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A nurse is preparing to administer Pitocin to a laboring client. Which finding would cause the nurse to question the order?
a. Cervix 3 cm dilated and 80% effaced
b. Cervix closed and firm
c. Regular contractions every 3 minutes
d. Postpartum hemorrhage with boggy uterus
b. Cervix closed and firm
Pitocin is contraindicated unless the cervix is ripened.
Which postpartum client would contraindicate the use of Hemabate?
a. Client with history of asthma
b. Client with gestational diabetes
c. Client with hypotension
d. Client with anemia
a. Client with history of asthma
Hemabate causes bronchoconstriction and is contraindicated in asthma.
A nurse is preparing to administer Rhogam. Which client is an appropriate candidate?
a. Rh-positive mother, Rh-negative newborn
b. Rh-negative mother, Rh-positive newborn
c. Rh-negative mother, Rh-negative newborn
d. Rh-positive mother, Rh-positive newborn
b. Rh-negative mother, Rh-positive newborn
Prevents antibodies from forming against fetal blood cells.
Which medications are used to treat postpartum hemorrhage? (Select all that apply)
a. Methergine
b. Hemabate
c. Pitocin
d. Cytotec
e. Betamethasone
a, b, c, d
All four treat postpartum hemorrhage. Betamethasone is for fetal lung maturity.
A client tells the nurse she has been feeling “fluttering” in her abdomen. How should the nurse document this finding?
a. Quickening — a positive sign of pregnancy
b. Quickening — a presumptive sign of pregnancy
c. Ballottement — a probable sign of pregnancy
d. Braxton-Hicks — a positive sign of pregnancy
b. Quickening — a presumptive sign of pregnancy
Felt only by the client = subjective = presumptive.
A postpartum client with severe bleeding is prescribed Methergine IM. Which assessment is the priority before administration?
a. Temperature
b. Blood pressure
c. Uterine tone
d. Hemoglobin level
b. Blood pressure
Methergine is contraindicated in hypertension and can cause stroke.
A nurse is administering misoprostol (Cytotec). Which is the expected effect?
a. Prevents uterine contractions
b. Softens and ripens the cervix
c. Stimulates fetal lung maturity
d. Relieves pain during labor
b. Softens and ripens the cervix
Misoprostol (Cytotec) is used for cervical ripening and labor induction.
When is the MMR vaccine appropriately given to a postpartum client?
a. During pregnancy at 20 weeks
b. Immediately after delivery, before discharge
c. Within 12 hours of labor onset
d. At the first prenatal visit
b. Immediately after delivery, before discharge
MMR is a live vaccine → only given postpartum.
A newborn delivered at 29 weeks gestation develops respiratory distress syndrome. Which medication should the nurse prepare?
a. Vitamin K
b. Survanta
c. Hepatitis B vaccine
d. Ampicillin
b. Survanta
Synthetic surfactant given to premature infants to treat RDS.
Which finding is a positive sign of pregnancy?
a. Nausea and vomiting
b. Palpation of fetal movement by provider
c. Supine hypotension
d. Goodell sign
b. Palpation of fetal movement by provider
Only a provider-confirmed fetal movement, ultrasound, or fetal heart tones are positive signs.
A nurse is caring for a client receiving magnesium sulfate for preeclampsia. Which assessment requires immediate intervention?
a. Urine output of 60 mL/hr
b. Respiratory rate of 10/min
c. Diminished DTRs
d. Serum calcium of 8.6 mg/dL
Respiratory rate of 10/min
Respiratory depression is the most dangerous sign of toxicity. DTRs and calcium may also be low, but RR < 12 is the priority.
A pregnant client at 29 weeks is ordered betamethasone. The nurse explains that the purpose of this medication is to:
a. Induce labor
b. Prevent postpartum hemorrhage
c. Promote fetal lung maturity
d. Prevent preeclampsia seizures
c. Promote fetal lung maturity
Steroid given to mom stimulates surfactant production in fetus.
A newborn is given vitamin K. What is the primary purpose?
a. Stimulate appetite
b. Prevent infection
c. Aid in blood clotting
d. Strengthen bones
c. Aid in blood clotting
Vitamin K prevents hemorrhagic disease.
A nurse is caring for a client receiving magnesium sulfate for severe preeclampsia. The nurse notes absent deep tendon reflexes, a respiratory rate of 10/min, and urine output of 20 mL/hr. Which action should the nurse take first?
a. Decrease the magnesium sulfate infusion by half
b. Administer calcium gluconate IV as prescribed
c. Increase IV fluids to improve urine output
d. Place the client in a high Fowler’s position
Correct Answer:
b. Administer calcium gluconate IV as prescribed
A nurse assesses a pregnant client with bluish-purple discoloration of the cervix. This finding is known as:
a. Hegar sign
b. Chadwick sign
c. Goodell sign
d. Ballottement
b. Chadwick sign
Chadwick = bluish/purplish cervix.
Hegar = softening of lower uterine segment.
Goodell = softening of cervix.
Ballottement = fetus rebounds when tapped.
The nurse is teaching about terbutaline. Which statement by the client indicates correct understanding?
a. “This medication will speed up my contractions.”
b. “I should expect some nervousness and tremors.”
c. “This medicine helps control my high blood pressure.”
d. “I will need to avoid eating while taking this drug.”
b. “I should expect some nervousness and tremors.”
Terbutaline causes jitteriness, palpitations, and hypotension. It delays contractions, not speeds them up.
A client with preterm labor is prescribed nifedipine. What is the priority nursing assessment?
a. Maternal heart rate
b. Maternal blood pressure
c. Uterine tone
d. Fetal position
b. Maternal blood pressure
Nifedipine is a calcium channel blocker → monitor for hypotension.
A newborn of an HBsAg-positive mother should receive which medications?
a. Hepatitis B vaccine only
b. Hepatitis immune globulin only
c. Both hepatitis B vaccine and hepatitis immune globulin
d. No treatment is necessary
c. Both hepatitis B vaccine and hepatitis immune globulin
Baby of Hep B+ mom needs both within 12 hours.
A woman reports nausea, breast tenderness, and urinary frequency. The nurse identifies these as which type of signs of pregnancy?
a. Presumptive
b. Probable
c. Positive
d. Diagnostic
a. Presumptive
a. Presumptive
N/V, breast tenderness, and urinary frequency are subjective (presumptive) signs.
A laboring client received fentanyl. Which finding is the most concerning?
a. Respiratory rate of 8/min
b. Constipation
c. Nausea and vomiting
d. Fatigue
a. Respiratory rate of 8/min
Respiratory depression is the greatest risk with fentanyl.
A postpartum client asks why she is prescribed docusate sodium (Colace). The best nursing response is:
a. “It stimulates your bowels to contract and pass stool quickly.”
b. “It softens your stool to make bowel movements less painful.”
c. “It prevents gas buildup in your intestines.”
d. “It eliminates constipation by increasing peristalsis.”
“It softens your stool to make bowel movements less painful.”
👉 Stool softener = softer stool; not a stimulant like laxatives.
A nurse is caring for a newborn receiving gentamicin. Which complication should be monitored?
a. Nephrotoxicity
b. Hepatotoxicity
c. Ototoxicity
d. Neurotoxicity
c. Ototoxicity
Gentamicin is associated with hearing loss.
Which of the following are considered probable signs of pregnancy? (Select all that apply)
a. Chadwick sign
b. Positive pregnancy test
c. Fetal heart tones by Doppler
d. Ballottement
e. Goodell sign
a, b, d, e
Probable = objective but not diagnostic: Chadwick, positive pregnancy test, ballottement, Goodell.
Fetal heart tones are positive.
The nurse is caring for a client at 36 weeks’ gestation with an amniotic fluid level of 2,200 mL. The nurse should document this as:
a. Normal amniotic fluid volume
b. Oligohydramnios
c. Polyhydramnios
d. Fetal growth restriction
c. Polyhydramnios
>2000 mL at 32–36 weeks = polyhydramnios.
<500 mL = oligohydramnios.