1

LONG EXAM IN OB C. Smoking

D. Exercising
What is the most common uterine site for implantation
in the human? * 9. She complained of leg cramps, which usually
a. upper posterior wall occurs at night. To provide relief, the nurse tells Diane
b. lower posterior wall to: * HOOMANS SIGN
c. upper anterior wall a. Dorsiflex the foot while extending the knee when
d. lower anterior wall the cramps occur
b. Dorsiflex the foot while flexing the knee when the
2. Which of the following is derived from mesoderm? cramps occurs
* c. Plantar flex the foot while flexing the knee when the
a. lining of the GI tract- endoderm cramps occur
b. liver d. Plantar flex the foot while extending the knee when
c. brain- endoderm the cramp occur
d. skeletal system
10. Which of the following is characteristics of false
3. Which of the following could be considered as a labor *
positive sign of pregnancy? * A. Bloody show
A. Amenorrhea, nausea, vomiting B. Contraction that are regular and increase in
B. Frequency of urination frequency and duration
C. Braxton hicks contraction C. Contraction are felt in the back and radiates
D. Fetal outline by sonography towards the abdomen
D. None of the above
4. The nurse checks the perineum of Helen. Which of
the following characteristic of the amniotic fluid 11. Which is a primary power of labor? *
would cause an alarm to the nurse? * a. uterine contractions
A. Greenish- meconium stain b. pushing of the mother
B. Scantly c. intrathoracic pressure
C. Colorless d. abdominal contraction
D. Blood tinged
12. A negative 1 [-1] station means that *
5. To determine the clients EDC, which day of the A. Fetus is crowning
menstrual period will you ask? * B. Fetus is floating
a. first C. Fetus is engaged
b. last D. Fetus is at the ischial spine
c. third
d. second 13. In what presentation is the head in extreme
flexion? *
6. In the immediate postpartum period the action of a. sinciput
methylegonovine is to: * b. brow
a. cause sustained uterine contractions c. vertex
b. causes intermittent uterine contractions d. face
c. relaxes the uterus
d. induces sleep so that the mother can rest after an 14. Ripening (SOFTENING) of the cervix occurs
exhausting labor during the: *
a. first stage
7. How many days and how much dosage will the b. second stage
IRON supplementation be taken? * c. third stage
A. 365 days / 300 mg d. fourth stage
B. 210 days / 200 mg
C. 100 days/ 100mg 15. Which of the following is not true regarding the
D. 50 days / 50 mg third stage of labor? *
a. Care should be taken in the administration of bolus
8. A 40 year old mother should avoid? * of oxytocin because it can cause hypertension
A. Traveling
B. Sex


 2

b. Signs of placental separation are lengthening of the d. A rupture of a graffian follicle- discoloration of
cord, sudden gush of blood and sudden change in periumbilical area
shape of the uterus
c. It ranges from the time of expulsion of the fetus to 21. A couple with one child had been trying, without
the delivery of the placenta success for several years to have another child. Which
d. The placenta is delivered approximately 5-15 of the following terms would describe the situation? *
minutes after delivery of the baby a. Primary Infertility
b. Secondary Infertility
16. The baby’s mother is RH(-). Which of the c. Irreversible infertility
following laboratory tests will probably be ordered for d. Sterility
the newborn? *
a. Direct Coomb’s- it is for the baby 22. When assessing the adequacy of sperm for
b. Indirect Coomb’s- ANTIBODY FOR THE conception to occur, which of the following is the
MOTHER most helpful criterion? *
c. Blood culture a. sperm count
d. Platelet count b. sperm motility- kung hindi nakakalangoy, walang
silbi din ang mga sperm
17. On clients first postpartal day, the nurse c. Sperm maturity
assessment reveals the following: vital signs within d. Semen volume
normal limits,a boggy uterus and perineal pad
saturation with lochia rubra. What should the nurse 23. During labor a client who has been receiving
do? * epidural anesthesia has a sudden episode of severe
a. reassess the patient after an hour nausea, and her skin becomes pale and clammy the
b. administer oxytocin nurse immediate reaction is to: *
c. massage the uterus a. Notify the physician
d. notify the physician b. Check for vaginal bleeding
c. Elevate the clients legs- to increase venous return
18. Magnesium Sulfate is ordered per IV. Which of to prevent shock
the following should prompt the nurse to refer to the d. Monitor the FHR every 3 minutes
obstetricians prior to administration of the drug? *
a. BP= 180/100 2. At about 5 cm, a laboring client receives medication
b. Urine output is 40 ml/hr for pain. The nurse is aware that one of the
c. RR=12 bpm- sign of toxicity??? medications is given to women in labor that could
d. (+) 2 deep tendon reflex cause respiratory depression of the new born is: *
a. Scopalamine
SITUATION b. Meperidine ( Demerol)
DANICA is 24 y/o Filipina married to an American. c. Promazine ( Sparine)
She is pregnant for the second time and now at 8 d. Promethazine ( Phenergan)
weeks AOG. She is RH (-) with blood type B
25. A client is on Magnesium So4 therapy for severe
19. Which of the following findings in DANICA’s pre-eclampsia. The nurse must be alert for the first
history would identify a need for her to receive RHo sign of an excessive blood magnesium level which is:
(d) immune globulin? * *
a. Rh -, coombs + a. Disturbance in sensorium
b. Rh -, Coombs – b. Increased in respiratory rate
c. Rh +, Coombs – c. Development of cardiac dysrythmia
d. Rh +, Coombs + d. Disappearance of the knee-jerk reflex

20. A client who has missed two menstrual

cycleperiod comes to the prenatal clinic complaining 26. nurse would suspect an ectopic pregnancy if the
of vaginal bleeding and one-sided lower-quadrant client complained of: *
pain. The nurse suspects that this client has. * a. An adherent painful ovarian mass
a. Abruptio placenta- dark red painful b. lower abdominal cramping for a long period of
b. An ectopic pregnancy time.
c. An incomplete abortion c. Leukorrhea and dysuria a few days after the first
missed period


 3

d. Sharp lower right or left abdominal pain radiating b. placental insufficiency
to the shoulder. c. fetal head compression
d. hypoxia

27. A client who has missed two menstrual cycle 33. Late deceleration indicates: *
period comes to the prenatal clinic complaining of a. cord compression
vaginal bleeding and one-sided lower-quadrant pain. b. placental insufficiency
The nurse suspects that this client has. * c. fetal head compression
a. Abruptio placentae d. hypoxia
b. An ectopic pregnancy
c. An incomplete abortion 34. Early deceleration indicates: *
d. A rupture of a graafian follicle. a. cord compression
b .placental insufficiency
SITUATION c .fetal head compression
Helen is arrived to the labor and delivery area in labor. d. hypoxia
She complains of regular uterine contractions with 8
to 10 minutes interval and states that her bag of water 35. Blood therapeutic level of magnesium So4?
has been ruptured. The fetus is in a left occiput a. 0.5 – 1.5 meq/l
anterior position (LOA). b..0.5 – 1 meq/
c. .0.5 – 5meq/
28. The nurse’s first action should be to: * d. .0.5 – 2 meq/.
a. check the FHR
b. start IV fluid as ordered 36. When the client is only 15 years old,the nurse
c. call the physician caring for such client during during labor process
d .place to lying positiona should assess the client for signs of: *
a. uterine atony
29. Which procedure would best determine if Helen’s b. cephalo-pelvic disproportion
BOW has ruptured * c. rapid second stage of labor
a. A complete blood count d. early deceleration pattern
b. Nitrazine Paper test
c. Urinalysis 37. Due to hyperventilation ,the nurse should assess
d. Vaginal examination the client for signs and symptom of: *
a. metabolic alkalosis
30. Initial assessment done and revealed the following b. metabolic acidosis
FH = 30cm, FHT 145bpm, BP =110/70 mmHg. IE c. respiratory acidosis
done by Dr. Zeus and revealed 4 cm cervical d. respiratory alkalosis
dilatation. Helen asked for Demerol. The nurse’s best
response is: * 38. The client experiences severe back pain the nurse
a. “Try to wait until you really need it.” should instruct that her severe back pain is cause by
b. “It is too early in your labor; medication will retard what fetal position? *
progress of uterine contraction.” a.oblique
c. “I know you are in pain. I’ll just prepare the b.transverse
medication.” c.posterior
d. “Perhaps a change in position will make you more d.anterior
comfortable.”
39. The client calls out the nurse.”the baby is coming”
31. The pregnant woman ask “ When does the heart the nurse first action is: *
and the brain of the baby form”. The best response a. inspect the perineum
made by the nurse is: * b. open the emergency delivery box
a. First month c. auscultate the heart sound
b. Second month d. contact the birth attendant
c. Third month
d. Fourth month 40. To help the client remain calm and cooperative
during immenent delivery,the nurse should tell the
32. Fetal heart tone variability indicates: * client: *
a. cord compression a.”you are right the baby is coming”


 4

b.”do you want to help me get you through this”
c. “your doctor will see you soon” 48. A primiparous client who is bottle feeding her
d.”ill explain whats happening” baby.Ask “when should I start giving the baby solid
food? The replay will be: *
41. The nurse is caring to woman in active a. 2 month of age
labor.Which information is most important to assess b. 6 month of age
in order to prevent the complication during labor and c. 8 month of age
delivery. * d. 10 month of age
a. family history of lung illness- affect delivery, lung
is needed sa pag ire 49. In collecting a breast milk,how many months
b. food allergies should a milk is stored in freezer? *
c. number of cigarette smoked per month a. 2 months
d. last food intake b. 3 months
c. 4 months
42. when the bag of water rupture’s,the nurse should d. 6 months
expext to see? *
a. a large amount of bloody fluid 50. What type of container should be use in storing the
b .a moderate amount of clear to straw-colored expressed breast milk? *
c. a small segment of umbilical cord a. stainless
d. greenish fliud b. rubber
c. latex
43. When bag of water rupture,the nurse first action d. plastic
is? *
a. notify the physician 51. To determine the date of confinement ,the nurse
b. measure the amount of fluid should assess: *
c. monitor fetal heart tone a. fundic height
d. perform vaginal examination b. date of last intercourse
c. last menstrual period
44. The client has midline episiotomy. The purpose of d. age of menarche
the episiotomy is? *
a. allow forcep to be applied 52. When discovering prolapse cord,the nurse
b. enlarge the vaginal opening- to prevent perineal anticipates that the client’s delivery is: *
laceration a. CS
c, eliminate possibility of laceration b. induced with oxytocin
d. eliminate the need for CS c. vaginal birth with forcep
d. postponed as possible
45. Baby boy Anthony is under photo therapy, the
nurse should: * 53. The nurse prepares a client with a ruptures tubal
a. limit fluid intake pregnancy for immediate surgery.The nurse
b. cover infants eye understand that an informed consent will have to
c. keep the baby covered with cloth include permission for? *
d, The light is 25 inches away from the baby a. myomectomy
b. hysterectomy
46. The neonate is post mature,the nurse should assess c. salphingectomy
for symptom of: * d. D/C
a. infection
b. hypoglycemia 54. A client with a history of rheumatic heart disease
c. delayed meconium as admitted in early labor. The nurse should encourage
d. elevated bilirubin this client to assume; *
a. Supine
47. While assessing post-term neonate,the nurse b. Semi-fowlers
anticipates that the neonate will have: * c. Trendelenburg
a. flat nose d. Left lateral
b. small hands and feet
c. a red rash on the abdomen
d. wrinkled and peeling skin


 5

55. a client who has just begun breastfeeding her a. I guess I’ll have to wait awhile to become aunt
newborn complains that her nipples feel very sore. b. This kind of thing can happen to my sister again
The mother should be encourage to; c. This kind of thing can happen after pelvic infection
a. apply continuous ice packs to her breast d. My sister is lucky because she’ll never have a
b. take the analgesic medication as ordered period again- kahit matanggal ang fallopian, menses
c. remove the baby from the breast for few days to rest are still present
the nipples
d. apply warm compress 61. Epidural anesthesia is administered to a client. A
primary responsibility of the nurse is to assess for: *
56. The nurse assess a newborn using the apgar a. Tachycardia
score.At one minute after birth the baby has a heart b. Hypotension- can cause systemic …
rate of 120,slow and irregular respiration ,weak c. Decrease urinary output
cry,some flexion of extremities and pink body with d. Precipitous second stage of labor
blue extremities. the one minute APGAR score should
be recorded as: * 62. Large for gestational age infant of a diabetic
a. 5 mother should be assesses for: *
b. 6 a. The presence of Mongolian spot
c. 7- twice, first min and 5 minute b. A blood sugar level less than 40
d. 8 c. A body temperature less than 184f
d. Elevated bilirubin levels in the first 24 hours
57. A 16 year old primipara, at 32 weeks gestation, is
admitted to the hospital. Her blood pressure is 63. While a client is receiving IV magnesium so4 for
170/110mmhg and she has +4 protienuria. She has preeclampsia, a primary nursing intervention would
gained 50 pounds during pregnancy and her face and be: *
extremities are edematous. The nurse assess that the a. Limiting her fluid intake to 1000ml per 24 hours
client probably has: * b. Preparing for the possibility of precipitate labor
a. Eclampsia c. Restricting visitors and keeping the room darkened
b. Mild pre eclmapsia and quiet
c. Severe pre eclampsia d. Obtaining magnesium gluconate for use as an
d. Chronic hypertensive disease antagonist of necessary

58. A client arrives in the birthing room with the fetal 64. A few weeks after discharge, a postpartum client
head crowning. The nurse recognizes that birth is develops mastitis and telephones for advice
imminent and tells the client to: * concerning breastfeeding. The nurse should tell the
a. push with all her power client to: *
b. Use pant blowing a. Start to wean the baby from the breast to reduce the
c. Assume trendelenburg position pain
d. Hold her breath and turn to left side b. Get an antibiotic from the physician and start
formula feedings
59. A new mother is inspecting her baby girl for the c. Pump her breast and wear tight feeding bra to
first time. The baby breast are swollen and there is a suppress milk production
red vaginal discharge. When the mother asks what is d. Breastfeed often because this will keep the breast
wrong the nurse should respond: empty and reduce pain
a. Your baby appears to have problem
b. I do not see any unusual. what exactly do you see 65. A client had a blood pressure of 90/50 during her
on the baby first visit to the pre natal clinic. At 34 weeks gestation
c. It is nothing to worry about. The swelling and her blood pressure is now 120/76. the nurse recognizes
discharge will go away that this can occur because of: *
d. The swelling and discharge are expected and a. The possible development of preeclampsia
Normal b. The development of essential hypertension
c. An increase stroke volume during pregnancy
60. A 17 year old client tells the nurse that her sister d. An expected rise in blood pressure as pregnancy
had an ectopic pregnancy about three months ago and progresses
had to have her tube removed. The nurse knows that
this young woman needs further explanation when she
states: *


 6

66. At a pre natal visit at 36 weeks gestation, a client
complains of discomfort with irregular contraction. 73. The client experiences urinary retention with
The nurse instruct the client to: * overflow,the nurse should instruct the client to
a. Lie down until they stop perform what exercise. *
b. Walk around a. swimming
c. Time the contraction b. pelvic raking
d. Take aspirin c. kegel’s exercise
d. walking
67. During the vaginal examination, the doctor
palpates the fetal head and a large diamond shaped 74. The nurse is checking a laboring client,her
fontanel, based on this assessment, the nurse knows assessment reveals the head at +3 station.What will
that the fetal presentation would be: * the nurse do? *
a. Face a. prepare for delivery of baby
b. Transverse b. administer oxygen
c. Vertex c. determine if contraction is increasing
d. Brow d. determine FHT

68. During augmentation of labor with intravenous 75. The nurse would identify which situation as an
oxytocin, a multiparous client becomes pale and indication for the administration Rhogam? *
diaphoretic and complains of severe lower abdominal a. A woman who is RH+
pain with a tearing sensation. Fetal distress is noted on b. woman on prolonged labor
the monitor. The nurse should suspect: * c. woman with endometritis
a. Precipitate labor d. abortion’
b. Amniotic fluid embolus
c. Rupture of uterus 76. Julie,a pregnant adolescent client ask the nurse
d. Uterine prolapsed about the menstrual cycle.The nurse describes the
cycle and tells the adolescent that its normal duration
69. Transmission of HIV from an infected person to is: *
another is: * a. 14 days
a. Most frequently in nurses with needle stick injury b. 28 days
b. Only if there is a large viral load in the blood c. 30 days
c. Most commonly as a result of sexual contact d. 45 days
d. In all infants born to woman with HIV infection
77.Liza,a multi gravida women ask the nurse in the
70. After vaginal examination, the nurse determines clinic when she will be able to start the fetus moving
that the client fetus is in occiput posterior position. ,the nurse correct response would be? *
The nurse would anticipate that the client will have: * a. 6 to 8 weeks
a. A precipitous birth b.10 to12 weeks
b. Intense back pain c. 14 to 16 weeks
c. Frequent leg cramps d. 24 to 30 weeks
d. Nausea and vomiting
78.Nurse Leda is providing instruction to a pregnant
71. placenta is combination of what structure? women regarding measure that will assist in allevating
a. decidua capsularis and blastocyst heartburn,Which statement of the client indicates
b. decidua vera and tropoblst understanding of these measure? *
c. decidua basalis and tropoblst a. ” I should lie down for an hour after eating”
d. decidua capsolaris and tropoblast b. ”I should avoid between meal snack”
c. ”I Should eat more spicy food”
72. Madel is instructing another pregnant client d. ”I should avoid eating gas-forming food
regarding measure to increase the source of iron from
the diet.She tells the client to consume which food that
contains the highest source of daily Iron” * 79. A primigravida client is experiencing Braxton-
a. milk hick’s contraction.Which statement is true concerning
b. dark green leafy vegetable this type of contraction: *
c. potatoes a. intensified by walking
d. ampalaya b. confined to low back


 7

c. do not increase in intensity and frequency d. knowledge about the procedure necessary to
d. cervical effacement and dilation occurs diagnose infertility

80. which statement would the nurse make to the 87. What could be the primary nursing diagnosis for
client about strae gravidarum * easy fatigability *
a. occur in all pregnancy a. pain
b. are silvery streaks that appears epecialy at late b. disturbace in role performance
period of pregnancy c. activity intolerance
c. can be decrease by application of cocoa d. self care deficit
d. will fade from reddish to silvery color streaks.
88.Which of the following food will you advise to
81.lecithin-salphingomyelin exam is done to relieve leg cramps? *
determine maturity of what organ? * a. mongo,cheese,dilis,sardines
a. liver b. petchay
b. lung c. nut,legumes
c. testes d. rice and bread
d. spleen
89. The lochia during the first 3 days post partum *
82 .The nurse is aware that the nausea and vomiting a.rubra
commonly experienced by many women during the b.serosa
first trimester of pregnancy is an adaptation to the c.alba
increase level of: * d. alca
a. estrogen
b. progesterone 90. What is the important nursing action when
c. human chorionic gonadotropin assisting the doctor with pelvic examination *
d. human placental lactogen a. instruct the client to douche before exam
b. explain to the client that she will not pain
83. A client who is 10weeks pregnant calls the clinic c. have the client empty the bladder
and complains of morning sickness. To promote relief, d. position on dorsal recumbent
the nurse should suggest: *
a. eating dry toast cracker 91. a client in labor has been pushing effectively for 2
b. increase fat intake hours.A nurse determine that the client’s primary
c. have 2 small meals everyday physiologic need at this time is to: *
d .give spicy food a. ambulate
b. rest between contraction
84. A pregnant client ask the nurse about the effect of c. change position frequently
smoking on pregnancy * d. consume oral food or fluid
a .the placenta is impermeable to nicotine
b. smoking relieves tension 92. The nurse determine that the client is beginning
c. vasoconstriction will impairs circulation the second stage of labor when which of the following
d. it has no effect to pregnancy assessment is noted. *
a. contractions are regular
85. The nurse is caring to a client with placenta b. membranes are ruptured
previa.The nurse reviews the physician order and c. cervix is dilated completely
would question which order? * d. the client begins to expel clear vaginal fluid
a. prepare client for ultrasound
b. obtain equipment for internal examination’ 93. A nurse performing an assessment of the client
c. prepare to draw blood sample who is scheduled for a cesarean section. Which
d. monitor FHT assessment finding would indicate a need to contact
doctor immediately *
86. Couples who visit infertility clinic have the 0/1
following need,which is the priority * a. hemoglobin 11g/l
a. education about reproduction b. FHT of 180bpm- 120-160
b. determine who between them is infertile c. maternal pulse of 85bpm
c. counseling to help them maximize there potential d. WBC of 12,000/mm3

 8

94. A nurse is caring to a mother who is receiving A. Take the client’s blood pressure
oxytocin by intravenously. which assessment finding B. Position the client on her side
indicated that infusion must be stop. * C. Give the client a drink of water
a. contraction every 2min D. Place the client in a Trendelenburg position
b. duration of 90seconds
c. FHT of 90bpm 102. The nurse is assessing the fundal height of a
d. all of the above client at 26 weeks’ gestation. The nurse should expect
the fundus to be: *
95. A nurse is caring for a client in labor and is A. Level with the umbilicus.
monitoring the fetal heart tone. The nurse notes that B. Halfway between the symphysis and umbilicus.
presence of episodic deceleration during uterine C. Slightly below ensiform cartilage.
contraction. * D. At 26 cm.
a. notify the physician immediately 103. When planning care for the client in her third
b. reposition the mother trimester, the nurse would give priority to teaching
c. document the finding which topic? *
d. administer oxygen 0/1
96. When a primigravida is in the active labor the A. Ways to decrease nausea and vomiting
patient may be taken to delivery room when the: * B. Positions to avoid shortness of breath
a. cervix is fully dilated C. Ways to lessen fatigue
b. bag of water ruptures D. The use of a supportive bra for treatment of breast
c. cervical effacement occurs tenderness
d. transition phase occurs
Correct answer 104. A nurse is planning to teach a 14-year-old
a. cervix is fully dilated pregnant adolescent at 38 weeks’ gestation. Which
topic would be most helpful at this time in the
97. The nurse should Mona who suffers from vaginal pregnancy? *
bleeding to: * 1/1
a. take laxative so that she does not strain at stool A. Nutrition for the third trimester
b. save all perineal pads B. Signs of true labor
c. call the clinic when the bleeding stop C. Abdominal exercises for postpartum
d. record fluid intake and urinary output D. Infant bathing

98. The nurse assesses the labor contraction by 105. The nurse is assessing the weight of a client who
describing all of the following except * is having a normal pregnancy. The nurse would expect
a. duration the client to have gained _____ pounds by 20 weeks’
b. intensity gestation. *
c. frequency A. 8.5 – 10 lbs.
d. location B. 10.5 – 12 lbs.
C. 12.5 – 15 lbs.
99. The post partum mother ask the nurse about when D. 15 – 17 lbs.
should coitus can be resumed. *
a.48 hours 106. Which outcome for a client who was underweight
b.2 weeks at the onset of her pregnancy should be the greatest
c.1 week concern to the nurse? *
d.6 weeks A. Weight gain in the first trimester is 4 pounds.
B. Weight gain in the second trimester is 8 pounds.
100. folic acid supplement is required during C. Weight gain in the third trimester is 14 pounds.
pregnancy to prevent: * D. Total weight gain is 36 pounds.
a.anemia
b.neural tube defect 107. Another client at 30 weeks’ gestation is admitted
c.cranio facial deformity to the birthing unit with vaginal bleeding. What is the
d.down syndrome first action the nurse should take? *
A. Administer oxygen.
101. While a pregnant client lies on her back, she B. Prepare equipment for examination.
reports that she is experiencing dizziness. What is the C. Assess family coping skills.
priority action for the nurse? * D. Take vital signs.


 9

113. Information gained using Leopold’s maneuver
108. The woman is hospitalized for the treatment of reveals that the fetus is in a cephalic position. Where
severe pre-eclampsia. Which of the following should the nurse place the Doppler to hear the fetal
represents an unusual finding for this condition? * heart tones? *
A. Convulsions A. The lower quadrant of the maternal abdomen
B. Blood pressure 160/100 B. The level of the maternal umbilicus
C. Proteinuria + 4 C. The upper quadrant of the maternal abdomen
D. Generalized Edema D. Above the apex of the fetal heart

109. What type of room should the nurse select for this 114. The nurse is caring for a 38-weeks’-gestation
woman? * client who was just in a motor vehicle accident. Which
A. A room next to the elevator assessment finding is associated with trauma? *
B. The room farthest from the nursing station A. Decreased uterine resting tone
C. The quietest room on the floor B. A prolapsed cord
D. The labor suite C. An increase in amniotic fluid production
D. An increase in abdominal girth
110. A woman 32 weeks gestation has developed mild
Pregnancy induced hypertension ( PIH ). What 115. A nurse is monitoring a laboring client whose
statement of the client would indicate understanding pelvic diameters are questionable. Based on the
of her treatment regimen? * nurse’s knowledge of cephalopelvic disproportion,
A. It is most important not to miss any of my BP which nursing intervention is most appropriate to
medication. encourage fetal descent? *
B. I will watch my diet restrictions very carefully A. Position the client in a squatting position.
C. I will spend most of my time in bed, on my left side B. Place the client in a supine position.
D. I’m happy that this only happens during a first C. Prepare for a forceps delivery.
pregnancy D. Maintain the client on bedrest.

SITUATION 116. Three hours postpartum, a primiparous client’s

A delivery room nurse understands that when fundus is firm and midline. On perineal inspection, the
complications develop, the pregnant woman is nurse observes a small, constant trickle of blood.
considered to be experiencing a high–risk pregnancy. Which of the following conditions should the nurse
In the following cases, a nurse’s clinical eye, critical suspect? *
judgment, and competent assessment skills are A. retained placental tissue
required in saving the life of the baby and the mother. B. uterine inversion
As such, the provision of safety for these types of C. bladder distention
clients is a minimum criterion for safe nursing care D. perineal lacerations
among entry-level nurses.
117. While making a home visit to a postpartum client
111. A nurse is assessing a client with rupture of on day 11, the nurse would anticipate that the client’s
membranes. A pelvic exam reveals the cervix to be 4 lochia would be which of the following colors? *
cm dilated, and the presenting part is ballottable. A. dark red
Based on this data, the client is most at risk for: * B. pink
A. Placenta previa. C. brown
B. Amniotic infection. D. white
C. Abruptio placentae.
D. Prolapsed cord. 118. During a home visit on the fourth postpartum
day, a primiparous client tells the nurse that she has
112. A nurse assesses a laboring client's blood been experiencing breast engorgement. To relieve
pressure to be 88/60. What nursing intervention is engorgement, the nurse teaches the client that before
most appropriate based on this assessment finding? * nursing her baby; the client should do which of the
A. Position the client in a side-lying position. following? *
B. Administer oxygen at 5 liters. A. apply an ice cube to the nipples
C. Position the client in a supine position.
D. Increase the intravenous drip rate. B. rub her nipples gently with lanolin cream
C. express a small amount of breast milk
D. offer the neonate a small amount of formula


 10

124. The nursing students emphasized that the most
119. A nurse is assessing the lochia in a 24-hour- common site of implantation is which part of the *
postpartum client, and expresses blood clots with A. Uterine fundus, posterior portion
fundal massage. The client’s fundus is firm but B. Uterine isthmus
elevated, and deviated to the right. What would be the C. Uterine corpus
most appropriate nursing action? * D. Outer portion of the uterine tube
A. Assess the activity pattern.
B. Change the perineal pad. 125. The topic of great interest for the pregnant
C. Assess the voiding pattern. mothers are fertilization and conception which occurs
D. Administer analgesics. in the fallopian tube, the most common site of which
is the: *
SITUATION A. ampulla.
Martha the MCN Nurse is preparing a Mother’s class B. fundus.
to be conducted in a Health Center. C. uterine isthmus.
D. corpus.
120. To facilitate understanding for pregnant mothers
regarding reproductive organs involve in pregnancy 126. To test the knowledge of the mothers the student
Martha is discussing with the pregnant mothers the nurses ask them which of the following is a function
differences between the male and female organs, of the ovarian hormone estrogen? *
emphasizing the organs/parts that are analogous; A. It is responsible for development of secondary sex
which is INCORRECT? * characteristics
A. Penis-vagina B. It decreases vascularity
B. Scrotum-labia majora C. It elevates basal body temperature during ovulation
C. Glans penis-Vagina D. It is responsible for infertile mucus
D. Spermatogenesis- oogenesis
127. The mothers are excited to know the onset of
121. The clitoris is the seat of sexual excitement in the labor and delivery. In which the exact cause of labor
female. Its significance is valuable for obstetrics is is unknown. However, some of the theories were
that it: * explain to them which include: 1. decreased estrogen
A. guides catheterization. level. 2. uterine stretch. 3. increased progesterone
B. serves as the sexual organ of stimulation. level. 4. oxytocin theory. *
C. guides internal examination. A. 1, 2 and 4
D. protects vestibular parts. B. 1, 3 and 4
C. 2 and 4
122. The pregnant mothers ask about external organs D. 2, 3 and 4
of reproduction and are collectively called: *
A. Vulva 128. The Supervisor in the Health center is teaching a
B. Perineum small group of pregnant women who are in their third
C. Vagina trimester. During the open forum, Cory a pregnant
D. External organs woman for the first time asks how she would know if
labor is near. The Supervisor response reflects an
123. One of the mothers ask why the vagina is acidic understanding of the premonitory signs of labor,
with pH of 4-6. The appropriate respond of the Nurse which include all of the following, except: *
would be because of the function of which bacteria? * A. weight gain and edema
A. Streptococci B. decreased dyspnea, increased leg varicosities and
B. Doderlein’s bacilli frequency of voiding
C. lightening around two weeks before labor
C. Escherichia coli D. increased maternal activity and abdominal muscle
D. Staphylococci tightening

SITUATION 129. The supervisor evaluates client Cory for signs of

The Mothers’ Class is also one of the ways where true labor, which include: 1. uterine discomfort
students can impart learning to pregnant mothers. The starting from the back radiating to the abdomen. 2.
following topics were discussed to them. cervical effacement and dilatation. 3. uterine
contractions increasing in interval and decreasing in

 11

duration. 4. rupture of the bag of waters and passage A. Locate the site of FHT auscultation before
of vaginal bleeding * performing the procedure
A. 1 and 2 B. Have the client drink 8 oz. of water one hour before
B. 1 and 4 the exam
C. 2 and 3 C. Warm the sonogram gel before the procedure
D. 2 and 4 D. Have the client empty her bladder before beginning
the exam
130. A Head Nurse assigned in a OB ward gave a
scenario while teaching trainees regarding signs of 135. As the nurse performs Leopold’s maneuver one,
immediate labor during emergency such as strong she palpates a hard, round ballottable mass. Which of
typhoon. She ask the trainees specific signs for labor the following is an appropriate interpretation of the
and delivery that they need to immediately attend to? findings? *
* A. The fetus is in cephalic presentation
A. Contractions are progressive and strong B. The fetus is in breech presentation
B. Cervical dilatation has begun C. The presenting part is engaged
C. The cervix is effacing D. The fetal back is on the left abdominal wall
D. The membranes have ruptured
136. A G2P1 woman in labor (parturient) asked if she
131. Delia a Nurse, assigned in an emergency first aid can still walk around in the labor room-DR-nursery
shelter after a Habagat weather disturbance. She will area. Which of the following is the most important
determine priority of care on the basis of which of the criterion to consider before allowing her to ambulate?
following? * *
A. Expected date of confinement A. station
B. Survival potential B. status of the bag of waters
C. Client’s requests C. permission by the physician
D. Age and parity D. cervical effacement

132. Nurse Delia is assessing the characteristics of 137. The Physician advised pregnant mother to
active labor contractions of a multiparous woman, just ambulate around labor room and to be re-assessed
admitted in a labor unit. Delia would assess the after 45 minutes. Which assessment distinguishes
frequency between which of the following? * between true and false labor? *
A. acme of one contraction to the beginning of the A. confirmation of spontaneous rupture of membranes
next contraction
B. beginning of one contraction to the end of the next B. signs and symptoms of increasing discomfort
contraction C. evidence of cervical dilation
C. end of one contraction to the end of the next D. presence of copious bloody vaginal discharge
contraction
D. beginning of one contraction to the beginning of SITUATION
the next contraction Mrs. Katerina has just delivered to a 7.5 lbs. healthy
133. A client 39 weeks pregnant has been admitted in baby boy. While in the post-partum ward the nurse is
the Labor room in the first stage of labor. Which of the preparing to assess her to identify problems and
following clinical manifestations would be considered prevent complications.
abnormal and should be reported to the Physician
immediately? * 138. Katerina asks the nurse when can she report to
A. Expulsion of a blood tinged mucous plug the office. The nurse’s response is based on the
B. Continuous contraction of 2 minutes duration Involution process. Which describes the following? *
C. Feeling of pressure on perineum causing her to bear A. Involution is a progressive descent of the uterus
down into the pelvic cavity, occurring approximately 1 cm
D. Expulsion of clear fluid from the vagina per day as it returns to its non pregnant weight.
B. Involution refers to the gradual reversal of the
134. The MCN nurse is preparing the mother for a uterine muscle into the abdominal cavity
Leopold’s Maneuver the nurse plans to perform C. Involution refers to the descent of the uterus into
Leopold’s Maneuver (LM) to Mrs. Fe. What would be the pelvic cavity, occurring at a rate of 2cm daily
the priority nursing actions that can be included in the D. Involution refers to the inverted uterus that is
nursing care plan before the Leopold’s maneuver? * beginning to return to normal

 12

139. Katerina is to receive Ergonovine maleate 144. Primigravida Nora is seen crying in the
(Methergine) by mouth during the first to third postpartum ward. As a MCN nurse what would be
postpartum days. Before administering Methergine, it your priority assessment for a postpartum mother
is most important to check her: * experiencing depression? *
A. lochia A. comfort measures to foster feelings of general well-
B. deep tendon reflexes being
C. blood pressure B. privacy and reassurance that crying is therapeutic
D. uterine tone and normal
C. to see and make tactile contact with her baby
140. Five hours postpartum, the client’s temperature D. to talk about her labor experience
is 101F (38°C). If you are the OB nurse what would
be your appropriate nursing action is to: * 145. Following episiotomy and delivery of a newborn
A. continue to monitor the temperature infant, the nurse performs a perineal assessment to
B. apply cool packs to the abdomen Nora. The nurse notes a trickle of bright red blood
C. notify the physician coming from the perineum. The nurse further assesses
D. remove the blanket from the client’s bed the fundus and notes that it is well contracted. What
would the nurse suspect? *
141. Jo a post partum mother wants to breast feed her A. this is a normal expectation following episiotomy
baby. As part of your nursing care to prevent sore B. the perineal assessment should be performed more
nipple soreness during breastfeeding, you would frequently
determine that the client needs further instruction C. the bright red bleeding is abnormal and should be
when she states which of the following? * reported
A. “I should position the baby the same way for each D. the mother should be allowed bathroom privileges
feeding.” only
B. “I should make sure the baby grasps the entire Correct answer
areola and nipple.”
C. “I should air dry my breast and nipples for 10-15 SITUATION
minutes after the feeding.” As a MCN nurse in the community it is expected that
D. “I shouldn’t use a hand breast pump if my nipples you will conduct a post-partum visit after delivery.
get sore.” The following findings were noted during the visit:
her left calf is swollen, warm to touch, reddened and
SITUATION painful. Temperature is 37.9C.
Juvy is three days postpartum. Her vital signs are
stable; her fundus is three fingerbreadths below the 146. You would advise her for immediate check and
umbilicus, and her lochia rubra is moderate. instructed her not to: *
A. decrease leg movement
142. The breasts are hard and warm to touch. What B. apply warmth to the leg
would be the analysis of these findings? * C. elevate the leg
A. is showing early signs of breast infection. D. gently massage the painful area of the leg
B. is normal for three days postpartum.
C. needs ice packs applied on breasts. 147. Cathy G3 P2 delivered a full-term newborn 14
D. should remove her nursing bra t reduce discomfort. hours ago. The Obstetric nurse noted an atonic uterus,
high and deviated to the right. What would be the most
143. A G4 P3 client who is breastfeeding complains appropriate nursing intervention? *
of severe cramps or after pains 30 hours after cesarean A. notify the physician
delivery. The nurse explains that these are caused by B. place the client on a pad count
which of the following? * C. massage the uterus and reevaluate in 30 minutes
A. flatulence accumulation after a cesarean delivery D. have the client void and reevaluate the fundus
B. healing of the abdominal incision after cesarean
delivery 148. A baby born from a primipara woman 6 hours
C. side effects of the medications administered after ago. The mother asks the nurse the white cheese-like
delivery substance under the baby’s arms. The appropriate
D. release of oxytocin during the breastfeeding response of the nurse would be:
session A. “This is a normal skin variation in newborn that
goes away in a few weeks.”
B. “The baby may have a skin infection.”


 13

C. “This material, called vernix, covered the baby
before it was born. It will disappear in few days.”
D. “Babies sometimes have sebaceous glands that get
plugged at birth. This substance is an example of that
condition.”

SITUATION
The Nurse is assessing a post-partum mother after
delivery. One of the major postpartum areas to be
assessed is the bladder.

149. Which of the following signs would the nurse

determine a full bladder? *
A. increased uterine contractions
B. fundus 2F above umbilicus to the side
C. decreased lochia
D. pulse 52 bpm

150. Mrs. Fe G2, P2, just undergone post Cesarean

Section and is diagnosed with Thrombophlebitis. The
Physician started treatment on her condition. The
client’s response to treatment will be evaluated
regularly assessing the client for: *
A. dysuria, frequency, urgency
B. red, swollen, painful calf
C. hematuria, ecchymosis, and epistaxis
D. sudden chest pains and dyspnea