RANDOM
Q1.A client at 20 weeks asks how often she should come in for prenatal visits. Which is the best nurse response?
A. Every week until 28 weeks, then every 2 weeks
B. Every month until 28 weeks, then every 2 weeks until 36 weeks
C. Every 2 weeks until 28 weeks, then weekly until delivery
D. Only as needed unless complications arise
Correct answer: B (Every month until 28 weeks, then every 2 weeks until 36 weeks)
👉 Schedule:
Every 4 weeks (monthly) until 28 weeks
Every 2 weeks from 28–36 weeks
Every week from 36 weeks until delivery
Which of the following is a presumptive sign of pregnancy?
A. Ballottement
B. Positive pregnancy test
C. Amenorrhea
D. Fetal heart tones with Doppler
C. Amenorrhea
A patient in labor is experiencing intense anxiety and expresses fear about the birthing process. Her cultural background influences her expectations. Which of the 'Five P's' of labor is most directly addressed by providing culturally sensitive, patient-centered care?
A.Powers
B.Passenger
C.Position
D.Psyche
D.PsycheThat's right!This component encompasses the pregnant person's psychological response, including cultural values, beliefs, and support systems, which significantly impact the experience of labor.
A nurse is evaluating a fetal heart rate strip and observes fluctuations in the baseline rate of 10-15 beats per minute. This is considered a reassuring sign and should be documented as what type of variability?
a. minimal
b. moderate
c. absent
d. marked
B.Moderate
This range of 6-25 beats per minute indicates a well-oxygenated fetus and is the most reassuring pattern.
Which piece of information can be precisely measured by an internal Intrauterine Pressure Catheter (IUPC) but only estimated by external palpation?
A.Presence of fetal heart rate accelerations.
B.Duration of uterine contractions.
C.Frequency of uterine contractions.
D.Strength of uterine contractions in mm Hg.
D.
Strength of uterine contractions in mm Hg.
That's right!
The IUPC provides an objective, quantitative measurement of contraction strength and resting tone, whereas palpation is a subjective assessment.
A pregnant client is prescribed iron supplements. Which statement made by the client indicates a need for further teaching by the nurse?
A. "I will take my iron pill with a glass of orange juice on an empty stomach first thing in the morning."
B. "I should expect my stools to turn dark, and I need to make sure I increase my daily fiber and water intake."
C. "I will take my iron at lunch with a cup of black coffee and a piece of whole-wheat toast."
D. "I need to avoid drinking milk or tea for at least an hour after I take my iron supplement."
Correct Answer: C. "I will take my iron at lunch with a cup of black coffee and a piece of whole-wheat toast."
Rationale: The guide states that iron must be taken:
Best on empty stomach. (Taking it with lunch is ↓ absorption).
Avoid milk/tea/coffee/calcium within 1 hr. (Coffee contains tannins that ↓ absorption).
Therefore, taking iron with coffee and a meal indicates a lack of understanding regarding the factors that inhibit absorption.
A nurse is teaching a client how to calculate EDD using Naegele’s rule. The client’s LMP was June 10. What is the EDD?
A. March 3
B. March 17
C. April 10
D. April 17
B (March 17) ✔️
👉 Rule: subtract 3 months, add 7 days, add 1 year → March 17
A client with gestational diabetes is receiving teaching. Which statement by the client indicates a need for further teaching?
A. “I will monitor my blood glucose more frequently in the third trimester.”
B. “If my blood sugar is high, my baby may have trouble breathing after birth.”
C. “My baby will likely be small and underdeveloped at delivery.”
D. “I understand I may be at higher risk for needing a C-section.”
Correct answer: C (My baby will likely be small and underdeveloped)
👉 Explanation:
Babies of GDM moms are usually large (macrosomia) due to extra glucose, not small.
They can have respiratory distress after birth due to delayed surfactant production → so your answer (B) was actually correct teaching.
The wrong statement is C, so that’s the one needing correction.
A client is fully dilated and begins pushing. The nurse recognizes this is which stage of labor?
A. First stage
B. Second stage
C. Third stage
D. Fourth stage
. Second stage
Q8.
A patient at 35 weeks presents with painless, bright red vaginal bleeding. What is the nurse’s priority action?
A. Prepare for emergency C-section
B. Perform a sterile vaginal exam to assess cervical dilation
C. Apply an external fetal monitor
D. Insert two large-bore IV lines for fluid replacement
Correct answer: C (Apply external fetal monitor)
👉 Explanation:
With suspected placenta previa → never perform vaginal exams.
The first step is to assess fetal status with an external monitor.
IV lines and prepping for C-section may follow, but priority is fetal monitoring.
Q1.
A pregnant client at 33 weeks is admitted with a diagnosis of preeclampsia. Which assessment finding requires the nurse’s immediate intervention?
A. BP 156/94 mmHg
B. 1+ protein on urine dipstick
C. Platelet count 90,000/mm³
D. +2 pitting edema in ankles
Correct answer: C (Platelet count 90,000/mm³)
👉 Explanation:
Mild preeclampsia can have BP ≥140/90 and proteinuria.
But platelets <100,000 suggests HELLP syndrome (Hemolysis, Elevated Liver enzymes, Low Platelets) — a severe complication that can lead to bleeding and maternal/fetal risk.
This is the most urgent finding.
Q2.The nurse is reviewing prenatal lab results. Which finding is most concerning and warrants urgent provider notification?
A. Hemoglobin 10.5 g/dL at 32 weeks
B. Negative rubella titer
C. Positive Group B Streptococcus at 36 weeks
D. Positive amnisure test at 30 weeks with no contractions
Correct answer: D (Positive Amnisure test at 30 weeks with no contractions)
👉 Explanation:
Positive GBS is concerning but expected at 36 weeks → treat in labor with antibiotics.
Rubella negative = give vaccine postpartum, not urgent.
Hgb 10.5 = physiologic anemia of pregnancy.
ROM (positive amnisure at 30 wks) with no contractions = risk of infection + preterm delivery. This is the most urgent finding.
A nurse is interpreting a fetal heart rate tracing that shows abrupt, sharp drops in the FHR that are variable in their timing relative to contractions. These findings are most indicative of what underlying issue?
A.Fetal head compression
B.Maternal fever
C.Umbilical cord compression
D.Uteroplacental insufficiency
C.Umbilical cord compression
The abrupt onset and recovery of variable decelerations are characteristic of pressure being applied to and released from the umbilical cord
A nurse is caring for a client at 32 weeks with preterm premature rupture of membranes (PPROM). Which intervention is the priority?
A. Administer corticosteroids for lung maturity
B. Start prophylactic antibiotics
C. Monitor temperature and fetal heart rate closely
D. Prepare for immediate delivery
Correct answer: B
👉 Rationale: With PPROM, the greatest risk is infection. Antibiotics are started immediately to reduce chorioamnionitis and prolong pregnancy. Corticosteroids are also important, but infection prevention takes priority. Monitoring is necessary, but not the first action
Q10.
A nurse is caring for a patient in labor whose membranes have ruptured. FHR suddenly shows variable decelerations. What is the nurse’s first action?
A. Administer oxygen at 10 L/min
B. Place the patient in knee-chest or Trendelenburg position
C. Prepare for amnioinfusion
D. Notify the provider
Correct answer: B (Position knee-chest or Trendelenburg)
👉 Explanation:
Variable decels = cord compression.
First action is to relieve cord pressure → reposition (knee-chest or Trendelenburg).
Then O₂, fluids, amnioinfusion, provider notification follow.
Preparing for amnioinfusion is correct later, but not first.
A nurse reviews lab results for a client with suspected HELLP syndrome. Which findings support this diagnosis?
A. Platelet count 85,000/mm³
B. LDH 700
C. AST 95
D. Hemoglobin 14 g/dL
E. Bilirubin 0.3
Correct answers: A, B, C ✔️
👉 HELLP = Hemolysis (↑LDH), Elevated LFTs (AST, ALT), Low platelets.
Normal Hgb and bili rule out the other options.
A nurse is reviewing a client's third-trimester laboratory results. The hemoglobin (Hgb) is 10.5 g/dL, and the hematocrit (Hct) is 32%. The nurse understands that this finding primarily reflects which of the following physiological mechanisms?
A. The lowest point of plasma volume concentration, peaking at 32−34 weeks.
B. The total blood volume increase of +1200−1600 mL causing hemodilution.
C. Pathological iron deficiency that requires immediate ferrous sulfate supplementation.
D. A cardiac output increase of 30−50%, causing a compensatory reduction in red blood cell production.
Correct Answer: B. The total blood volume increase of +1200−1600 mL causing hemodilution.
Rationale: The study guide defines the Hgb/Hct drop as "Anemia of pregnancy = hemodilution" and notes the ↑ Blood volume: +1200−1600 mL and ↑ Plasma volume: peaks 32−34 wks. The increase in plasma volume is proportionally greater than the increase in red blood cells, leading to a dilutional effect on the blood (hemodilution).
A nurse is counseling an obese client during a pre-conception visit about pregnancy risks. The nurse correctly explains that the most critical fetal risk directly linked to obesity that occurs early in gestation is:
A. Macrosomia, requiring early delivery via Cesarean section.
B. Neural Tube Defects (NTDs), which may be prevented with adequate Folic Acid.
C. Preterm birth (PTB), necessitating fetal lung maturity assessments.
D. Intrauterine Growth Restriction (IUGR), requiring frequent BPPs and NSTs.
Correct Answer: B. Neural Tube Defects (NTDs), which may be prevented with adequate Folic Acid.
Rationale: The formation of the neural tube occurs very early in gestation (first 4 weeks) and is highly sensitive to maternal conditions. The guide lists NTDs as a risk of obesity and notes that Folic Acid prevents NTDs. Macrosomia occurs late in gestation as a result of fetal overgrowth. Since the question asks about the early risk, NTDs is the correct answer.
A primigravida client has progressed from 4 cm to 8 cm of cervical dilation in the last hour. She reports strong contractions occurring every 2−3 minutes, lasting 55 seconds, and she is feeling increasing rectal pressure. What is the most appropriate nursing response at this stage of labor?
A. Encourage the client to begin open glottis pushing with her contractions.
B. Use this opportunity as a great time for childbirth education and reassurance.
C. Monitor for signs of the placenta separating, as delivery is imminent.
D. Provide coaching on breathing techniques and encourage the client to remain focused through the rapid dilation phase.
Correct Answer: D. Provide coaching on breathing techniques and encourage the client to remain focused through the rapid dilation phase.
Rationale: The client is in the Active Phase of the first stage of labor (typically 6−10 cm ) and is progressing rapidly (4 cm to 8 cm in 1 hour). This phase is characterized by stronger contractions and rapid dilation. This is often the most intense time, requiring focused support, pain management, and breathing coaching
A laboring client with an epidural suddenly reports shortness of breath and chest pain. BP is 78/40, HR 120, O₂ sat 88%. What complication should the nurse suspect?
A. Amniotic fluid embolism
B. Placental abruption
C. Uterine rupture
D. Maternal hypotension from epidural
Correct answer: D
👉 Rationale: The most likely complication with an epidural is maternal hypotension from vasodilation.
Amniotic fluid embolism also causes SOB/chest pain but is sudden, catastrophic, often with DIC and cardiac arrest.
Here, the BP drop after epidural placement points to epidural-induced hypotension.
A nurse is conducting a health history on a client at an initial prenatal visit. The client states she has experienced nausea, breast tenderness, and feels "flutters" in her abdomen. On physical examination, the nurse notes Chadwick's sign and a uterine fundal height at the level of the umbilicus. Based on these findings, which conclusion is correct?
A. Quickening is a positive sign of pregnancy, confirming gestation.
B. The combination of signs and symptoms falls only under the "Probable" category of diagnosis.
C. The nurse can definitively diagnose pregnancy based on the observed signs.
D. The presence of Chadwick's sIgn and quickening places the diagnosis in two different categories
Correct Answer: D. The presence of Chadwick's sign and quickening places the diagnosis in two different categories.
Grade: CORRECT
Rationale: The signs of pregnancy are categorized:
Presumptive (Mom feels): Nausea, breast changes, fatigue, quickening ("flutters").
Probable (HCP observes): Abdominal enlargement, Chadwick's (Goodell’s, Hegar’s).
Positive (Fetus only): FHR, fetal movement felt by HCP, ultrasound.
Since quickening is Presumptive and Chadwick's is Probable, the combination is correctly placed in two different categories. No positive signs are present, so a definitive
The nurse observes a Fetal Heart Rate (FHR) tracing that shows a sudden, immediate drop in rate (abrupt ↓ lasting less than 30 seconds). This change has no consistent relationship with the onset of the uterine contraction (UC). The most likely cause of this FHR pattern is:
A. Head compression, as the deceleration is a gradual drop mirroring the UC.
B. Cord compression, requiring repositioning as the first step in resuscitation.
C. Placental insufficiency, which warrants the administration of supplemental oxygen.
D. Uterine tachysystole, which is defined as contractions greater than 5 in 10 minutes.
Correct Answer: B. Cord compression, requiring repositioning as the first step in resuscitation.
Rationale: The pattern described is a Variable Deceleration. The guide defines it as: "Variable: abrupt ↓ (<30 sec) → cord compression." The first intervention in the L.I.O.N sequence is L: Left side (repositioning).
A client at 36 weeks gestation presents to the emergency department with sudden onset of severe, localized abdominal pain, vaginal bleeding that is dark red, and a rigid, board-like uterus on palpation. Which condition should the nurse suspect and prepare for immediate management?
A. Placenta Previa, requiring avoidance of a vaginal exam.
B. Placental Abruption, with a high risk for Disseminated Intravascular Coagulation (DIC).
C. Placenta Accreta, requiring preparation for massive hemorrhage.
D. Preterm Labor, necessitating administration of corticosteroids.
Correct Answer: B. Placental Abruption, with a high risk for Disseminated Intravascular Coagulation (). Grade: CORRECT
Rationale: The classic triad of signs for Placental Abruption is: painful dark red bleeding + a rigid uterus. A major risk associated with abruption is
(Disseminated Intravascular Coagulation) due to the release of thromboplastin from the site of separation.
Placenta Previa is characterized by painless bright red bleeding.
Accreta is the placenta stuck to the uterine wall and is diagnosed later, often during or after delivery.
Q5.
A 28-week pregnant client with a history of preterm birth reports pelvic pressure and mild back pain. Which order should the nurse question?
A. Administer nifedipine orally as prescribed
B. Obtain cervical cultures for GBS
C. Give betamethasone IM
D. Perform a digital vaginal exam immediately
Correct answer: D (Perform digital vaginal exam immediately)
👉 Explanation:
Preterm labor: Avoid digital vaginal exams if ROM suspected → can introduce infection.
Cultures for GBS are appropriate, betamethasone helps lung maturity, nifedipine is a tocolytic.
So the unsafe order is D.
A biophysical profile (BPP) is ordered for a client at 35 weeks gestation. The nurse reviews the components and finds the following: NST is reactive, 3 episodes of fetal body movement are observed, fetal tone is absent, fetal breathing movements are absent, and adequate amniotic fluid volume. What BPP components were assessed, and what is the resulting score?
A. 4 components assessed, score of 8/10.
B. 5 components assessed, score of 6/10.
C. 5 components assessed, score of 4/10.
D. 4 components assessed, score of 4/10.
Correct Answer: B. 5 components assessed, score of 6/10.
Rationale: The guide states: "BPP=5 letters, 5 parts (NST, movement, tone, breathing, fluid)." All 5 components were assessed. Each normal component scores 2 points; abnormal scores 0 points.
NST Reactive (Normal): 2 points
Body Movement (≥3 episodes are needed): 2 points (The client had 3 episodes)
Fetal Tone (Absent): 0 points
Fetal Breathing (Absent): 0 points
Amniotic Fluid Volume (Adequate): 2 points
Total Score: 2+2+0+0+2=6/10