

Question 47

The MAJOR developmental task that the mother must accomplish during the first trimester of pregnancy is?

Accepted Answer

Answer reason: In early pregnancy the primary maternal developmental task is to accept the reality of being pregnant; acceptance of the fetus as a separate being occurs later (second trimester) and resolving birth-related fears is a third-trimester task.

Question 48

The mother of a child with a neural tube defect asks the nurse what she can do to decrease the chances of having another baby with a neural tube defect. The BEST response by the nurse is?

Accepted Answer

Answer reason: Periconceptional folic acid supplementation significantly reduces the risk of neural tube defects; the other options are general nutrition advice and not specific for NTD prevention.

Question 49

A high school nurse is advising a class of unwed pregnant students that the MOST important action they can perform to deliver a healthy child is?

Accepted Answer

Answer reason: Maternal nutrition and adequate pregnancy weight gain are major modifiable predictors of infant birth weight and outcomes; advising good nutrition is the highest-impact action.

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