‫اسـئـلة مــراجـعـة شـامـلة لـمـادة‬

MATERNITY OF NURSING
PREPARED BY : Mohanad Omar Hamad
1. What is the name given to the process in which a reproductive cell divides to produce four daughter
cells with only 23 chromosomes ?
A. Mitosis
B. Meiosis
C. Oogenesis
D. Spermatogenesis

2. In which of the following structures do sperm marture?

A. Epididymis
B. Vas deferens
C. Spermatic cord
D. Urethra

3. Which of the following structures all secrete fluids that combine with sperm to form semen?
A. Seminal vesicles, mammary glands, bulbourethral glands
B. Prostate gland, corpus luteum, Graafian follicle
C. Bulbourethral glands, prostate gland, seminal vesicle
D. Mammary glands, corpus luteum, corpus albicans

4. What is the name of the hormone responsible for the development of masculine secondary sexual
characteristics?
A. Follicle stimulating hormone
B. Oestrogen
C. Progesterone
D. Testosterone

5. Where are the ovaries located?

A. The inferior portion of the pelvic cavity beneath the uterus
B. The middle portion of the pelvic cavity inside of the uterus
C. The middle portion of the pelvic cavity below the uterus
D. The superior portion of the pelvic cavity on either side of the uterus

6. What are the female gonads called?

A. Ovaries
B. Oocytes
C. Ova
D. Gamates

7. What is the name of the disorder in which endometrial tissue develops outside of the uterus?
A. Benign prostatic hyperplasia
B. Endometriosis
C. Fibroids
D. Mastitis

8. What is the name of the principal hormone that stimulates the production of milk in the mammary
glands?
A. Lutenizing hormone
B. Relaxin
C. Inhibin
D. Prolactin

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9. Where in the female reproductive system do the sperm and ovum unite and fuse to form a zygote?
A. Urethra
B. Fallopian tubes
C. Uterus
D. Ovaries

10. The onset of menstruation at puberty is referred to as:

A. menopause
B. menorhagia
C. menarche
D. amenorrhea
E. dysmenorrhea.

11. During the ovarian cycle, ovulation occurs

A. during the period of menstrual flow
B. during sexual intercourse
C. when estrogen levels are very low
D. when the corpus luteum degenerates
E. during the surge in LH and FSH concentration.

12. In the menstrual cycle, the menstrual phase or menses, usually occurs between day ____ and day ____
of the cycle.
A.(25 and 28)
B.(1 and 5)
C. (13 and l5)
D. (20 and 25)

13. The secretory phase of the endometrium corresponds to which of the following ovarian phases?
A. follicular phase
B. ovulation
C. luteal phase
D. menstrual phase.

14. The dominant hormone controlling the proliferative phase of the uterine endometrium is:
A. estrogen
B. FSH
C. LH
D. progesterone
E. hCG

15. A woman with a typical 28-day menstrual cycle is most likely to become pregnant as a result of sexual
intercourse on days:
A. 1 - 3
B. 5-8
C. 12-15
D. 22-24
E. 24-28.

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16. The female structures that correspond (are homologous) to the scrotum of the male are the:
A. labia minora
B. labia majora
C. clitoris
D. urethral folds
E. answers A and C.

17.Human egg and sperm are similar in that:

a. About the same number are produced per month
b. They have the same degree of motility
c. They have the same number of chromosomes
d. They are about the same size

18.The rounded region of the uterus superior to the entrance of the uterine tubes is the:
a. Ampulla
b. Fundus
c. Corpus
d. Isthmus
e. Superior flexure

19.The corpus luteum secretes progesterone which negatively feeds back and inhibits the release of:
a. ABP and ICSH
b. LH and ICSH
c. LH and FSH
d. FSH and TSH

20.Spermatogenesis BEGINS in the:

a. Epididymis
b. Uterine horn
c. Rete testes
d. Seminiferous tubules
e. Seminal vesicles

21.The site of oogenesis is the:

a. Ovary
b. Ovum
c. Oocyte
d. Oviduct
e. Ovarian lacunae

22.During ovulation, all of the following occur EXCEPT:

a. Rupture of the Graafian follicle
b. Estrogen production reaches its nadir
c. FSH and LH production become very high
d. Corpus luteum is formed

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23.The end of the fallopian tubes have fingerlike projections called?
A. Cilia
B. Fimbriae
C. Fundus
D. Corpus

24. The _________ is responsible for secreting gonadotropin-releasing hormone.

A. Thalamus
B. Hypothalamus
C. Anterior pituitary gland
D. Posterior pituitary gland

25. During which cycle day of a typical 28 day menstrual cycle does the follicular phase occur?
A. Cycle days 7-14
B. Cycle days 14-28
C. Cycle days 1-6
D. Cycle days 1-13

26. As the graafian follicle matures, a massive amount of estrogen is released by the follicle which causes
a luteinizing hormone surge. Approximately, what cycle day does the LH surge occur?
A. Cycle day 11-13
B. Cycle Day 14
C. Cycle day 5-8
D. Cycle day 1-6

27. Select all the functions of the luteinizing hormone:

A. Forming the corpus luteum
B. Thickening the endometrium layer for implantation
C. Breaking down the wall of the graffian follicle to allow for release of the ovum
D. Thinning cervical mucous

28. During which stage of the menstrual cycle does the endometrium layer thicken?
A. Secretory Phase
B. Luteal Phase
C. Ovulation Phase
D. Proliferative Phase

29. What cycle day does the proliferative stage occur?

A. Cycle day 7-14
B. Cycle day 14-28
C. Cycle day 1-6
D. Cycle day 1-14

30. Which statement is TRUE about the ovulation phase?

A. The newly released egg will live for 72 hours and disintegrate if not fertilized.
B. The woman will have a low basal body temperature before ovulation and then a temperature increase
of 0.4-1’F degrees around ovulation.
C. The ovum is directly released into the fallopian tube.
D. Fertilization most commonly occurs at the fimbria.

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31. If the ovum is to be fertilized, where is the most common site of fertilization?
A. Uterine wall
B. Fimbria
C. Ampulla of the Fallopian Tube
D. Isthmus of the Fallopian Tube

32. In what stage does the corpus luteum form?

A. Luteal Phase
B. Follicular Phase
C. Proliferative Phase
D. None of the above

33. What cycle day does the luteal phase occur?

A. Cycle days 15-28
B. Cycle days 5-13
C. Cycle day 14
D. Cycle days 7-14

34. The corpus luteum secretes (select-all-that-apply)?

A. Progesterone
B. Estrogen
C. FSH
D. LH

35. A patient is trying to prevent pregnancy by using the rhythm method. At what time during a
woman’s cycle is she the most fertile?
A. Cycle days 21-28
B. Cycle days 1-6
C. Cycle days 9-16
D. Cycle days 6-9

36. ___________ is released from the anterior pituitary gland and stimulates the follicles in the ovary to
mature.
A. Progesterone
B. Follicle-stimulating hormone
C. Estrogen
D. Human chorionic gonadotropin

37. Select all the following that is NOT a function of progesterone and estrogen:
A. Inhibits the production of LH and FSH
B. Causes the hypothalamus to release gonadotropin releasing hormone
C. Maintains the endometrium for pregnancy
D. Causes the follicle to mature into a graafian follicle

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38. If fertilization occurs the corpus luteum will act as a temporary endocrine structure to release
hormones. It will do this until the placenta is fully developed to take over with hormone secretion and this
occurs at approximately?
A. 4 weeks gestation
B. 8 weeks gestation
C. 20 weeks gestation
D. 2 weeks gestation

39. Menstruation occurs because the:

a. Hormone stimulation from the corpus luteum ceases.
b. Blood vessels in the uterine lining become too long and twisted.
c. Corpus luteum increases estrogen and progesterone production.
d. Ovum has been passed from the woman’s body.

40. An important purpose of seminal fluid is to:

a. Digest microorganisms in the female reproductive tract.
b. Prevent premature movement of sperm tails.
c. Protect sperm from the acidic vaginal environment.
d. Transport the sperm into the uterine cavity.

41. Fertilization is complete when:

a. Fusion of the sperm and ovum nuclei occurs.
b. A sperm enters the ovum in the fallopian tube.
c. The fertilized ovum has its first cell division.
d. The morula fully implants into the uterine lining.

42. The embryo is fully implanted in the uterus on which day after conception?
a. 3
b. 6
c. 10
d. 15

43. Which fetal circulatory structure carries blood with the highest oxygen concentration?
a. Umbilical artery
b. Umbilical vein
c. Ductus arteriosus
d. Pulmonary vein

44. To reduce the incidence of neural tube defects such as spina bifida, it is recommended that women of
childbearing age consume:
a. 400 mcg of folic acid/ day in foods and supplements.
b. 300 extra calories near the expected conception date.
c. 60 mg of supplemental iron in addition to high-iron foods.
d. Two added servings of foods that are high in vitamin C.

45. The main risk to a woman who practices pica during pregnancy is:
a. Inadequate intake of essential nutrients.
b. Rapid absorption of nutrients such as iron.
c. Reduced fluid intake and dehydration.
d. Nonacceptance of the practice by caregivers.

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46. When performing Leopold’s maneuvers, the nurse palpates a hard round object in the uterine
fundus. A smooth rounded surface is on the mother’s right side, and irregular movable parts are felt on
her left side. An irregularly shaped fetal part is felt in the suprapubic area and is easily moved upward.
How should these findings be interpreted?
a. The fetal presentation is cephalic, position is ROA, and the presenting part is engaged.
b. The fetal presentation is cephalic, position is LOP, and the presenting part is not engaged.
c. The fetal presentation is breech, position is RST, and the presenting part is engaged.
d. The fetal presentation is breech, position is RSA, and the presenting part is not engaged.

47. When performing the fourth Leopold’s maneuver, the nurse determines that the cephalic prominence
is on the same side as the fetal back. How should this assessment be interpreted?
a. The fetus is in a breech presentation, with the head extended.
b. The fetus is in a face presentation, with the head extended.
c. The fetus is in a transverse lie, with the face toward the mother’s back.
d. The fetus is in a cephalic presentation, with the head well flexed.

48. Pharmacologic preparations can be used to treat primary dysmenorrhea. Which preparation would
be least effective in relieving the symptoms of primary dysmenorrhea?
a. Oral contraceptive pill (OCP)
b. Naproxen sodium (Anaprox)
c. Acetaminophen (Tylenol)
d. Ibuprofen (Motrin)

49. Women experiencing PMS should be advised to avoid use of which of the following?
a. Chamomile tea
b. Coffee
c. Whole-grain cereals
d. Parsley to season food

50. A woman at 30 weeks of gestation assumes a supine position for a fundal measurement and Leopold’s
maneuvers. She begins to complain about feeling dizzy and nauseated. Her skin feels damp and cool. The
nurse’s first action would be to:
a. assess the woman’s respiratory rate and effort.
b. provide the woman with an emesis basin.
c. elevate the woman’s legs 20 degrees from her hips.
d. turn the woman on her side.

51. A woman’s temperature has just risen 0.4°F and will remain elevated during the remainder of her
cycle. She expects to menstruate in about 2 weeks. Which of the following hormones is responsible for the
change?
1. Estrogen.
2. Progesterone.
3. Luteinizing hormone (LH).
4. Follicle-stimulating hormone (FSH).

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52. A woman is menstruating. If hormonal studies were to be done at this time, which of the following
hormonal levels would the nurse expect to see?
1. Both estrogen and progesterone are high.
2. Estrogen is high and progesterone is low.
3. Estrogen is low and progesterone is high.
4. Both estrogen and progesterone are low.

53. When a nurse is teaching a woman about her menstrual cycle she mentions that which of the
following is the most important change that happens during the follicular phase of the menstrual cycle?
1. Maturation of the graafian follicle.
2. Multiplication of the fimbriae.
3. Secretion of human chorionic gonadotropin.
4. Proliferation of the endometrium.

54. A client complaining of secondary amenorrhea is seeking care from her gynecologist. Which of the
following may have contributed to her problem?
1. Athletic activities.
2. Vaccination history.
3. Pet ownership.
4. Genetic history.

55. Once oogenesis is complete, the resultant gamete cell contains how many chromosomes?
1. 23.
2. 46.
3. 47.
4. 92.

56. A nursing instructor is conducting a lecture and is reviewing the functions of the female reproductive
system. She asks Mark to describe the follicle stimulating hormone (FSH) and the luteinizing hormone
(LH). Mark accurately responds by stating that:
A. FSH and LH are released from the anterior pituitary gland.
B. FSH and LH are secreted by the corpus luteum of the ovary
C. FSH and LH are secreted by the adrenal glands
D. FSH and LH stimulate the formation of milk during pregnancy.

57. A nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse
accurately tells the client that fetal circulation consists of:
A. Two umbilical veins and one umbilical artery
B. Two umbilical arteries and one umbilical vein
C. Arteries carrying oxygenated blood to the fetus
D. Veins carrying deoxygenated blood to the fetus

58. During a prenatal visit at 38 weeks, a nurse assesses the fetal heart rate. The nurse determines that the
fetal heart rate is normal if which of the following is noted?
A. 80 BPM
B. 100 BPM
C. 150 BPM
D. 180 BPM

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59. A client arrives at a prenatal clinic for the first prenatal assessment. The client tells a nurse that the
first day of her last menstrual period was September 19th, 2013. Using Naegele’s rule, the nurse
determines the estimated date of confinement as:
A. July 26, 2013
B. June 12, 2014
C. June 26, 2014
D. July 12, 2014

60. A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The
client has a healthy 5 year old child that was delivered at 37 weeks and tells the nurse that she doesn’t
have any history of abortion or fetal demise. The nurse would document the GTPAL for this client as:
A. G = 3, T = 2, P = 0, A = 0, L =1
B. G = 2, T = 0, P = 1, A = 0, L =1
C. G = 1, T = 1. P = 1, A = 0, L = 1
D. G = 2, T = 0, P = 0, A = 0, L = 1

61. Rho (D) immune globulin (RhoGAM) is prescribed for a woman following delivery of a newborn
infant and the nurse provides information to the woman about the purpose of the medication. The nurse
determines that the woman understands the purpose of the medication if the woman states that it will
protect her next baby from which of the following?
A. Being affected by Rh incompatibility
B. Having Rh-positive blood
C. Developing a rubella infection
D. Developing physiological jaundice

62. 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.

63. In a lecture on sexual functioning, the nurse plans to include the fact that ovulation occurs when the:
A. Oxytocin is too high
B. Blood level of LH is too high
C. Progesterone level is high
D. Endometrial wall is sloughed off.

64. The chief function of progesterone is the:

A. Development of the female reproductive system
B. Stimulation of the follicles for ovulation to occur
C. Preparation of the uterus to receive a fertilized egg
D. Establishment of secondary male sex characteristics

65. The developing cells are called a fetus from the:

A. Time the fetal heart is heard
B. Eighth week to the time of birth
C. Implantation of the fertilized ovum
D. End of the send week to the onset of labor

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66. After the first four months of pregnancy, the chief source of estrogen and progesterone is the:
A. Placenta
B. Adrenal cortex
C. Corpus luteum
D. Anterior hypophysis

67. A pregnant client is making her first Antepartum visit. She has a two year old son born at 40 weeks, a
5 year old daughter born at 38 weeks, and 7 year old twin daughters born at 35 weeks. She had a
spontaneous abortion 3 years ago at 10 weeks. Using the GTPAL format, the nurse should identify that
the client is:
A. G4 T3 P2 A1 L4
B. G5 T2 P2 A1 L4
C. G5 T2 P1 A1 L4
D. G4 T3 P1 A1 L4

68. During a prenatal examination, the nurse draws blood from a young Rh negative client and explain
that an indirect Coombs test will be performed to predict whether the fetus is at risk for:
A. Acute hemolytic disease
B. Respiratory distress syndrome
C. Protein metabolic deficiency
D. Physiologic hyperbilirubinemia

69. When involved in prenatal teaching, the nurse should advise the clients that an increase in vaginal
secretions during pregnancy is called leukorrhea and is caused by increased:
A. Metabolic rates
B. Production of estrogen
C. Functioning of the Bartholin glands
D. Supply of sodium chloride to the cells of the vagina

70. A 26-year old multigravida is 14 weeks’ pregnant and is scheduled for an alpha-fetoprotein test. She
asks the nurse, “What does the alpha-fetoprotein test indicate?” The nurse bases a response on the
knowledge that this test can detect:
A. Kidney defects
B. Cardiac defects
C. Neural tube defects
D. Urinary tract defects

71. The nurse teaches a pregnant woman to avoid lying on her back. The nurse has based this statement
on the knowledge that the supine position can:
A. Unduly prolong labor
B. Cause decreased placental perfusion
C. Lead to transient episodes of hypotension
D. Interfere with free movement of the coccyx

72. The pituitary hormone that stimulates the secretion of milk from the mammary glands is:
A. Prolactin
B. Oxytocin
C. Estrogen
D. Progesterone

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73. Which of the following answers best describes the stage of pregnancy in which maternal and fetal
blood are exchanged?
A. Conception
B. 9 weeks’ gestation, when the fetal heart is well developed
C. 32-34 weeks gestation
D. maternal and fetal blood are never exchanged

74. Gravida refers to which of the following descriptions?

A. A serious pregnancy
B. Number of times a female has been pregnant
C. Number of children a female has delivered
D. Number of term pregnancies a female has had.

75. A pregnant woman at 32 weeks’ gestation complains of feeling dizzy and lightheaded while her fundal
height is being measured. Her skin is pale and moist. The nurse’s initial response would be to:
A. Assess the woman’s blood pressure and pulse
B. Have the woman breathe into a paper bag
C. Raise the woman’s legs
D. Turn the woman on her left side.

76. A pregnant woman’s last menstrual period began on April 8, 2005, and ended on April 13. Using
Naegele’s rule her estimated date of birth would be:
A. January 15, 2006
B. January 20, 2006
C. July 1, 2006
D. November 5, 2005

77. After doing Leopold’s maneuvers, the nurse determines that the fetus is in the ROP position. To best
auscultate the fetal heart tones, the Doppler is placed:
A. Above the umbilicus at the midline
B. Above the umbilicus on the left side
C. Below the umbilicus on the right side
D. Below the umbilicus near the left groin

78. The nurse observes the client’s amniotic fluid and decides that it appears normal, because it is:
A. Clear and dark amber in color
B. Milky, greenish yellow, containing shreds of mucus
C. Clear, almost colorless, and containing little white specks
D. Cloudy, greenish-yellow, and containing little white specks

79.If a pregnant woman is at 20 weeks gestation, at what level should a clinic nurse expect to palpate the
woman’s uterine height?
a. Two finger-breadths above the symphysis pubis
b. Halfway between the symphysis pubis and the umbilicus
c. At the umbilicus
d. Two finger-breadths above the umbilicus

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80. What is the approximate time that the blastocyst spends traveling to the uterus for implantation?
A. 2 days
B. 7 days
C. 10 days
D. 14 weeks

81. The nurse is counseling a couple who has sought information about conceiving. The couple asks the
nurse to explain when ovulation usually occurs. Which statement by the nurse is correct?
A. Two weeks before menstruation
B. Immediately after menstruation
C. Immediately before menstruation
D. Three weeks before menstruation

82. FHR can be auscultated with a fetoscope as early as which of the following?
A. 5 weeks gestation
B. 10 weeks gestation
C. 15 weeks gestation
D. 20 weeks gestation

83. A client LMP began July 5. Her EDD should be which of the following?
A. January 2
B. March 28
C. April 12
D. October 12

84. Which of the following fundal heights indicates less than 12 weeks’ gestation when the date of the
LMP is unknown?
A. Uterus in the pelvis
B. Uterus at the xiphoid
C. Uterus in the abdomen
D. Uterus at the umbilicus

85. Before birth, which of the following structures connects the right and left auricles of the heart?
A. Umbilical vein
B. Foramen ovale
C. Ductus arteriosus
D. Ductus venosus

86. The client tells the nurse that her last menstrual period started on January 14 and ended on January
20. Using Nagele’s rule, the nurse determines her EDD to be which of the following?
A. September 27
B. October 21
C. November 7
D. December 27

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87. When taking an obstetrical history on a pregnant client who states, “I had a son born at 38 weeks
gestation, a daughter born at 30 weeks gestation and I lost a baby at about 8 weeks,” the nurse should
record her obstetrical history as which of the following?
A. G2 T2 P0 A0 L2
B. G3 T1 P1 A0 L2
C. G3 T2 P0 A0 L2
D. G4 T1 P1 A1 L2

88. When measuring a client’s fundal height, which of the following techniques denotes the correct
method of measurement used by the nurse?
A. From the xiphoid process to the umbilicus
B. From the symphysis pubis to the xiphoid process
C. From the symphysis pubis to the fundus
D. From the fundus to the umbilicus

89. A woman who is Rh-negative has delivered an Rh-positive infant. The nurse explains to the client
that she will recieve RhoGAM. The nurse determines that the client understands the purpose of
RhoGAM when she states:
a. “RhoGAM will protect my next baby if it is Rh-negative.”
b. “RhoGAM will prevent antibody formation in my blood.”
c. “RhoGAM will be given to prevent German measles.”
d. “RhoGAM will be used to prevent bleeding in my newborn.”

90. Which of the following refers to the single cell that reproduces itself after conception?
A. Chromosome
B. Blastocyst
C. Zygote
D. Trophoblast

91. When teaching a group of adolescents about variations in the length of the menstrual cycle, the nurse
understands that the underlying mechanism is due to variations in which of the following phases?
A. Menstrual phase
B. Proliferative phase
C. Secretory phase
D. Ischemic phase

92. Which of the following would be most appropriate for a nurse to use when describing menarche to a
13-year-old?
A. A female’s first menstruation or menstrual “periods.”
B. The first year of menstruation or “period.”
C. The entire menstrual cycle or from one “period” to another
D. The onset of uterine maturation or peak growth

92. You performed Leopold’s maneuver and found the following: breech presentation, fetal back at the
right side of the mother. Based on these findings, you can hear the fetal heart beat (PMI) BEST in which
location?
A. Left lower quadrant
B. Right lower quadrant
C. Left upper quadrant
D. Right upper quadrant

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93. In Leopold’s maneuver step #1, you palpated a soft, broad mass that moves with the rest of the mass.
The correct interpretation of this finding is:
A. The mass palpated at the fundal part is the head part.
B. The presentation is breech.
C. The mass palpated is the back
D. The mass palpated is the buttocks.

94. In Leopold’s maneuver step # 3 you palpated a hard round movable mass at the supra pubic area.
The correct interpretation is that the mass palpated is:
A. The buttocks because the presentation is breech.
B. The mass palpated is the head.
C. The mass is the fetal back.
D. The mass palpated is the small fetal part

95. The hormone responsible for the maturation of the Graafian follicle is:
A. Follicle stimulating hormone
B. Progesterone
C. Estrogen
D. Luteinizing hormone

96. In Bartholomew’s rule of 4, when the level of the fundus is midway between the umbilicus and
xiphoid process the estimated age of gestation (AOG) is:
A. 5th month
B. 6th month
C. 7th month
D. 8th month

97. The following are ways of determining expected date of delivery (EDD) when the LMP is unknown
EXCEPT:
A. Naegele’s rule
B. Quickening
C. McDonald’s rule
D. Batholomew’s rule of 4

98. If the LMP is Jan. 30, the expected date of delivery (EDD) is
A. Oct. 7
B. Oct. 24
C. Nov. 7
D. Nov. 8

99. The main reason for an expected increased need for iron in pregnancy is:
A. The mother may have physiologic anemia due to the increased need for red blood cell mass as well as
the fetal requires about 350-400 mg of iron to grow
B. The mother may suffer anemia because of poor appetite
C. The fetus has an increased need for RBC which the mother must supply
D. The mother may have a problem of digestion because of pica

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100. The diet that is appropriate in normal pregnancy should be high in
A. Protein, minerals, and vitamins
B. Carbohydrates and vitamins
C. Proteins, carbohydrates, and fats
D. Fats and minerals

101. You want to perform a pelvic examination on one of your pregnant clients. You prepare your client
for the procedure by:
A. Asking her to void
B. Taking her vital signs and recording the readings
C. Giving the client a perineal care
D. Doing a vaginal prep

102. The common normal site of nidation/implantation in the uterus is

A. Upper uterine portion
B. Mid-uterine area
C. Lower uterine segment
D. Lower cervical segment

103. Mrs. Santos is on her 5th pregnancy and has a history of abortion in the 4th pregnancy, and the first
pregnancy was a twin. She is considered to be
A. G 4 P 3
B. G 5 P 3
C. G 5 P 4
D. G 4 P 4

104. Which of the following statements is TRUE of conception?

A. Within 2-4 hours after intercourse, conception is possible in a fertile woman
B. Generally, fertilization is possible 4 days after ovulation
C. Conception is possible during menstruation in a long menstrual cycle
D. To avoid conception, intercourse must be avoided 5 days before and 3 days after menstruation

105. Which of the following are the functions of amniotic fluid?

1. Cushions the fetus from abdominal trauma
2. Serves as the fluid for the fetus
3. Maintains the internal temperature
4. Facilitates fetal movement
A. 1 & 3
B. 1, 3, 4
C. 1, 2, 3
D. All of the above

106. You are performing an abdominal exam on a 9th-month pregnant woman. While lying supine, she
felt breathless, had pallor, tachycardia, and cold clammy skin. The correct assessment of the woman’s
condition is that she is:
A. Experiencing the beginning of labor
B. Having supine hypotension
C. Having sudden elevation of BP
D. Going into shock

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107. Smoking is contraindicated in pregnancy because
A. Nicotine causes vasodilation of the mother’s blood vessels
B. Carbon monoxide binds with the hemoglobin of the mother reducing available hemoglobin for the
fetus
C. The smoke will make the fetus, and the mother feel dizzy
D. Nicotine will cause vasoconstriction of the fetal blood vessels
Carbon monoxide is one of the substances found in cigarette smoke. This substance diminishes the ability of the
hemoglobin to bind with oxygen thus reducing the amount of oxygenated blood reaching the fetus.

108. The nursing measure to relieve fetal distress due to maternal supine hypotension is:
A. Place the mother in semi-Fowler’s position
B. Put the mother on left side lying position
C. Place mother on a knee chest position
D. Any of the above

109. Which of the following is TRUE in Rh incompatibility?

A. The condition can occur if the mother is Rh(+) and the fetus is Rh(-)
B. Every pregnancy of a Rh(-) mother will result to erythroblastosis fetalis
C. On the first pregnancy of the Rh(-) mother, the fetus will not be affected
D. RhoGam is given only during the first pregnancy to prevent incompatibility

110. The lower limit of viability for infants in terms of age of gestation is:
A. 21-24 weeks
B. 25-27 weeks
C. 28-30 weeks
D. 38-40 weeks

111. The normal umbilical cord is composed of:

A. 2 arteries and 1 vein
B. 2 veins and 1 artery
C. 2 arteries and 2 veins
D. none of the above

112. After a Rh(-) mother has delivered her Rh (+) baby, the mother is given RhoGam. This is done in
order to:
A. Prevent the recurrence of Rh(+) baby in future pregnancies
B. Prevent the mother from producing antibodies against the Rh(+) antigen that she may have gotten
when she delivered to her Rh(+) baby
C. Ensure those future pregnancies will not lead to maternal illness
D. To prevent the newborn from having problems of incompatibility when it breastfeeds

113. Which of the following are signs of ovulation?

1. Mittelschmerz;
2. Spinnbarkeit;
3. Thin watery cervical mucus;
4. Elevated body temperature of 4.0 degrees centigrade
A. 1 & 2
B. 1, 2, & 3
C. 3 & 4
D. 1, 2, 3, 4

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114. Which of the following is a TRUE statement about normal ovulation?
A. It occurs on the 14th day of every cycle
B. It may occur between 14-16 days before next menstruation
C. Every menstrual period is always preceded by ovulation
D. The most fertile period of a woman is 2 days after ovulation

115. A woman is considered to be menopause if she has experienced cessation of her menses for a period
of
A. 6 months
B. 12 months
C. 18 months
D. 24 months

116. The foramen ovale closes because the:

a. Arterial pressures in the lungs are higher than in the body.
b. Presence of slight hypoxia and acidosis causes constriction.
c. Blood flow through it is redirected through the liver.
d. Pressure in the left atrium is higher than in the right.

117. Which woman should receive Rho(D) immune globulin after birth?
a. Rh-negative mother, Rh-positive infant, positive direct Coombs’ test
b. Rh-positive mother, Rh-negative infant, negative direct Coombs’ test
c. Rh-negative mother, Rh-positive infant, negative direct Coombs’ test
d. Rh-positive mother, Rh-positive infant, positive direct Coombs’ test

118. The neonatal circulation differs from the fetal circulation because
A. The fetal lungs are non-functioning as an organ and most of the blood in the fetal circulation is mixed
blooD.
B. The blood at the left atrium of the fetal heart is shunted to the right atrium to facilitate its passage to the lungs
C. The blood in the left side of the fetal heart contains oxygenated blood while the blood on the right side
contains unoxygenated blooD.
D. None of the above

1. A nurse is performing an assessment of a primipara who is being evaluated in a clinic during her
second trimester of pregnancy. Which of the following indicates an abnormal physical finding
necessitating further testing?
A. Consistent increase in fundal height
B. Fetal heart rate of 180 BPM
C. Braxton Hicks contractions
D. Quickening

2. A nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The
physician has documented the presence of a Goodell’s sign. The nurse determines this sign indicates:
A. A softening of the cervix
B. A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus.
C. The presence of hCG in the urine
D. The presence of fetal movement

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3. A nursing instructor asks a nursing student who is preparing to assist with the assessment of a
pregnant client to describe the process of quickening. Which of the following statements if made by the
student indicates an understanding of this term?
A. “It is the irregular, painless contractions that occur throughout pregnancy.”
B. “It is the soft blowing sound that can be heard when the uterus is auscultated.”
C. “It is the fetal movement that is felt by the mother.”
D. “It is the thinning of the lower uterine segment.”

4. A nurse midwife is performing an assessment of a pregnant client and is assessing the client for the
presence of ballottement. Which of the following would the nurse implement to test for the presence of
ballottement?
A. Auscultating for fetal heart sounds
B. Palpating the abdomen for fetal movement
C. Assessing the cervix for thinning
D. Initiating a gentle upward tap on the cervix

5. The nurse recognizes that an expected change in the hematologic system that occurs during the
2nd trimester of pregnancy is:
A. A decrease in WBC’s
B. In increase in hematocrit
C. An increase in blood volume
D. A decrease in sedimentation rate

6. The nurse is aware than an adaptation of pregnancy is an increased blood supply to the pelvic region
that results in a purplish discoloration of the vaginal mucosa, which is known as:
A. Ladin’s sign
B. Hegar’s sign
C. Goodell’s sign
D. Chadwick’s sign

7. An expected cardiopulmonary adaptation experienced by most pregnant women is:

A. Tachycardia
B. Dyspnea at rest
C. Progression of dependent edema
D. Shortness of breath on exertion

8. Which of the following conditions is common in pregnant women in the 2nd trimester of pregnancy?
A. Mastitis
B. Metabolic alkalosis
C. Physiologic anemia
D. Respiratory acidosis

9. A nurse is caring for a client in labor. The nurse determines that the client is beginning in the second
stage of labor when which of the following assessments is noted?
A. The client begins to expel clear vaginal fluid
B. The contractions are regular
C. The membranes have ruptured
D. The cervix is dilated completely

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10. A nurse in the labor room is caring for a client in the active phases of labor. The nurse is assessing the
fetal patterns and notes a late deceleration on the monitor strip. The most appropriate nursing action is
to:
A. Place the mother in the supine position
B. Document the findings and continue to monitor the fetal patterns
C. Administer oxygen via face mask
D. Increase the rate of Pitocin IV infusion

11. A nurse is performing an assessment of a client who is scheduled for a cesarean delivery. Which
assessment finding would indicate a need to contact the physician?
A. Fetal heart rate of 180 beats per minute
B. White blood cell count of 12,000
C. Maternal pulse rate of 85 beats per minute
D. Hemoglobin of 11.0 g/Dl

12. A client in labor is transported to the delivery room and is prepared for a cesarean delivery. The
client is transferred to the delivery room table, and the nurse places the client in the:
A. Trendelenburg’s position with the legs in stirrups
B. Semi-Fowler position with a pillow under the knees
C. Prone position with the legs separated and elevated
D. Supine position with a wedge under the right hip

13. A nurse is beginning to care for a client in labor. The physician has prescribed an IV infusion of
Pitocin. The nurse ensures that which of the following is implemented before initiating the infusion?
A. Placing the client on complete bed rest
B. Continuous electronic fetal monitoring
C. An IV infusion of antibiotics
D. Placing a code cart at the client’s bedside

14. A nurse is monitoring a client in active labor and notes that the client is having contractions every 3
minutes that last 45 seconds. The nurse notes that the fetal heart rate between contractions is 100 BPM.
Which of the following nursing actions is most appropriate?
A. Encourage the client’s coach to continue to encourage breathing exercises
B. Encourage the client to continue pushing with each contraction
C. Continue monitoring the fetal heart rate
D. Notify the physician or nurse midwife

15. A nurse is reviewing the record of a client in the labor room and notes that the nurse midwife has
documented that the fetus is at (-1) station. The nurse determines that the fetal presenting part is:
A. 1 cm above the ischial spine
B. 1 fingerbreadth below the symphysis pubis
C. 1 inch below the coccyx
D. 1 inch below the iliac crest

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16. A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the
umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as
signs of:
A. Hematoma
B. Placenta previa
C. Uterine atony
D. Placental separation

17. A client arrives at a birthing center in active labor. Her membranes are still intact, and the nurse-
midwife prepares to perform an amniotomy. A nurse who is assisting the nurse-midwife explains to the
client that after this procedure, she will most likely have:
A. Less pressure on her cervix
B. Increased efficiency of contractions
C. Decreased number of contractions
D. The need for increased maternal blood pressure monitoring

18. A nurse is caring for a client in the second stage of labor. The client is experiencing uterine
contractions every 2 minutes and cries out in pain with each contraction. The nurse recognizes this
behavior as:
A. Exhaustion
B. Fear of losing control
C. Involuntary grunting
D. Valsalva’s maneuver

19. A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing
labor. The nurse is reviewing the physician’s orders and would expect to note which of the following
prescribed treatments for this condition?
A. Medication that will provide sedation
B. Increased hydration
C. Oxytocin (Pitocin) infusion
D. Administration of a tocolytic medication

20. A nurse in the labor room is preparing to care for a client with hypertonic uterine dysfunction. The
nurse is told that the client is experiencing uncoordinated contractions that are erratic in their frequency,
duration, and intensity. The priority nursing intervention would be to:
A. Monitor the Pitocin infusion closely
B. Provide pain relief measures
C. Prepare the client for an amniotomy
D. Promote ambulation every 30 minutes

21. A nurse in the delivery room is assisting with the delivery of a newborn infant. After the delivery of the
newborn, the nurse assists in delivering the placenta. Which observation would indicate that the placenta
has separated from the uterine wall and is ready for delivery?
A. The umbilical cord shortens in length and changes in color
B. A soft and boggy uterus
C. Maternal complaints of severe uterine cramping
D. Changes in the shape of the uterus

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22. A client is admitted to the birthing suite in early active labor. The priority nursing intervention on the
admission of this client would be:
A. Auscultating the fetal heart
B. Taking an obstetric history
C. Asking the client when she last ate
D. Ascertaining whether the membranes were ruptured

23. A client who is gravida 1, para 0 is admitted in labor. Her cervix is 100% effaced, and she is dilated to
3 cm. Her fetus is at +1 station. The nurse is aware that the fetus’ head is:
A. Not yet engaged
B. Entering the pelvic inlet
C. Below the ischial spines
D. Visible at the vaginal opening

24. The physician asks the nurse the frequency of a laboring client’s contractions. The nurse assesses the
client’s contractions by timing from the beginning of one contraction:
A. Until the time it is completely over
B. To the end of a second contraction
C. To the beginning of the next contraction
D. Until the time that the uterus becomes very firm

25. A laboring client complains of low back pain. The nurse replies that this pain occurs most when the
position of the fetus is:
A. Breech
B. Transverse
C. Occiput anterior
D. Occiput posterior

26. A client arrives at the hospital in the second stage of labor. The fetus’ head is crowning, the client is
bearing down, and the birth appears imminent. The nurse should:
A. Transfer her immediately by stretcher to the birthing unit
B. Tell her to breathe through her mouth and not to bear down
C. Instruct the client to pant during contractions and to breathe through her mouth
D. Support the perineum with the hand to prevent tearing and tell the client to pant

27. Which of the following fetal positions is most favorable for birth?
A. Vertex presentation
B. Transverse lie
C. Frank breech presentation
D. Posterior position of the fetal head

28. A laboring client is in the first stage of labor and has progressed from 4 to 7 cm in cervical dilation. In
which of the following phases of the first stage does cervical dilation occur most rapidly?
A. Preparatory phase
B. Latent phase
C. Active phase
D. Transition phase

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29. A multiparous client who has been in labor for 2 hours states that she feels the urge to move her
bowels. How should the nurse respond?
A. Let the client get up to use the potty
B. Allow the client to use a bedpan
C. Perform a pelvic examination
D. Check the fetal heart rate

30. Labor is a series of events affected by the coordination of the five essential factors. One of these is the
passenger (fetus). Which are the other four factors?
A. Contractions, passageway, placental position and function, pattern of care
B. Contractions, maternal response, placental position, psychological response
C. Passageway, contractions, placental position, and function, psychological response
D. Passageway, placental position and function, paternal response, psychological response

31. Fetal presentation refers to which of the following descriptions?

A. Fetal body part that enters the maternal pelvis first
B. Relationship of the presenting part to the maternal pelvis
C. Relationship of the long axis of the fetus to the long axis of the mother
D. A classification according to the fetal part

32. Upon completion of a vaginal examination on a laboring woman, the nurse records 50%, 6 cm, -1.
Which of the following is a correct interpretation of the data?
A. Fetal presenting part is 1 cm above the ischial spines
B. Effacement is 4 cm from completion
C. Dilation is 50% completed
D. Fetus has achieved passage through the ischial spines

33. Which of the following urinary symptoms does the pregnant woman most frequently experience
during the first trimester?
A. Dysuria
B. Frequency
C. Incontinence
D. Burning

34. Heartburn and flatulence, common in the second trimester, are most likely the result of which of the
following?
A. Increased plasma HCG levels
B. Decreased intestinal motility
C. Decreased gastric acidity
D. Elevated estrogen levels

35. On which of the following areas would the nurse expect to observe chloasma?
A. Breast, areola, and nipples
B. Chest, neck, arms, and legs
C. Abdomen, breast, and thighs
D. Cheeks, forehead, and nose

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36. A pregnant client states that she “waddles” when she walks. The nurse’s explanation is based on
which of the following as the cause?
A. The large size of the newborn
B. Pressure on the pelvic muscles
C. Relaxation of the pelvic joints
D. Excessive weight gain

37. Which of the following represents the average amount of weight gained during pregnancy?
A. 12 to 22 lb
B 15 to 25 lb
C. 24 to 30 lb
D. 25 to 40 lb

38. When talking with a pregnant client who is experiencing aching swollen, leg veins, the nurse would
explain that this is most probably the result of which of the following?
A. Thrombophlebitis
B. Pregnancy-induced hypertension
C. Pressure on blood vessels from the enlarging uterus
D. The force of gravity pulling down on the uterus

39. Cervical softening and uterine souffle are classified as which of the following?
A. Diagnostic signs
B. Presumptive signs
C. Probable signs
D. Positive signs

40. Which of the following would the nurse identify as a presumptive sign of pregnancy?
A. Hegar sign
B. Nausea and vomiting
C. Skin pigmentation changes
D. Positive serum pregnancy test

41. During which of the following would the focus of classes be mainly on physiologic changes, fetal
development, sexuality, during pregnancy, and nutrition?
A. Prepregnant period
B. First trimester
C. Second trimester
D. Third trimester

42. Which of the following characteristics of contractions would the nurse expect to find in a client
experiencing true labor?
A. Occurring at irregular intervals
B. Starting mainly in the abdomen
C. Gradually increasing intervals
D. Increasing intensity with walking

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43. During which of the following stages of labor would the nurse assess “crowning”?
A. First stage
B. Second stage
C. Third stage
D. Fourth stage

44. Immediately before expulsion, which of the following cardinal movements occur?
A. Descent
B. Flexion
C. Extension
D. External rotation

45. 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

46. During a pelvic exam, the nurse notes a purple-blue tinge of the cervix. The nurse documents this as
which of the following?
A. Braxton-Hicks sign
B. Chadwick’s sign
C. Goodell’s sign
D. McDonald’s sign

47. The nurse understands that the fetal head is in which of the following positions with a face
presentation?
A. Completely flexed
B. Completely extended
C. Partially extended
D. Partially flexed

48. A client has a mid pelvic contracture from a previous pelvic injury due to a motor vehicle accident as
a teenager. The nurse is aware that this could prevent a fetus from passing through or around which
structure during childbirth?
A. Symphysis pubis
B. Sacral promontory
C. Ischial spines
D. Pubic arch

49. The hormone responsible for a positive pregnancy test is:

A. Estrogen
B. Progesterone
C. Human Chorionic Gonadotropin
D. Follicle Stimulating Hormone

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50. The most common normal position of the fetus in utero is:
A. Transverse position
B. Vertical position
C. Oblique position
D. None of the above

51. In the later part of the 3rd trimester, the mother may experience shortness of breath. This complaint
maybe explained as:
A. A normal occurrence in pregnancy because the fetus is using more oxygen
B. The fundus of the uterus is high pushing the diaphragm upwards
C. The woman is having allergic reaction to the pregnancy and its hormones
D. The woman maybe experiencing complication of pregnancy

52. Which of the following findings in a woman would be consistent with a pregnancy of two months
duration?
A. Weight gain of 6-10 lbs. And the presence of striae gravidarum
B. Fullness of the breast and urinary frequency
C. Braxton Hicks contractions and quickening
D. Increased respiratory rate and ballottement

53. Which of the following is a positive sign of pregnancy?

A. Fetal movement felt by mother
B. Enlargement of the uterus
C. (+) pregnancy test
D. (+) ultrasound

54. What event occurring in the second trimester helps the expectant mother to accept the pregnancy?
A. Lightening
B. Ballotment
C. Pseudocyesis
D. Quickening

55. Which of the following signs will require a mother to seek immediate medical attention?
A. When the first fetal movement is felt
B. No fetal movement is felt on the 6th month
C. Mild uterine contraction
D. Slight dyspnea on the last month of gestation

56. The nursing intervention to relieve “morning sickness” in a pregnant woman is by giving
A. Dry carbohydrate food like crackers
B. Low sodium diet
C. Intravenous infusion
D. Antacid

57. A pregnant woman asks the nurse about skin changes during her pregnancy. The nurse tells her that:
a. The striae will fade to silvery lines.
b. Sunshine will help lighten the melasma.
c. The linea nigra will darken over time.
d. Women with dark skin tones have less hyperpigmentation.

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58. The most apropriate time for the nurse to assist a laboring woman to push is:
a. During the interval between contractions.
b. During first-stage labor.
c. During second-stage labor.
d. Whenever she feels the need.

59. The abbreviation LOA means that the fetal occiput is:
a. On the examiner’s left and in the front of the pelvis.
b. In the left front part of the mother’s pelvis.
c. Anterior to the fetal breech.
d. Lower than the fetal breech.

60. Choose the most reliable evidence that true labor has begun.
a. Regular contractions that occur every 15 minutes
b. Change in the amount of cervical thinning
c. Increased ease of breathing with frequent urination
d. A sudden urge to do household tasks

61. Choose the abbreviation that represents the fetal presentation and position that is most favorable for
vaginal birth.
a. LOA
b. RMP
c. LST
d. ROP

62. A station of +1 means that the:

a. Maternal cervix is open 1 cm.
b. Mother’s ischial spines project into her pelvis 1 cm.
c. Fetus is unlikely to be born vaginally because the pelvis is small.
d. Fetal presenting part is 1 cm below the mother’s ischial spines.

63. Bloody show differs from active vaginal bleeding in that bloody show:
a. Quickly clots on the perineal pad.
b. Is dark red and mixed with mucus.
c. Flows freely during vaginal examination.
d. Decreases in quantity as labor progresses.

64. A woman’s membranes rupture during a contraction. The priority nursing action is to:
a. Assess the fetal heart rate.
b. Note the color of the discharge.
c. Check the woman’s vital signs.
d. Determine whether the fluid has a foul odor.

65. When palpating labor contractions, the nurse should:

a. Use the palm of one hand while palpating the lower uterus.
b. Avoid palpating during the period of maximum intensity.
c. Place the fingertips over the fundus of the uterus.
d. Limit palpation to three consecutive contractions.

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66. The nurse notes the following contraction pattern.
Beginning of Contraction End of Contraction
11:15:00 11:15:40
11:20:00 11:20:45
11:24:00 11:24:50
11:28:30 11:29:10
11:33:00 11:33:35

Choose the correct documentation for the pattern.

a. Contractions every 4 to 5 minutes, duration 35 to 50 seconds
b. Contractions every 5 minutes, duration 35 to 40 seconds
c. Contractions every 3 to 5 minutes, duration 30 to 50 seconds
d. Contractions every 3 to 4 minutes, duration 30 to 40 seconds

67. A woman having her first baby has been observed for 2 hours for labor but is having false labor
contractions. Choose the most appropriate teaching before she returns home.
a. “It is unlikely that your labor will be fast, so you can stay home until your water breaks.”
b. “If your water breaks, you can wait until contractions are 5 minutes apart or closer.”
c. “As long as the baby is active, there is no hurry to return to the birth center.”
d. “Your contractions will usually be 5 minutes apart or closer for 1 hour if labor is really happening.”

68. When checking a woman’s fundus 24 hours after the cesarean birth of her first baby, the nurse finds
her fundus at the level of her umbilicus, firm, and in the midline. The appropriate nursing action related
to this assessment is to:
a. Document the normal assessment.
b. Determine when she last urinated.
c. Limit her intake of oral fluids.
d. Massage her fundus vigorously.

69. The nurse places one hand above the symphysis pubis during uterine massage to:
a. Make the massage more comfortable for the woman.
b. Increase the effectiveness of the procedure.
c. Help prevent the uterus from inverting.
d. Help determine the firmness of the uterus.

70. A client asks the nurse what was meant when the physician told her she had a positive Chadwick’s
sign. Which of the following information about the finding would be appropriate for the nurse to convey
at this time?
1. “It is a purplish stretch mark on your abdomen.”
2. “It means that you are having heart palpitations.”
3. “It is a bluish coloration of your cervix and vagina.”
4. “It means the doctor heard abnormal sounds when you breathed in.”

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71. A client enters the prenatal clinic. She states that she believes she is pregnant. Which of the following
hormone elevations will indicate a high probability that the client is pregnant?
1. Chorionic gonadotropin.
2. Oxytocin.
3. Prolactin.
4. Luteinizing hormone.

72. The nurse notes each of the following findings in a 12-week gestation client. Which of the findings
would enable the nurse to tell the client that she is positively pregnant?
1. Fetal heart rate via Doppler.
2. Positive pregnancy test.
3. Positive Chadwick’s sign.
4. Montgomery gland enlargements.

73. The nurse midwife tells a client that the baby is growing and that ballottement was evident during the
vaginal examination. How should the nurse explain what the nurse midwife means by ballottement?
1. The nurse midwife saw that the mucus plug was intact.
2. The nurse midwife felt the baby rebound after being pushed.
3. The nurse midwife palpated the fetal parts through the uterine wall.
4. The nurse midwife assessed that the baby is head down.

74. The following are skin changes in pregnancy EXCEPT:

A. Chloasma
B. Striae gravidarum
C. Linea negra
D. Chadwick’s sign

75. The cervical dilatation taken at 8:00 AM in a G1P0 patient was 6 centimeters. A repeat I.E. done at 10
A. M. showed that cervical dilation was 7 cm. The correct interpretation of this result is:
A. Labor is progressing as expected
B. The latent phase of Stage 1 is prolonged
C. The active phase of Stage 1 is protracted
D. The duration of labor is normal

76. The fetal heart rate is checked following rupture of the bag of waters in order to:
A. Check if the fetus is suffering from head compression
B. Determine if cord compression followed the rupture
C. Determine if there is uteroplacental insufficiency
D. Check if fetal presenting part has adequately descended following the rupture

77. The primary power involved in labor and delivery is

A. Bearing down ability of mother
B. Cervical effacement and dilatation
C. Uterine contraction
D. Valsalva technique

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78. The proper technique to monitor the intensity of a uterine contraction is
A. Place the palm of the hands on the abdomen and time the contraction
B. Place the fingertips lightly on the suprapubic area and time the contraction
C. Put the tip of the fingers lightly on the fundal area and try to indent the abdominal wall at the height
of the contraction
D. Put the palm of the hands on the fundal area and feel the contraction at the fundal area

79. To monitor the frequency of the uterine contraction during labor, the right technique is to time the
contraction
A. From the beginning of one contraction to the end of the same contraction
B. From the beginning of one contraction to the beginning of the next contraction
C. From the end of one contraction to the beginning of the next contraction
D. From the deceleration of one contraction to the acme of the next contraction

80. When determining the duration of a uterine contraction the right technique is to time it from
A. The beginning of one contraction to the end of the same contraction
B. The end of one contraction to the beginning of another contraction
C. The acme point of one contraction to the acme point of another contraction
D. The beginning of one contraction to the end of another contraction

81. When the bag of waters ruptures, the nurse should check the characteristic of the amniotic fluiD. The
normal color of amniotic fluid is
A. Clear as water
B. Bluish
C. Greenish
D. Yellowish

82. The mechanisms involved in fetal delivery is

A. Descent, extension, flexion, external rotation
B. Descent, flexion, internal rotation, extension, external rotation
C. Flexion, internal rotation, external rotation, extension
D. Internal rotation, extension, external rotation, flexion

83. The first thing that a nurse must ensure when the baby’s head comes out is
A. The cord is intact
B. No part of the cord is encircling the baby’s neck
C. The cord is still attached to the placenta
D. The cord is still pulsating

84. What are the important considerations that the nurse must remember after the placenta is delivered?
1.Check if the placenta is complete including the membranes
2.Check if the cord is long enough for the baby
3.Check if the umbilical cord has 3 blood vessels
4.Check if the cord has a meaty portion and a shiny portion
A. 1 and 3
B. 2 and 4
C. 1, 3, and 4
D. 2 and 3

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85. The following are correct statements about false labor EXCEPT
A. The pain is irregular in intensity and frequency.
B. The duration of contraction progressively lengthens over time
C. There is no bloody vaginal discharge
D. The cervix is still closeD.

86. The passageway in labor and delivery of the fetus include the following EXCEPT
A. Distensibility of lower uterine segment
B. Cervical dilatation and effacement
C. Distensibility of vaginal canal and introitus
D. Flexibility of the pelvis

87. At what stage of labor and delivery does a primigravida differ mainly from a multigravida?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4

88. The second stage of labor begins with ___ and ends with __?
A. Begins with full dilatation of cervix and ends with delivery of placenta
B. Begins with true labor pains and ends with delivery of baby
C. Begins with complete dilatation and effacement of cervix and ends with delivery of baby
D. Begins with passage of show and ends with full dilatation and effacement of cervix

89. The following are signs that the placenta has detached EXCEPT:
A. Lengthening of the cord
B. Uterus becomes more globular
C. Sudden gush of blood
D. Mother feels like bearing down

90. When the baby’s head is out, the immediate action of the nurse is
A. Cut the umbilical cord
B. Wipe the baby’s face and suction mouth first
C. Check if there is cord coiled around the neck
D. Deliver the anterior shoulder

91.The main parameter to evaluate normal progress of labor is:

a. rate of cervical dilation
b. fetal distress
c. number of hours since the rupture of membranes maternal condition

92.Formation of the mucous plug is caused by which one of the following cervical Changes:
a. Hyperplasia of the mucosal glands
b. Increased vascularity of cervical tissue
c. Softening of the cervical tissue
d. Edema of the endocervical canal

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93.First Stage of Labor:
a. It is the period from complete dilatation of the cervix to birth of the baby.
b. It is the period from the contractions to complete dilatation of the cervix.
c. It is the period from birth of the baby through delivery of the placenta
d. It is the period from the delivery of the placenta until the uterus remains firm on its own.

94.The fetal heart rate (FHTs) should be checked in the second stage of labor:
a. Every 5 minutes .
b. Every 15 minutes
c. Every 10 minutes.
d. Every 30 minutes.

95.All of the following is malpresentation Except:

a. Breech presentation.
b. Brow presentation.
c. Vertex presentation.
d. Face presentation.

96.In true labor, the contractions:

a- Are irregular and do not increase in frequency
b- Produce progressive dilation and effacement of the cervix.
c- Do not produce progressive dilatation and effacement
d- Relieved by mild analgesics.

97. Which of the following would be considered as a probable signs of pregnancy?

a. Cessation of menstruation
b. Braxton Hicks contraction
c. Nausea and vomiting
d. Fetal heart beat

98. What is the type of lochia would you expect to find when you assessing a woman gave a birth 2 days
ago
a. Lochia rubra
b. Lochia serosa
c. Lochia alba
d. All of the above

99.True labor can be differentiated from False labor is that true labor is:
a. Progress of uterine contraction and cervical dilation.
b. Failure of presenting to descend.
c. Lack of cervical effacement or dilation
d. Cessation of uterine contraction with walking

100.The span of time, during which the female sex organs return to the pregnancy position is:
a. 6 weeks
b. 6 months.
c. 2 weeks
d. During the first year after delivery.

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101.A female client experience amenorrhea, nausea, urinary frequency, and breast tenderness with
respect to pregnancy, these signs are known as:
a. Expected signs.
b. Presumptive signs.
c. Probable signs.
d. Positive signs.

102.midwifery nursing care during Labor includes:

a. Recording fluid and food intake.
b. Observing character of patient's contractions and checking vital signs.
c. Observing fetal heart rate.
d. B & c only.
e. All the above.

103.Skin changes that occur during pregnancy are:

a. Linea nigra and striea gravid arum
b. Chlosma gravid arum
c. Darkening of breast areola
d. All of the above.

104.Pain perception during labor depend on the followings:

a. Expectations.
b. Fear and anxiety.
c. Cultural and social experience.
d. Personality.
e. All the above.

105.which type of anemia is mostly common during pregnancy:

a. Anemia due to folic acid deficiency.
b. Sickle cell anemia.
c. Iron deficiency anemia.
d. Anemia due to infection

106.Lie refers to:

a. How deep the baby's head has dropped into the pelvis.
b. The relation of the long axis of the baby to that of the mother.
c. The baby's head being on the right or left side of the mother.
d. How long it takes for the baby to move down the birth canal.

107.Fatma age 38 and pregnant with her third child, asks the nurse for information about diabetic
changes in pregnancy . Which one of the following is true regarding insulin/glucose metabolism during
pregnancy:
a. Anti-insulin enzymes antagonize maternal insulin to facilitate glucose transfer to the fetus
b. Maternal insulin crosses the placenta and stimulates fetal pancreatic receptor sites
c. Maternal insulin demand is decreased due to the mother’s decreased ability to utilize her won insulin .
d. Fetal glucose reserves are augmented by the transplacental shift of maternal insulin/glucose units .

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108.Your patient is 10 weeks pregnant, she complains to you for having to get up during the night to
urinate . You would tell her
a. A lot of women experience frequent urination in early pregnancy . It’s annoying , but normal.”
b. It sounds like you have an urinary tract infection”
c. You might have a urethral constriciton”
d. If you decrease your fluid intake, you won’t have to get up during the night to urinate”

109.At birth ،Baby’s heart rate was 126. she cried vigorously, actively moved
her arms and legs, pulled her head back when the midwife tried to suction her nose with a bulb syringe,
and had blue hands and feet . What is Baby Apgar score
a. 7
b. 8
c. 9
d. 10

110.All of the following is characteristic of puerperium except?

a. The generative organs return almost to their pre-pregnant state
b. Lactation is initiated and established
c. The involution of the uterus does not occur in this period
d. The mother recovers from the physical and emotional stress of labour

111.Lochia rubra is red in color, it is the period extends from:

a. First day only
b. First 3-4 days
c. The 5th –9th days
d. After 10 days

112.Occipito posterior is :
A. Mal presentation.
B. Mal position.
C. Mal lie.
D. Mal attitude.

113.The physician orders intermittent fetal heart rate monitoring for a 20-year-old obese primigravid
client at 40 weeks’ gestation who is admitted to the birthing center in the first stage of labor. The nurse
should monitor the client’s fetal heart rate pattern at which of the following intervals?
a. Every 15 minutes during the latent phase.
b. Every 30 minutes during the active phase.
c. Every 60 minutes during the initial phase.
d. Every 2 hours during the transition phase.

114.Assessment of a primigravid client in active labor who has had no analgesia or anesthesia reveals
complete cervical effacement, dilation of 8 cm, and the fetus at 0 station. The nurse should expect the
client to exhibit which of the following behaviors during this phase of labor:
a. Excitement.
b. Loss of control.
c. Numbness of the legs.
d. Feelings of relief.

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115.The Mechanisms of labor are:
a. External Rotation, Expulsion, engagement and flexion.
b. Engagement, Descent, Flexion, internal rotation, extension, external rotation
c. descent, Engagement, flexion, internal rotation, extension, external rotation, and expulsion.
d. Engagement, flextion descent, internal rotation extension, external rotation and expulsion.

116.The physician plans to perform an amniotomy on a multiparous client admitted to the labor area at
41 weeks’ gestation for labor induction. After the amniotomy, the nurse should first:
a. Monitor the client’s contraction pattern.
b. Assess the fetal heart rate (FHR) for 1 full minute.
c. Assess the client’s temperature and pulse.
d. Document the color of the amniotic fluid.

117.While the nurse is caring for a multiparous client in active labor at 36 weeks’ gestation, the client
tells the nurse, “I think my water just broke.” Which of the following should the nurse do first ?
a. Turn the client to the right side.
b. Assess the color, amount, and odor of the fluid.
c. Assess the fetal heart rate pattern.
d. Check the client’s cervical dilation.

118.A nurse is caring for a woman who is being evaluated for a suspected malpresentation. The fetus’s
long axis is lying across the maternal abdomen, and the con-tour of the abdomen is elongated. Which
should be the nurse’s documentation of the lie of the fetus:
a. Vertex
b. Breech
c. Transverse
d. Brow

119.A client presents with regular contractions that she describes as strong in intensity. Her cervical
exam indi-cates that she is dilated to 3 cm. This information should suggest to a nurse that the client is
experiencing:
a. early labor.
b. false labor.
c. cervical ripening.
d. lightening.

120.A nurse is assisting in the delivery of a term new-born. Immediately after delivery of the placenta, the
nurse palpates the uterine fundus and finds that it is firm and located halfway between the client’s
umbili-cus and symphysis pubis. Which action should the nurse take based on the assessment findings:
a. Immediately begin to massage the uterus
b. Document the findings
c. Assess for bladder distension
d. Monitor the client closely for increased vaginal bleeding

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121.While performing Leopold’s maneuvers on a woman in labor, the nurse palpates a hard round mass
in the fundal area, a flat surface on the left side, small objects on the right side, and a soft round mass
just above the symphysis. Which of the fol-lowing is a reasonable conclusion by the nurse:
a. The fetal position is transverse.
b. The fetal presentation is vertex.
c. The fetal lie is vertical.
d. The fetal attitude is flexed

122.The nurse is assessing the fetal station during a vaginal examination. Which of the following
structures should the nurse palpate:
a. Sacral promontory.
b. Ischial spines.
c. Cervix.
d. Symphysis pubis.

123.The labor and delivery nurse performs Leopold’s maneuvers. A soft round mass is felt in the fundal
region. A flat object is noted on the left and small objects are noted on the right of the uterus. A hard
round mass is noted above the symphysis. Which of the following positions is consistent with these
findings:
a. Left occipital anterior (LOA)
b. Left sacral posterior (LSP)
c. Right mentum anterior (RMA)
d. Right sacral posterior (RSP)

124.During a vaginal examination, the nurse palpates fetal buttocks that are facing the left posterior and
are 1 cm above the ischial spines. Which of the following is consistent with this assessment?
a. LOA -1 station.
b. LSP -1 station.
c. LMP +1 station.
d. LSA +1 station.

125.On examination, it is noted that a full-term primipara in active labor is right occipi-toanterior
(ROA), 7 cm dilated, and +3 station. Which of the following should the nurse report to the physician?
a. Descent is progressing well.
b. Fetal head is not yet engaged.
c. Vaginal delivery is imminent.
d. External rotation is complete.

126.A nurse determines that a client is carrying a fetus in the vertical lie. The nurse’s judgment should be
questioned if the fetal presenting part is which of the following?
a. Sacrum.
b. Occiput.
c. Mentum.
d. Scapula

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127.During delivery, the nurse notes that the baby’s head has just been delivered. The nurse concludes
that the baby has just gone through which of the following cardinal moves of labor?
a. Flexion.
b. Internal rotation.
c. Extension.
d. External rotation.

128.A client is in the third stage of labor. Which of the following assessments should the nurse
make/observe for?
a. Fetal heart assessment after each contraction.
b. Uterus rising in the abdomen and feeling globular.
c. Rapid cervical dilation to ten centimeters.
d. Maternal complaints of intense rectal pressure.

129.A client in labor is talkative and happy. How many centimeters dilated would a maternity nurse
suspect that the client is at this time?
a. 2 cm.
b. 4 cm.
c. 8 cm.
d. 10 cm.

130.A nurse concludes that a woman is in the latent phase of labor. Which of the fol-lowing
signs/symptoms would lead a nurse to that conclusion?
a. The woman talks and laughs during contractions.
b. The woman complains about severe back labor.
c. The woman performs effleurage during a contraction.
d. The woman asks to go to the bathroom to defecate.

131.which of the following are true about transitional phase of first stage of labour :
a. Uterine contractions are usually 1.5-2 min apart and lasting 40 seconds
b. This phase is generally the most difficult one of all stages of labour
c. The mother begin to loss of control
d. Non of the above are true

132.which of the following systems is the last system return to pre pregnant state :
a. The reproductive system
b. The musculoskeletal system
c. The urinary system
d. The cardiovascular system

133.which of the following hormones are increase in puerperium period :

a. Oxytocin
b. Estrogen
c. Prolactine
d. A & C are correct

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134. As soon as the placenta is delivered, the nurse must do which of the following actions?
A. Inspect the placenta for completeness including the membranes
B. Place the placenta in a receptacle for disposal
C. Label the placenta properly
D. Leave the placenta in the kidney basin for the nursing aide to dispose properly

135. This drug is usually given parentally to enhance uterine contraction:

A. Terbutaline
B. Pitocin
C. Magnesium sulfate
D. Lidocaine

136. At what stage of labor is the mother is advised to bear down?

A. When the mother feels the pressure at the rectal area
B. During a uterine contraction
C. In between uterine contraction to prevent uterine rupture
D. Anytime the mother feels like bearing down

137. The normal dilatation of the cervix during the first stage of labor in a nullipara is
A. 1.2 cm./hr
B. 1.5 cm./hr.
C. 1.8 cm./hr
D. 2.0 cm./hr

138. When the fetal head is at the level of the ischial spine, it is said that the station of the head is
A. Station –1
B. Station “0”
C. Station +1
D. Station +2

139. During an internal examination, the nurse palpated the posterior fontanel to be at the left side of the
mother at the upper quadrant. The interpretation is that the position of the fetus is:
A. LOA
B. ROP
C. LOP
D. ROA

140. When the nurse palpates the suprapubic area of the mother and found that the presenting part is
still movable, the right term for this observation that the fetus is
A. Engaged
B. Descended
C. Floating
D. Internal Rotation

141. Which finding would the nurse view as normal when evaluating the laboratory reports of a 34-week
gestation client?
1. Anemia.
2. Thrombocytopenia.
3. Polycythemia.
4. Hyperbilirubinemia.

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142.A female client experience amenorrhea, nausea, urinary frequency, and breast tenderness with
respect to pregnancy, these signs are known as:
a. Expected signs.
b. Presumptive signs.
c. Probable signs.
d. Positive signs

143.these indications of pregnancy are mainly subjective :

a. Presumptive
b. Probable
c. Positive
d. None of the above

144.it's a softening of the lower uterine segment at 6-8 weeks of pregnancy :

a. Goodell's sign
b. Ballottement
c. Hegar's sign
d. Chadwick sign

145.which of the following signs are presumptive indications of pregnancy :

a. Quickening sign
b. Braxton hicks contractions
c. Ballottement
d. B & C are correct

146.it's the strongest Probable indication of pregnancy :

a. Positive HCG test
b. Ballottement
c. Braxton hicks contraction
d. Abdominal enlargement

147.all the following are true about physiological changes that occurs in pregnancy Except :
a. The normal weight gain are 11.5-16kg for normal maternal pre pregnant weight
b. Pregnancy can initiate DM
c. Uterus dilates and enlarge mainly in left side
d. Total volume of circulating RBC mass increases by 250-450 ml

148.all the following are true about physiological changes that occurs in pregnancy Except :
a. Pregnant women usually have respiratory alkalosis
b. Pancreatic enzymes are increased
c. Pigmentation changes occur as MSH is elevated from second month of pregnancy until birth
d. Increased production of aldosterone

149.is called hormone of pregnancy and should be maintained at high level in order to maintain
pregnancy :
a. Estrogen
b. Progesterone
c. HCG
d. A &B are correct

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150. Which the following are true about frequency of urination during pregnancy :
a. It increases in early weeks of pregnancy and decreased until birth
b. It increases in early weeks of pregnancy and decreased in mid pregnancy and return to increases in
late of pregnancy
c. It decreased in early weeks of pregnancy and increases in mid pregnancy until birth
d. It decreased along the pregnancy

151.A nurse is in the room during a physician’s examina-tion of a client who thinks that she may be
pregnant. Which findings during the examination support a possibility of pregnancy?
a. Increased hyperplasia and hypertrophy in thebreasts
b. Vaginal atrophy
c. Decrease in respiratory tidal volume
d. Increase in hemoglobin

152.If a pregnant woman is at 20 weeks gestation, at what level should a clinic nurse expect to palpate the
woman’s uterine height?
e. Two finger-breadths above the symphysis pubis
f. Halfway between the symphysis pubis and the umbilicus
g. At the umbilicus
h. Two finger-breadths above the umbilicus

153.A pregnant woman asks a nurse, who is teaching a prepared childbirth class, when she should expect
to feel fetal movement. The nurse responds that fetal movement usually can be first felt between which
time frame?
a. 8 and 12 weeks of pregnancy
b. 12 and 16 weeks of pregnancy
c. 18 and 20 weeks of pregnancy
d. 22 and 26 weeks of pregnancy

154.A nurse should recommend which suggested weight gain for a woman who is in the ideal weight
range before becoming pregnant?
a. Less than 15 lb
b. 15–25 lb
c. 25–35 lb
d. 35–45 lb

155. The placenta should be delivered normally within ___ minutes after the delivery of the baby.
A. 5 minutes
B. 30 minutes
C. 45 minutes
D. 60 minutes

156. A 31-year-old multipara is admitted to the birthing room after initial examination reveals her cervix
to be at 8 cm, completely effaced (100 %), and at 0 station. What phase of labor is she in?
A. Active phase
B. Latent phase
C. Expulsive phase
D. Transitional phase

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157. For a patient in active labor, the nurse-midwife plans to use an internal electronic fetal monitoring
(EFM) device. What must occur before the internal EFM can be applied?
A. The membranes must rupture
B. The fetus must be at 0 station
C. The cervix must be dilated fully
D. The patient must receive anesthesia

158. The nurse in charge is caring for a patient who is in the first stage of labor. What is the shortest but
most difficult part of this stage?
A. Active phase
B. Complete phase
C. Latent phase
D. Transitional phase

159. The nurse is developing a teaching plan for a patient who is 8 weeks pregnant. The nurse should tell
the patient that she can expect to feel the fetus move at which time?
A. Between 10 and 12 weeks’ gestation
B. Between 16 and 20 weeks’ gestation
C. Between 21 and 23 weeks’ gestation
D. Between 24 and 26 weeks’ gestation

160. A patient is in the second stage of labor. During this stage, how frequently should the nurse in charge
assess her uterine contractions?
A. Every 5 minutes
B. Every 15 minutes
C. Every 30 minutes
D. Every 60 minutes

161. After completing a second vaginal examination of a client in labor, the nurse-midwife determines
that the fetus is in the right occiput anterior position and at (–1) station. Based on these findings, the
nurse-midwife knows that the fetal presenting part is:
A. 1 cm below the ischial spines.
B. directly in line with the ischial spines.
C. 1 cm above the ischial spines.
D. in no relationship to the ischial spines.

162. A client who’s admitted to labor and delivery has the following assessment findings: gravida 2 para
1, estimated 40 weeks gestation, contractions 2 minutes apart, lasting 45 seconds, vertex +4 station.
Which of the following would be the priority at this time?
A. Placing the client in bed to begin fetal monitoring.
B. Preparing for immediate delivery.
C. Checking for ruptured membranes.
D. Providing comfort measures.

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163. The multigravida mother with a history of rapid labor who us in active labor calls out to the nurse,
“The baby is coming!” which of the following would be the nurse’s first action?
A. Inspect the perineum
B. Time the contractions
C. Auscultate the fetal heart rate
D. Contact the birth attendant

164. When performing a PP 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. Document the findings
B. Notify the physician
C. Reassess the client in 2 hours
D. Encourage increased intake of fluids.

165. A PP 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:
A. One the day of the delivery
B. 3 days PP
C. 7 days PP
D. within 2 weeks PP

166. A nurse is caring for a PP woman who has received epidural anesthesia and is monitoring the
woman for the presence of a vulva 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

167. A nurse is monitoring a new mother in the PP period for signs of hemorrhage. Which of the
following signs, if noted in the mother, would be an early sign of excessive blood loss?
A. A temperature of 100.4*F
B. An increase in the pulse from 88 to 102 BPM
C. An increase in the respiratory rate from 18 to 22 breaths per minute
D. A blood pressure change from 130/88 to 124/80 mm Hg

168. A nurse is preparing to assess the uterine fundus of a client in the immediate postpartum period.
When the nurse locates the fundus, she notes that the uterus feels soft and boggy. Which of the following
nursing interventions would be most appropriate initially?
A. Massage the fundus until it is firm
B. Elevate the mother’s legs
C. Push on the uterus to assist in expressing clots
D. Encourage the mother to void

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169. A nurse performs an assessment on a client who is 4 hours PP. The nurse notes that the client has
cool, clammy skin and is restless and excessively thirsty. The nurse prepares immediately to:
A. Assess for hypovolemia and notify the health care provider
B. Begin hourly pad counts and reassure the client
C. Begin fundal massage and start oxygen by mask
D. Elevate the head of the bed and assess vital signs

170. On completing a fundal assessment, the nurse notes the fundus is situated on the client’s left
abdomen. Which of the following actions is appropriate?
A. Ask the client to empty her bladder
B. Straight catheterize the client immediately
C. Call the client’s health provider for direction
D. Straight catheterize the client for half of her uterine volume

171. Which of the following findings would be expected when assessing the postpartum client?
A. Fundus 1 cm above the umbilicus 1 hour postpartum
B. Fundus 1 cm above the umbilicus on a postpartum day 3
C. Fundus palpable in the abdomen at 2 weeks postpartum
D. Fundus slightly to the right; 2 cm above umbilicus on postpartum day 2

172. On which of the postpartum days can the client expect lochia serosa?
A. Days 3 and 4 PP
B. Days 3 to 10 PP
C. Days 10-14 PP
D. Days 14 to 42 PP

173. Which of the following complications may be indicated by continuous seepage of blood from the
vagina of a PP client, when palpation of the uterus reveals a firm uterus 1 cm below the umbilicus?
A. Retained placental fragments
B. Urinary tract infection
C. Cervical laceration
D. Uterine atony

174. Which of the following complications is most likely responsible for a delayed postpartum
hemorrhage?
A. Cervical laceration
B. Clotting deficiency
C. Perineal laceration
D. Uterine subinvolution

175. Which of the following physiological responses is considered normal in the early postpartum period?
A. Urinary urgency and dysuria
B. Rapid diuresis
C. Decrease in blood pressure
D. Increase motility of the GI system

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176. Which of the following circumstances is most likely to cause uterine atony and lead to PP
hemorrhage?
A. Hypertension
B. Cervical and vaginal tears
C. Urine retention
D. Endometritis

177. Which type of lochia should the nurse expect to find in a client 2 days PP?
A. Foul-smelling
B. Lochia serosa
C. Lochia alba
D. Lochia rubra

178. 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. 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

179. The nurse examines a woman one hour after birth. The woman’s fundus is boggy, midline, and 1 cm
below the umbilicus. Her lochial flow is profuse, with two plum-sized clots. The nurse’s initial action
would be to:
A. Place her on a bedpan to empty her bladder
B. Massage her fundus
C. Call the physician
D. Administer Methergine 0.2 mg IM which has been ordered prn

180. A postpartum patient was in labor for 30 hours and had ruptured membranes for 24 hours. For which
of the following would the nurse be alert?
A. Endometritis
B. Endometriosis
C. Salpingitis
D. Pelvic thrombophlebitis

181. Normal lochial findings in the first 24 hours post-delivery include:

A. Bright red blood
B. Large clots or tissue fragments
C. A foul odor
D. The complete absence of lochia

182. Which change would the nurse identify as a progressive physiological change in the postpartum
period?
A. Lactation
B. Lochia
C. Uterine involution
D. Diuresis

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183. Which of the following may happen if the uterus becomes overstimulated by oxytocin during the
induction of labor?
A. Weak contraction prolonged to more than 70 seconds
B. Tetanic contractions prolonged to more than 90 seconds
C. Increased pain with bright red vaginal bleeding
D. Increased restlessness and anxiety

184. Which of the following amounts of blood loss following birth marks the criterion for describing
postpartum hemorrhage?
A. More than 200 ml
B. More than 300 ml
C. More than 400 ml
D. More than 500 ml

185. Before assessing the postpartum client’s uterus for firmness and position in relation to the umbilicus
and midline, which of the following should the nurse do first?
A. Assess the vital signs
B. Administer analgesia
C. Ambulate her in the hall
D. Assist her to urinate

186. The nurse assesses the vital signs of a client, 4 hours’ postpartum that are as follows: BP 90/60;
temperature 100.4ºF; pulse 100 weak, thready; R 20 per minute. Which of the following should the nurse
do first?
A. Report the temperature to the physician
B. Recheck the blood pressure with another cuff
C. Assess the uterus for firmness and position
D. Determine the amount of lochia

187. The nurse assesses the postpartum vaginal discharge (lochia) on four clients. Which of the following
assessments would warrant notification of the physician?
A. A dark red discharge on a 2-day postpartum client
B. A pink to brownish discharge on a client who is 5 days postpartum
C. Almost colorless to creamy discharge on a client 2 weeks after delivery
D. A bright red discharge 5 days after delivery

188. A postpartum client has a temperature of 101.4ºF, with a uterus that is tender when palpated,
remains unusually large, and not descending as normally expected. Which of the following should the
nurse assess next?
A. Lochia
B. Breasts
C. Incision
D. Urine

189. The mother asks the nurse. “What’s wrong with my son’s breasts? Why are they so enlarged?”
Whish of the following would be the best response by the nurse?
A. “The breast tissue is inflamed from the trauma experienced with birth.”
B. “A decrease in material hormones present before birth causes enlargement,”
C. “You should discuss this with your doctor. It could be a malignancy.”
D. “The tissue has hypertrophied while the baby was in the uterus.”

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190. 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 hours
C. Preparing for a cesarean section for failure to progress
D. Increasing the encouragement to the patient when pushing begins

191. While assessing a G2P2 client who had a normal spontaneous vaginal delivery 30 minutes ago, the
nurse notes a large amount of red vaginal bleeding. What would be the initial priority nursing action?
A. Notify the physician
B. Encourage to breast-feed soon after birth
C. Monitor vital signs
D. Provide fundal massage

192. Postpartum Period:

The fundus of the uterus is expected to go down normally postpartally about __ cm per day.
A. 1.0 cm
B. 2.0 cm
C. 2.5 cm
D. 3.0 cm

193. The lochia on the first few days after delivery is characterized as
A. Pinkish with some blood clots
B. Whitish with some mucus
C. Reddish with some mucus
D. Serous with some brown tinged mucus

194. Lochia normally disappears after how many days postpartum?

A. 5 days
B. 7-10 days
C. 18-21 days
D. 28-30 days

195.The most common cases of anemia in pregnancy is:

a. Folic acid deficiency
b. Iron deficiency
c. Sickle cell
d. Vitamin B12 deficiency

196. A woman who delivered normally per vagina is expected to void within ___ hours after delivery.
A. 3 hrs
B. 4 hrs.
C. 6-8 hrs
D. 12-24 hours

197. Which of the following is an abnormal vital sign in postpartum?

A. Pulse rate between 50-60/min
B. BP diastolic increase from 80 to 95mm Hg
C. BP systolic between 100-120mm Hg
D. Respiratory rate of 16-20/min

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198. The uterine fundus right after delivery of placenta is palpable at
A. Level of Xyphoid process
B. Level of umbilicus
C. Level of symphysis pubis
D. Midway between umbilicus and symphysis pubis

199. A nurse is monitoring the amount of lochia drainage in a client who is 2 hours postpartum and notes
that the client has a saturated a perineal pad in 1 hour. The nurse reports the amount of lochial flow as:
A. Excessive
B. Heavy
C. Light
D. Scanty

200. In a woman who is not breastfeeding, menstruation usually occurs after how many weeks?
A. 2-4 weeks
B. 6-8 weeks
C. 6 months
D. 12 months

201. The following are interventions to make the fundus contract postpartally EXCEPT
A. Make the baby suck the breast regularly
B. Apply ice cap on fundus
C. Massage the fundus vigorously for 15 minutes until contracted
D. Give oxytocin as ordered

202. The following are nursing interventions to relieve episiotomy wound pain EXCEPT
A. Giving analgesic as ordered
B. Sitz bath
C. Perineal heat
D. Perineal care

203. Postpartum blues is said to be normal provided that the following characteristics are present. These
are
1. Within 3-10 days only;
2. Woman exhibits the following symptoms- episodic tearfulness, fatigue, oversensitivity, poor appetite;
3. Maybe more severe symptoms in primipara
A. All of the above
B. 1 and 2
C. 2 only
D. 2 and 3

204. A woman who is 4 hours postpartum ambulates to the bathroom and suddenly has a large gush of
lochia rubra. The nurse’s first action should be to:
a. Determine whether the bleeding slows to normal or remains as a large volume.
b. Observe vital signs for signs of hypovolemic shock.
c. Check to see what her previous lochia flow has been.
d. Identify the type of pain relief that was given when she was in labor.

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205. To help the postpartum woman avoid constipation, the nurse should teach her to:
a. Avoid intake of foods such as milk, cheese, or yogurt.
b. Take a laxative for the first 3 postpartum days.
c. Drink at least 1600 mL of noncaffeinated fluids daily.
d. Limit her walking until the episiotomy is fully healed.

206. The infant of a diabetic mother is prone to hypoglycemia because:

a. Liver conversion of glycogen to glucose is sluggish.
b. Excess subcutaneous fat interferes with the use of insulin.
c. High insulin production rapidly metabolizes glucose.
d. Vulnerability to infections increases metabolic stress.

207. At what APGAR score at 5 minutes after birth should resuscitation be initiated?
A. 1-3
B. 7-8
C. 9-10
D. 6-7

208. Right after birth, when the skin of the baby’s trunk is pinkish but the soles of the feet and palm of
the hands are bluish this is called:
A. Syndactyly
B. Acrocyanosis
C. Peripheral cyanosis
D. Cephalo-caudal cyanosis

209. A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe
preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client
for:
A. Any bleeding, such as in the gums, petechiae, and purpura.
B. Enlargement of the breasts
C. Periods of fetal movement followed by quiet periods
D. Complaints of feeling hot when the room is cool

210. A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has
been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client
regarding management of care. Which statement, if made by the client, indicates a need for further
education?
A. “I will maintain strict bedrest throughout the remainder of the pregnancy.”
B. “I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of
bleeding.”
C. “I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the
pad.”
D. “I will watch for the evidence of the passage of tissue.”

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211. A homecare nurse visits a pregnant client who has a diagnosis of mild Preeclampsia and who is being
monitored for pregnancy induced hypertension (PIH). Which assessment finding indicates a worsening of
the Preeclampsia and the need to notify the physician?
A. Blood pressure reading is at the prenatal baseline
B. Urinary output has increased
C. The client complains of a headache and blurred vision
D. Dependent edema has resolved

212. A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational
diabetes. Which statement if made by the client indicates a need for further education?
A. “I need to stay on the diabetic diet.”
B. “I will perform glucose monitoring at home.”
C. “I need to avoid exercise because of the negative effects of insulin production.”
D. “I need to be aware of any infections and report signs of infection immediately to my health care provider.”

213. A primigravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension
(PIH). The nurse who is caring for the client is performing assessments every 30 minutes. Which
assessment finding would be of most concern to the nurse?
A. Urinary output of 20 ml since the previous assessment
B. Deep tendon reflexes of 2+
C. Respiratory rate of 10 BPM
D. Fetal heart rate of 120 BPM

214. A nurse is caring for a pregnant client with Preeclampsia. The nurse prepares a plan of care for the
client and documents in the plan that if the client progresses from Preeclampsia to eclampsia, the nurse’s
first action is to:
A. Administer magnesium sulfate intravenously
B. Assess the blood pressure and fetal heart rate
C. Clean and maintain an open airway
D. Administer oxygen by face mask

215. A nurse is monitoring a pregnant client with pregnancy induced hypertension who is at risk for
Preeclampsia. The nurse checks the client for which specific signs of Preeclampsia (select all that apply)?
A. Elevated blood pressure
B. Negative urinary protein
C. Facial edema
D. Increased respirations

216. A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse
determines the client is experiencing toxicity from the medication if which of the following is noted on
assessment?
A. Presence of deep tendon reflexes
B. Serum magnesium level of 6 mEq/L
C. Proteinuria of +3
D. Respirations of 10 per minute

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217. A woman with preeclampsia is receiving magnesium sulfate. The nurse assigned to care for the client
determines that the magnesium therapy is effective if:
A. Ankle clonus in noted
B. The blood pressure decreases
C. Seizures do not occur
D. Scotomas are present

218. Which of the following symptoms occurs with a hydatidiform mole?

A. Heavy, bright red bleeding every 21 days
B. Fetal cardiac motion after 6 weeks gestation
C. Benign tumors found in the smooth muscle of the uterus
D. “Snowstorm” pattern on ultrasound with no fetus or gestational sac

219. A 21-year old client, 6 weeks’ pregnant is diagnosed with hyperemesis gravidarum. This excessive
vomiting during pregnancy will often result in which of the following conditions?
A. Bowel perforation
B. Electrolyte imbalance
C. Miscarriage
D. Pregnancy induced hypertension (PIH)

220. Clients with gestational diabetes are usually managed by which of the following therapies?
A. Diet
B. NPH insulin (long-acting)
C. Oral hypoglycemic drugs
D. Oral hypoglycemic drugs and insulin

221. The antagonist for magnesium sulfate should be readily available to any client receiving IV
magnesium. Which of the following drugs is the antidote for magnesium toxicity?
A. Calcium gluconate
B. Hydralazine (Apresoline)
C. Narcan
D. RhoGAM

222. A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant
following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor
the client for which of the following risks associated with placenta previa?
A. Disseminated intravascular coagulation
B. Chronic hypertension
C. Infection
D. Hemorrhage

223. A nurse in the labor room is performing a vaginal assessment on a pregnant client in labor. The
nurse notes the presence of the umbilical cord protruding from the vagina. Which of the following would
be the initial nursing action?
A. Place the client in Trendelenburg’s position
B. Call the delivery room to notify the staff that the client will be transported immediately
C. Gently push the cord into the vagina
D. Find the closest telephone and stat page the physician

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224. A maternity nurse is caring for a client with abruptio placenta and is monitoring the client for
disseminated intravascular coagulopathy. Which assessment finding is least likely to be associated with
disseminated intravascular coagulation?
A. Swelling of the calf in one leg
B. Prolonged clotting times
C. Decreased platelet count
D. Petechiae, oozing from injection sites, and hematuria

225. A nurse is assessing a pregnant client in the 2nd trimester of pregnancy who was admitted to the
maternity unit with a suspected diagnosis of abruptio placentae. Which of the following assessment
findings would the nurse expect to note if this condition is present?
A. Absence of abdominal pain
B. A soft abdomen
C. Uterine tenderness/pain
D. Painless, bright red vaginal bleeding

226. A maternity nurse is preparing for the admission of a client in the 3rd trimester of pregnancy that is
experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the
physician’s orders and would question which order?
A. Prepare the client for an ultrasound
B. Obtain equipment for external electronic fetal heart monitoring
C. Obtain equipment for a manual pelvic examination
D. Prepare to draw a Hgb and Hct blood sample

227. An ultrasound is performed on a client at term gestation that is experiencing moderate vaginal
bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on these
findings, the nurse would prepare the client for:
A. Complete bed rest for the remainder of the pregnancy
B. Delivery of the fetus
C. Strict monitoring of intake and output
D. The need for weekly monitoring of coagulation studies until the time of delivery

228. A nurse in a labor room is assisting with the vaginal delivery of a newborn infant. The nurse would
monitor the client closely for the risk of uterine rupture if which of the following occurred?
A. Hypotonic contractions
B. Forceps delivery
C. Schultz delivery
D. Weak bearing down efforts

229. Which measure would be least effective in preventing postpartum hemorrhage?

A. Administer Methergine 0.2 mg every 6 hours for 4 doses as ordered
B. Encourage the woman to void every 2 hours
C. Massage the fundus every hour for the first 24 hours following birth
D. Teach the woman the importance of rest and nutrition to enhance healing

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230. 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.

231. A nurse is preparing to perform a fundal assessment on a postpartum client. The initial nursing
action in performing this assessment is which of the following?
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.

232. The nurse is assessing the lochia on a 1 day PP patient. The nurse notes that the lochia is red and has
a foul-smelling odor. 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

233. The nurse is about the give a Type 2 diabetic her insulin before breakfast on her first day postpartum.
Which of the following answers best describes insulin requirements immediately postpartum?
A. Lower than during her pregnancy
B. Higher than during her pregnancy
C. Lower than before she became pregnant
D. Higher than before she became pregnant

234. Which of the following changes best described the insulin needs of a client with type 1 diabetes who
has just delivered an infant vaginally without complications?
A. Increase
B. Decrease
C. Remain the same as before pregnancy
D. Remain the same as during pregnancy

235. A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells
the client that the usual treatment for partial placenta previa is which of the following?
A. Activity limited to bed rest
B. Platelet infusion
C. Immediate cesarean delivery
D. Labor induction with oxytocin

236. Which of the following would the nurse most likely expect to find when assessing a pregnant client
with abruption placenta?
A. Excessive vaginal bleeding
B. Rigid, board-like abdomen
C. Titanic uterine contractions
D. Premature rupture of membranes

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237. A patient in her 14th week of pregnancy has presented with abdominal cramping and vaginal
bleeding for the past 8 hours. She has passed several clots. What is the primary nursing diagnosis for this
patient?
A. Knowledge deficit
B. Fluid volume deficit
C. Anticipatory grieving
D. Pain

238. A patient with pregnancy-induced hypertension probably exhibits which of the following symptoms?
A. Proteinuria, headaches, vaginal bleeding
B. Headaches, double vision, vaginal bleeding
C. Proteinuria, headaches, double vision
D. Proteinuria, double vision, uterine contractions

239. 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.”

240. A client makes a routine visit to the prenatal clinic. Although she is 14 weeks pregnant, the size of
her uterus approximates that in an 18- to 20-week pregnancy. Dr. Charles diagnoses gestational
trophoblastic disease and orders ultrasonography. The nurse expects ultrasonography to reveal:
A. an empty gestational sac.
B. grapelike clusters.
C. a severely malformed fetus.
D. an extrauterine pregnancy.

241. A 39-year-old at 37 weeks gestation is admitted to the hospital with complaints of vaginal bleeding
following the use of cocaine 1 hour earlier. Which complication is most likely causing the client’s
complaint of vaginal bleeding?
A. Placenta previa
B. Abruptio placentae
C. Ectopic pregnancy
D. Spontaneous abortion

242. When administering magnesium sulfate to a client with preeclampsia, the nurse understands that this
drug is given to:
A. Prevent seizures
B. Reduce blood pressure
C. Slow the process of labor
D. Increase dieresis

243. 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

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244. Which of the following statements best describes hyperemesis gravidarum?
A. Severe anemia leading to an electrolyte, metabolic, and nutritional imbalances in the absence of other
medical problems.
B. Severe nausea and vomiting leading to an electrolyte, metabolic, and nutritional imbalances in the
absence of other medical problems.
C. Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately decreasing
maternal nutrients
D. Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding

245. Which of the following would the nurse identify as a classic sign of PIH?
A. Edema of the feet and ankles
B. Edema of the hands and face
C. Weight gain of 1 lb/week
D. Early morning headache

246. In which of the following types of spontaneous abortions would the nurse assess dark brown vaginal
discharge and a negative pregnancy test?
A. Threatened
B. Imminent
C. Missed
D. Incomplete

247. Which of the following factors would the nurse suspect as predisposing a client to placenta previa?
A. Multiple gestation
B. Uterine anomalies
C. Abdominal trauma
D. Renal or vascular disease

248. Which of the following would the nurse assess in a client experiencing abruptio placenta?
A. Bright red, painless vaginal bleeding
B. Concealed or external dark red bleeding
C. Palpable fetal outline
D. Soft and nontender abdomen

249. Which of the following is described as premature separation of a normally implanted placenta
during the second half of pregnancy, usually with severe hemorrhage?
A. Placenta previa
B. Ectopic pregnancy
C. Incompetent cervix
D. Abruptio placentae

250. When PROM occurs, which of the following provides evidence of the nurse’s understanding of the
client’s immediate needs?
A. The chorion and amnion rupture 4 hours before the onset of labor.
B. PROM removes the fetus most effective defense against infection
C. Nursing care is based on fetal viability and gestational age.
D. PROM is associated with malpresentation and possibly incompetent cervix

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251. When uterine rupture occurs, which of the following would be the priority?
A. Limiting hypovolemic shock
B. Obtaining blood specimens
C. Instituting complete bed rest
D. Inserting a urinary catheter

252. Which of the following is the nurse’s initial action when umbilical cord prolapse occurs?
A. Begin monitoring maternal vital signs and FHR
B. Place the client in a knee-chest position in bed
C. Notify the physician and prepare the client for delivery
D. Apply a sterile warm saline dressing to the exposed cord

253. Which of the following best describes thrombophlebitis?

A. Inflammation and clot formation that result when blood components combine to form an aggregate body
B. Inflammation and blood clots that eventually become lodged within the pulmonary blood vessels
C. Inflammation and blood clots that eventually become lodged within the femoral vein
D. Inflammation of the vascular endothelium with clot formation on the vessel wall

254. Which of the following assessment findings would the nurse expect if the client develops DVT?
A. Midcalf pain, tenderness and redness along the vein
B. Chills, fever, malaise, occurring 2 weeks after delivery
C. Muscle pain the presence of Homans sign, and swelling in the affected limb
D. Chills, fever, stiffness, and pain occurring 10 to 14 days after delivery

255. A client in her third trimester tells the nurse, “I’m constipated all the time!” Which of the following
should the nurse recommend?
A. Daily enemas
B. Laxatives
C. Increased fiber intake
D. Decreased fluid intake

256. 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

257. A client 12 weeks’ pregnant come to the emergency department with abdominal cramping and
moderate vaginal bleeding. Speculum examination reveals 2 to 3 cm cervical dilation.The nurse would
document these findings as which of the following?
A. Threatened abortion
B. Imminent abortion
C. Complete abortion
D. Missed abortion

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258. Which of the following would be the priority nursing diagnosis for a client with an ectopic
pregnancy?
A. Risk for infection
B. Pain
C. Knowledge Deficit
D. Anticipatory Grieving

259. A client with severe preeclampsia is admitted with of BP 160/110, proteinuria, and severe pitting
edema. Which of the following would be most important to include in the client’s plan of care?
A. Daily weights
B. Seizure precautions
C. Right lateral positioning
D. Stress reduction

260. A multigravida at 38 weeks’ gestation is admitted with painless, bright red bleeding and mild
contractions every 7 to 10 minutes. Which of the following assessments should be avoided?
A. Maternal vital sign
B. Fetal heart rate
C. Contraction monitoring
D. Cervical dilation

261. Which of the following would be the nurse’s most appropriate response to a client who asks why she
must have a cesarean delivery if she has a complete placenta previa?
A. “You will have to ask your physician when he returns.”
B. “You need a cesarean to prevent hemorrhage.”
C. “The placenta is covering most of your cervix.”
D. “The placenta is covering the opening of the uterus and blocking your baby.”

262. With a fetus in the left anterior breech presentation, the nurse would expect the fetal heart rate
would be most audible in which of the following areas?
A. Above the maternal umbilicus and to the right of midline
B. In the lower-left maternal abdominal quadrant
C. In the lower-right maternal abdominal quadrant
D. Above the maternal umbilicus and to the left of midline

263. The amniotic fluid of a client has a greenish tint. The nurse interprets this to be the result of which
of the following?
A. Lanugo
B. Hydramnios
C. Meconium
D. Vernix

264. A patient is in labor and has just been told she has a breech presentation. The nurse should be
particularly alert for which of the following?
A. Quickening
B. Ophthalmia neonatorum
C. Pica
D. Prolapsed umbilical cord

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265. Which of the following signs and symptoms will most likely make the nurse suspect that the patient
has hydatidiform mole?
A. Slight bleeding
B. Passage of clear vesicular mass per vagina
C. Absence of fetal heart beat
D. Enlargement of the uterus

266. Upon assessment, the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last
menstrual period (LMP) 5 months ago, fetal heart beat (FHB) not appreciated. Which of the following is
the most possible diagnosis of this condition?
A. Hydatidiform mole
B. Missed abortion
C. Pelvic inflammatory disease
D. Ectopic pregnancy

267. When a pregnant woman goes into a convulsive seizure, the MOST immediate action of the nurse to
ensure the safety of the patient is:
A. Apply restraint so that the patient will not fall out of bed
B. Put a mouth gag so that the patient will not bite her tongue and the tongue will not fall back
C. Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration
D. Check if the woman is also having a precipitate labor

268. A gravidocardiac mother is advised to observe bed rest primarily to

A. Allow the fetus to achieve normal intrauterine growth
B. Minimize oxygen consumption which can aggravate the condition of the compromised heart of the
mother
C. Prevent perinatal infection
D. Reduce incidence of premature labor

269. Which of the following signs will distinguish threatened abortion from imminent abortion?
A. Severity of bleeding
B. Dilation of the cervix
C. Nature and location of pain
D. Presence of uterine contraction

270. To prevent preterm labor from progressing, drugs are usually prescribed to halt the labor. The
drugs commonly given are:
A. Magnesium sulfate and terbutaline
B. Prostaglandin and oxytocin
C. Progesterone and estrogen
D. Dexamethasone and prostaglandin

271. In placenta praevia marginalis, the placenta is found at the:

A. Internal cervical os partly covering the opening
B. External cervical os slightly covering the opening
C. Lower segment of the uterus with the edges near the internal cervical os
D. Lower portion of the uterus completely covering the cervix

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272. In which of the following conditions can the causative agent pass through the placenta and affect the
fetus in utero?
A. Gonorrhea
B. Rubella
C. Candidiasis
D. moniliasis

273. Before giving a repeat dose of magnesium sulfate to a pre-eclamptic patient, the nurse should assess
the patient’s condition. Which of the following conditions will require the nurse to temporarily suspend a
repeat dose of magnesium sulfate?
A. 100 cc. urine output in 4 hours
B. Knee jerk reflex is (+)2
C. Serum magnesium level is 10mEg/L.
D. Respiratory rate of 16/min

274. The preferred manner of delivering the baby in a gravido-cardiac is vaginal delivery assisted by
forceps under epidural anesthesiA. The main rationale for this is:
A. To allow atraumatic delivery of the baby
B. To allow a gradual shifting of the blood into the maternal circulation
C. To make the delivery effort free and the mother does not need to push with contractions
D. To prevent perineal laceration with the expulsion of the fetal head

275. Upon assessment, the nurse got the following findings: 2 perineal pads highly saturated with blood
within 2 hours postpartum, PR= 80 bpm, fundus soft and boundaries not well defineD. The appropriate
nursing diagnosis is:
A. Normal blood loss
B. Blood volume deficiency
C. Inadequate tissue perfusion related to hemorrhage
D. Hemorrhage secondary to uterine atony

276. When the bag of waters ruptures spontaneously, the nurse should inspect the vaginal introitus for
possible cord prolapse. If there is part of the cord that has prolapsed into the vaginal opening the correct
nursing intervention is:
A. Push back the prolapsed cord into the vaginal canal
B. Place the mother on semi fowlers position to improve circulation
C. Cover the prolapsed cord with sterile gauze wet with sterile NSS and place the woman in
Trendelenburg position
D. Push back the cord into the vagina and place the woman on sims position

277. The neonate of a mother with diabetes mellitus is prone to developing hypoglycemia because:
A. The pancreas is immature and unable to secrete the needed insulin
B. There is rapid diminution of glucose level in the baby’s circulating blood and his pancreas is normally
secreting insulin
C. The baby is reacting to the insulin given to the mother
D. His kidneys are immature leading to a high tolerance for glucose

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278. When the uterus is firm and contracted after delivery but there is vaginal bleeding, the nurse should
suspect
A. Laceration of soft tissues of the cervix and vagina
B. Uterine atony
C. Uterine inversion
D. Uterine hypercontractility

279. When assessing the adequacy of sperm for conception to occur, which of the following is the most
useful criterion?
A. Sperm count
B. Sperm motility
C. Sperm maturity
D. Semen volume

280. When teaching a client about contraception. Which of the following would the nurse include as the
most effective method for preventing sexually transmitted infections?
A. Spermicides
B. Diaphragm
C. Condoms
D. Vasectomy

281. Oral contraceptive pills are of different types. Which type is most appropriate for mothers who are
breastfeeding?
A. Estrogen-only
B. Progesterone only
C. Mixed type- estrogen and progesterone
D. 21-day pills mixed type

282. Infertility can be attributed to male causes such as the following EXCEPT:
A. Cryptorchidism
B. Orchitis
C. Sperm count of about 20 million per milliliter
D. Premature ejaculation

283. Vasectomy is a procedure done on a male for sterilization. The organ involved in this procedure is
A. Prostate gland
B. Seminal vesicle
C. Testes
D. Vas deferens

284. Choose the primary distinction between threatened and inevitable abortion.
a. Presence of cramping
b. Rupture of membranes
c. Vaginal bleeding
d. Pelvic pressure

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285. A woman is admitted to the emergency department with a possible ectopic pregnancy. Choose the
sign or symptom that should be immediately reported to her physician.
a. Low level of beta-hCG (human chorionic gonadotropin)
b. Hemoglobin level, 11.5 g/dL; hematocrit level, 34%
c. Light vaginal bleeding
d. Pulse rate increases from 78 to 112 beats per minute (bpm)

286. When caring for a woman who has had gestational trophoblastic tissue evacuated, the clinic nurse’s
priority intervention is to:
a. Reinforce the need to delay a new pregnancy for 1 year.
b. Ask the woman whether she has any cramping or bleeding.
c. Observe return of her blood pressure to normal.
d. Palpate the uterus for return to its normal size.

287. The woman who is receiving methotrexate for an ectopic pregnancy should be cautioned to avoid:
a. Driving or operating machinery.
b. Eating raw vegetables or fruits.
c. Using latex condoms for intercourse.
d. Taking vitamins with folic acid.

288. The nurse makes the following assessments of a woman who is receiving intravenous magnesium
sulfate: fetal heart rate (FHR), 148 to 158 bpm; pulse, 88 bpm; respirations, 9 breaths/min; blood
pressure, 158/96 mm Hg. The woman is drowsy. The priority nursing action is to:
a. Increase the rate of the magnesium infusion.
b. Maintain the magnesium infusion at the current rate.
c. Slow the rate of the magnesium infusion.
d. Stop the magnesium infusion.

289. When providing intrapartum care for the woman with severe preeclampsia, priority nursing care is
to:
a. Maintain the ordered rate of anticonvulsant medications.
b. Promote placental blood flow and prevent maternal injury.
c. Give intravenous fluids and observe urine output.
d. Reduce maternal blood pressure to the prepregnancy level.

290. The feature that distinguishes preeclampsia from eclampsia is the:

a. Amount of blood pressure elevation.
b. Edema of the face and fingers.
c. Presence of 41 proteinuria.
d. Onset of one or more seizures.

291. The test used to screen for gestational diabetes is the:

a. Glycosylated hemoglobin test.
b. Glucose challenge test.
c. Oral glucose tolerance test.
d. Postprandial glucose test.

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292. The primary fetal risk when the mother has any type of anemia is for:
a. Neonatal anemia.
b. Elevated bilirubin level.
c. Limited infection defenses.
d. Reduced oxygen delivery.

293. The nurse notes that a woman has excess lochia 2 hours after the vaginal birth of an 8-lb baby. The
priority nursing action is to:
a. Catheterize her to check urine output.
b. Check her blood pressure, pulse, and respirations.
c. Assess the firmness of her uterus.
d. Notify her physician or nurse-midwife.

294. Which of the following lab values should the nurse report to the physician as being consistent with
the diagnosis of HELLP syndrome:
a. Hematocrit 48%.
b. Potassium 5.5 mEq/L.
c. Platelets 75,000.
d. Sodium 130 mEq/L.

295. Which of the following physical findings would lead the nurse to suspect that a client with severe
preeclampsia has developed HELLP syndrome:
a. +3 pitting edema and pulmonary edema.
b. Epigastric pain and systemic jaundice.
c. +4 deep tendon reflexes and clonus.
d. Oliguria and elevated specific gravity.

296. A client is on magnesium sulfate for severe preeclampsia. The nurse must notify the attending
physician regarding which of the following findings:
a. Patellar and biceps reflexes of +3.
b. Urinary output of 30 cc/hr.
c. Respiratory rate of 16 rpm.
d. Serum magnesium level of 9 gm/dL.

297. The nurse is caring for an eclamptic client. Which of the following is an important action for the
nurse to perform:
a. Check each urine for presence of ketones.
b. Pad the client’s bed rails and head board.
c. Provide visual and auditory stimulation.
d. Place the bed in the high Fowler’s position.

298. You are assessing the one minute APGAR score for a newborn. She is pink all over and has a pulse
of 130. As you dry her off she begins to cry vigorously and kick her legs. Her APGAR score is:
a. 10
b. 9
c. 7
d. 8

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299. A neonatal patient has a pink color, a pulse rate of 102, and a respiration rate of 27. She grimaces in
response to stimuli, has limited muscle movement. This patient has an APGAR score of :
a. 8
b. 6
c. 7
d. 4

300. A newborn has a strong cry and is actively moving his blue extremities when stimulated. Vital signs
are P140, R48. What is his APGAR score:
a. 8
b. 6
c. 9
d. 3

301. After assisting in the delivery of a newborn the infant is pale and limp(flaccid), has a slow heartbeat
but shows some respiratory effort. What APGAR score would you give this infant:
a. 5
b. 4
c. 3
d. 2

302. You just delivered a baby boy. His body is pink, but his hands and feet are blue. Vital signs are
P110, R rapid and irregular. He has a weak cry when stimulated and resists attempts to straighten his
legs. His APGAR score is :
a. 7
b. 5
c. 9
d. 6

303. A newly delivered infanthas a pink trunk and blue hands and feet, pulse rate of 60 and does not
respond to your attempts to stimulate her. She also appears to be limp and taking slow, gasping breaths.
What is her APGAR score:
a. 4
b. 5
c. 6
d. 3

304. One minute after birth, your newborn patient is actively crying in response to your bulb syringe. His
body is pink, and he is moving his extremities which are blue. His heart rate is 110. What is the newborns
APGAR score:
a. 10
b. 5
c. 6
d. 9

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305. One of the first symptoms of puerperal infection in post partum woman
a. Fatigue
b. pain
c. Profuse vaginal bleeding
d. Temperature of more than 38c

306. the breast feeding is not recommended for this class of heart disease :
a. Class 2
b. Class 4
c. Class 3
d. Class 3 & class 4

307. Late post partum hemorrhage is mostly caused by:

a. Retained placental parts
b. Uterine Atony
c. Cervical laceration
d. Defective vascularity of the decidua

308. .The most common cause of early post partum hemorrhage is:
a. Atrony of the uterus
b. Lacerations of birth canal
c. Retained placenta
d. Interference with blood coagulation

309. all of the complications listed below are common during the puerperium period EXCET:
a. Mastitis.
b. Endometritis.
c. Hepatitis.
d. Cystitis.

310. the most common cause of male infertility is:

a. Abnormalities of the sperm
b. Hyper prolactinemie
c. Chromosomal abnormalities
d. Hypogonadism

311. All of the followings are causes of Sub-involution of the uterus EXCEPT:
a. Infection
b. Retained products
c. Oligohydramnios
d. Multiparous

312. Which of the followings considered to be causes of post partum hemorrhage:

a. Uterine atony.
b. Retained placental fragments.
c. Laceration of vagina, cervix or perineum.
d. All the above

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313.what is the preferred method of anesthesia for cesarean section :
a. Local anesthesia
b. Epidural anesthesia
c. Spinal anesthesia
d. General anesthesia

314.it is type of cesarean useful when the fetus in transverse lie :

a. Classic
b. Low segment
c. Extra peritoneal
d. Porro operation

315.the operation of choice in cesarean delivery :

a. Porro operation
b. Low segment
c. Extra peritoneal
d. Classic

316. cesarean delivery followed by the removal of uterus :

a. Porro operation
b. Extra peritoneal
c. Classic
d. Low segment

317.the blood loss is greater and the repair is difficult are considered a limitation for this method :
a. Median episiotomy
b. Low segment episiotomy
c. Mediolateral episiotomy
d. Non of the above

318.all the following are prerequisites for application of forceps EXCEPT:

a. No CPD
b. Vertex or face presentation
c. Some form of anesthesia should be used
d. Membrane should be intact

319.all the following are indications for vacuum assistant delivery EXCEPT:
a. PIH
b. Fetal distress
c. Occipito anterior position
d. Abruption placenta

320.forceps are applied after the head has reached the perineal floor :
a. High forceps
b. Low forceps
c. Mid forceps
d. Non of the above

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321. what is the class of women heart disease has slight limitation of physical activity :
a. Class 1
b. Class 2
c. Class 3
d. Class 4

322.absolute bed rest and hospitalization are necessary for which class of heart disease :
a. Class 2
b. Class 4
c. Class 3
d. Class 3 & class 4

323. is the most serious form of postpartum mood disorders :

a. PPD
b. PPP
c. PPH
d. PIH

324. A woman has a history of toxic shock syndrome. She should be taught to avoid which of the
following forms of birth control:
a. Diaphragm.
b. Intrauterine device.
c. Birth control pills (estrogen-progestin combination).
d. Depo-Provera (medroxyprogesterone acetate).

325. Which symptom would the nurse expect to observe in a postpartum client with a vaginal hematoma:
a. Pain.
b. Bleeding.
c. Warmth.
d. Redness.

326.In managing diabetic case during pregnancy. You as a nurse should monitor the following:
a. Blood sugar several times during the day.
b. Insulin requirement may remain the same or increase accordingly.
c. Monitor signs and symptoms of hypoglycemia.
d. All the above.

327.In case of a prolapsed umbilical cord, the nusing actions are:

a. Administer oxygen.
b. Place the women in trendelenburg.
c. Prepare for immediate cesarean section if not fully dilation cx.
d. All the above..

328.A client is diagnosed as a superimposed preeclampsia, how can youy explain this to mother and
family:
1. It is a persistent hypertension of what ever cause before pregnancy.
2. It is the development of preeclampsia or eclampsia in a patient with chronic hypertension.
3. It is developing hypertension during pregnancy.
4. All the above are correct.

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329.In which grade of cardiac disease, the patient complains of orthopnea:
a. Grade I
b. Grade II
c. Grade III
d. Grade IV

330.The main cause of Hyperemesis gravidarum is:

a. Endocrine influence of Adreno-cortical hormones
b. Due to not arranged metabolism of CHO and fats
c. Neurosis
d. Unclear cause

331.Cord prolapse means, that:

a. The cord lies infront of the presenting part and the membranes are intact
b. The cord lies infront of the presenting part and the membranes are ruptured
c. The cord lies along side the presenting part.

332.Amniotic Fluid embolism is characterized by:

a. Immediate respiratory distress occurs with cyanosis
b. Pulmonary edema with exudation of fluid into the legs
c. Rapid heart rate and increase B/P may occur
d. All of the above

333.All the following are possible complications of preeclampsia EXCEPT:

a. Eclampsia.
b. Abruptio placenta.
c. Pulmonary edema.
d. Gestational diabetes.

334.If toxic of magnesium sulfate are reached, which of the following is the antidote:
a. Hydralazine.
b. Calcium glyconate.
c. Dopamine.
d. Apresoline.

335.In case of cord prolapse the most appropriate position to relief pressure is:
a. Knee chest position
b. Semi fowler position
c. Lateral position
d. Squatting position

336.All of the following affect the infant of diabetic mother Except:

a- Hypoglycemia.
b- Respiratory distress
c- Hyperglycemia
d- Macrosomia.

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337.All of the following are a nursing instruction to pregnant woman suffering from nausea and vomiting
during pregnancy are true except:
a. Eats small frequent meals
b. A void hard to digest, greasy foods
c. Eating dry carbohydrates
d. Take more caffeine

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