Maternity Nursing Study

Guide (QUICK REVIEW)

TYPES OF FEMALE PELVISES
1. Female Reproductive
System Gynecoid: Ideal for vaginal
delivery.
MENSTRUAL CYCLE
Android: Male-like, narrow; may
Phases: require cesarean delivery.

1. Menstrual Phase (Day 1– Anthropoid: Oval-shaped, often

5): Shedding of the uterine favorable for vaginal delivery.
lining.
Platypelloid: Flat, wide; usually
2. Proliferative Phase (Day not ideal for vaginal birth.
6–14): Estrogen stimulates the
repair and thickening of the
endometrium. UMBILICAL CORD

3. Ovulation (Day 14): Structure: Two arteries (carry

Triggered by a surge in deoxygenated blood) and one
Luteinizing Hormone (LH). vein (carries oxygenated blood).

4. Secretory Phase (Day 15– Function: Connects fetus to

28): Progesterone maintains the placenta, ensuring nutrient and
endometrium for potential oxygen transfer.
implantation.

PLACENTA
 Hormone Release:
Estrogen, progesterone, Function: Provides
FSH, LH regulate the cycle. oxygen/nutrients, removes
waste, produces hormones (hCG,
 Ovulation Timing: Typically estrogen, progesterone).
occurs 14 days before the
next period. Fertilization/Implantation:

 Fertilization occurs in the

fallopian tube.

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  Implantation happens 6–10 A: Abortions
days post-fertilization in the (spontaneous/elective).
uterine lining.
FETAL DEVELOPMENT L: Living children.

Week 4: Heart begins to beat. NAEGELE'S RULE

Week 8: Major organs start Formula: First day of the last

forming. menstrual period (LMP) - 3
months + 7 days + 1 year.
Week 12: Fetal movements
begin.
SIGNS OF PREGNANCY
Week 20: Quickening felt;
gender identifiable. Presumptive: Subjective signs
(e.g., nausea, missed period).
Week 36–40: Lungs mature;
fetus gains weight. Probable: Objective signs (e.g.,
Chadwick's sign, Goodell's sign).

Positive: Definitive signs (e.g.,

2. Assessing the Pregnant fetal heartbeat, ultrasound).
Mom

Maternity-Specific Terminology RISK FACTORS

Gravida: Total pregnancies. HIV, Hepatitis: Vertical

transmission risks, requiring
Para: Deliveries past 20 weeks interventions (e.g., antiretroviral
gestation. therapy).

GTPAL:
3. Prenatal Care
G: Gravida (total pregnancies).
Normal Changes in Pregnancy
T: Term births (37+ weeks).
Physical: Breast tenderness,
P: Preterm births (<37 weeks). weight gain, skin changes,
increased blood volume.

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  Interventions: Methotrexate
Mental: Emotional lability, or surgery.
nesting behaviors.

DIAGNOSTIC TESTS
5. Labor and Delivery
Amniocentesis: Tests genetic
conditions and lung maturity. STAGES OF LABOR

Non-Stress Test (NST): First Stage: Cervical dilation

Monitors fetal heart rate. (0–10 cm).

Contraction Stress Test: Second Stage: Delivery of the

Evaluates fetal response to baby.
contractions.
Third Stage: Delivery of the
placenta.
NUTRITION EDUCATION
Fourth Stage: Recovery.
Pica: Cravings for non-food
items; associated with iron
deficiency. TRUE VS. FALSE LABOR

Gestational Diabetes: Requires True Labor: Regular

glucose monitoring and dietary contractions, cervical changes.
adjustments. False Labor: Irregular
contractions, no cervical change.

4. Pregnancy Risks FETAL MONITORING

High-Risk Conditions *Decelerations:

 Early: Head compression,
 Ectopic Pregnancy: normal.
Implantation outside the  Late: Placental
uterus (e.g., fallopian tube). insufficiency, requires
 Symptoms: Severe intervention.
abdominal pain, spotting,
shoulder pain.

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  Variable: Cord Serosa (pink): 4–10 days.
compression, reposition
mother. Alba (white): 10–14 days.

Uterine Involution: Fundus

descends 1 cm/day.

COMPLICATIONS
BREASTFEEDING CARE
1. Prolapsed Cord: Emergency -Proper latch to prevent
requiring immediate delivery. soreness.
2. Placenta Previa: Placenta -Mastitis: Infection; treat with
covers cervix; requires antibiotics and continued
cesarean delivery. breastfeeding.
3. Abruptio Placenta: Placental
detachment; causes bleeding,
pain.
7. Newborn Care

PAIN RELIEF Apgar Scoring - evaluates

Appearance, Pulse, Grimace,
Non-pharmacologic: Breathing Activity, Respiration at 1 and 5
techniques, positioning. minutes.
Pharmacologic: Epidural, spinal
block. Vital Signs

Heart rate: 120–160 bpm.

Respiratory rate: 30–60
6. Postpartum Care and breaths/min.
Complications Temperature: 36.5–37.5°C.

Normal vs. Abnormal Findings Newborn Medications

LOCHIA: 1. Vitamin K: Prevents

bleeding.
Rubra (red): 1–3 days. 2. Erythromycin Eye Drops:
Prevents infection.

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 1. A client asks why ovulation occurs
around the middle of the menstrual
cycle. Which hormone surge should
COMMON COMPLICATIONS
the nurse explain triggers ovulation?
1. Respiratory Distress A. Estrogen
Syndrome: Surfactant B. Progesterone
deficiency; manage with C. Follicle-Stimulating Hormone (FSH)
oxygen/ventilation. D. Luteinizing Hormone (LH)
2. Jaundice: Monitor bilirubin
2. A pregnant woman is found to have
levels, phototherapy if
a platypelloid pelvis. Which is the
needed. most likely mode of delivery?
A. Normal spontaneous vaginal
delivery
B. Assisted vaginal delivery
C. Cesarean section
D. Forceps delivery
8. Medications
3. While educating a group of
Pain Relief During Labor pregnant clients, the nurse explains
--Epidural, opioids (monitor for the umbilical cord structure. Which
respiratory depression). statement requires further
clarification?
Labor Medications A. “The cord contains one artery and
two veins.”
1. Induction: Oxytocin B. “The cord supplies oxygen and
(Pitocin). nutrients to the fetus.”
2. Stopping Labor: C. “The cord has a Wharton’s jelly
Tocolytics (e.g., magnesium covering for protection.”
sulfate). D. “The umbilical vein carries
oxygenated blood to the fetus.”

NEWBORN MEDICATIONS II. Assessing the Pregnant Mom

--Vitamin K, erythromycin, and
hepatitis B vaccine. 4. A pregnant woman reports her LMP
was March 15, 2024. Using Naegele's
Rule, what is her estimated due date?
A. December 15, 2024
Now, let’s try what you’ve B. December 22, 2024
learned. C. January 15, 2025
D. January 22, 2025
PRACTICE QUESTIONS:
5. During assessment, the nurse notes
I. Female Reproductive System a bluish discoloration of the vaginal

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mucosa and cervix. This finding is accelerations after 20 minutes. What
documented as: is the next best action?
A. Goodell’s sign A. Notify the physician immediately.
B. Hegar’s sign B. Reposition the mother and
C. Chadwick’s sign reassess.
D. Ballottement C. Administer oxygen to the mother.
6. A G4P2 woman presents for a D. Prepare for an emergency delivery.
prenatal visit. She has a history of
delivering one term baby, one preterm
baby, one miscarriage, and has two IV. Pregnancy Risks
living children. What is her GTPAL?
A. 4-1-1-1-2 10. A client at 7 weeks gestation
B. 4-2-1-0-2 reports severe lower abdominal pain
C. 4-1-2-0-2 and light vaginal bleeding. The nurse
D. 4-1-1-0-2 should suspect:
A. Placenta previa
B. Abruptio placentae
III. Prenatal Care C. Ectopic pregnancy
D. Hydatidiform mole
7. A pregnant client at 28 weeks
gestation has a strong craving for non- 11. During care of a client with an
food items like clay. The nurse ectopic pregnancy, which nursing
recognizes this as: intervention is a priority?
A. A normal pregnancy craving A. Prepare the client for a cesarean
B. A sign of hyperemesis gravidarum delivery.
C. Pica, which may indicate iron B. Monitor the client for signs of
deficiency hypovolemic shock.
D. An early sign of gestational C. Encourage ambulation to relieve
diabetes pain.
D. Provide iron supplements.
8. A pregnant client is scheduled for
an amniocentesis. The nurse should
prioritize which post-procedure V. Labor and Delivery
instruction?
A. “You may resume normal activities 12. A laboring woman is in the active
immediately.” phase of the first stage of labor. Which
B. “Notify the doctor if you experience cervical dilation measurement is
any leakage of fluid.” expected?
C. “Avoid drinking fluids for 24 hours A. 0–3 cm
after the procedure.” B. 4–7 cm
D. “Do not take any pain C. 8–10 cm
medications.” D. Fully dilated

9. During a non-stress test, the nurse 13. A client at 39 weeks gestation

notes the absence of fetal reports regular contractions but no

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cervical dilation. This finding preventing mastitis. Which instruction
indicates: is appropriate?
A. True labor A. "Avoid feeding from the affected
B. False labor breast if it feels sore."
C. Active labor B. "Breastfeed frequently and empty
D. Transition phase both breasts completely."
C. "Apply cold compresses before
14. During a labor assessment, the feeding."
nurse observes late decelerations on D. "Wear a tight-fitting bra for
the fetal heart monitor. The nurse’s support."
priority action is to:
A. Administer IV fluids.
B. Reposition the mother to the left VII. Newborn Care
lateral position.
C. Encourage the mother to ambulate. 18. A newborn has an Apgar score of 6
D. Notify the physician to prepare for at 1 minute. What should the nurse do
delivery. first?
A. Provide full resuscitation.
15. A nurse is caring for a client B. Reassess the Apgar score after 10
experiencing a prolapsed umbilical minutes.
cord. What is the priority intervention? C. Administer oxygen and stimulate
A. Administer oxygen via face mask. the newborn.
B. Insert two fingers to lift the D. Wrap the newborn in warm
presenting part off the cord. blankets.
C. Reposition the client into a supine
position. 19. A 2-day-old newborn exhibits
D. Prepare for immediate cesarean yellow discoloration of the skin and
delivery. sclera. Which intervention is the
nurse’s priority?
A. Encourage the mother to
VI. Postpartum Care and breastfeed every 4 hours.
Complications B. Prepare the newborn for
phototherapy.
16. A postpartum client is 2 days post- C. Administer a high-protein formula.
delivery. She reports heavy bleeding D. Monitor for signs of infection.
with large clots. Which nursing action
is most appropriate? 20. Which vital sign in a newborn
A. Encourage the client to ambulate. requires immediate intervention?
B. Assess the uterine fundus and A. Respiratory rate of 50 breaths/min
perform fundal massage. B. Axillary temperature of 36.3°C
C. Provide pain medication and C. Heart rate of 120 bpm
monitor bleeding. D. Oxygen saturation of 95%
D. Notify the physician immediately.

17. The nurse is teaching a VIII. Medications

breastfeeding mother about

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21. The nurse administers oxytocin to A. The client is in active labor.
a laboring client. Which observation B. The cervix is favorable for
indicates the medication should be induction.
stopped? C. The cervix is not yet ready for
A. Contractions occurring every 2–3 induction.
minutes. D. The client requires immediate
B. Fetal heart rate of 110 bpm with delivery.
variability.
C. Uterine hypertonicity with 26. A client with gestational diabetes
contractions lasting >90 seconds. asks about insulin requirements
D. Cervical dilation of 6 cm. during pregnancy. The nurse explains:
A. "Your insulin needs will decrease as
22. A newborn is scheduled to receive the pregnancy progresses."
Vitamin K. The nurse understands the B. "Insulin needs typically increase
purpose of this medication is to: during the second and third
A. Promote bone development. trimesters."
B. Prevent hemorrhagic disorders. C. "You will not need insulin since you
C. Boost the immune system. have gestational diabetes."
D. Facilitate oxygen transport in the D. "Oral medications are the preferred
blood. treatment."

23. The nurse administers magnesium 27. A nurse notes variable

sulfate to a preeclamptic client. Which decelerations on the fetal monitor
finding indicates the need to strip. What intervention should be
discontinue the medication? performed first?
A. Respiratory rate of 10 breaths/min A. Administer oxygen via mask.
B. Deep tendon reflexes of +2 B. Increase the IV fluid rate.
C. Urinary output of 40 mL/hour C. Reposition the client.
D. Blood pressure of 150/90 mmHg D. Notify the physician.

28. A client in active labor is

Critical Thinking Scenarios requesting pain relief. Which non-
pharmacologic intervention is most
24. A postpartum mother has a firm appropriate?
fundus but continues to experience A. Administering an epidural.
heavy vaginal bleeding. What is the B. Encouraging the use of breathing
likely cause? techniques.
A. Uterine atony C. Providing IV pain medications.
B. Retained placental fragments D. Applying a sedative.
C. Vaginal laceration
D. Endometritis 29. The nurse is preparing to
administer RhoGAM. Which client
25. During a prenatal visit, the nurse qualifies for this injection?
identifies that the client has a Bishop A. Rh-positive mother with an Rh-
score of 6. What does this score positive baby.
indicate?

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B. Rh-negative mother with an Rh- 29. B. Rh-negative mother with an Rh-positive baby
30. C. Monitor for signs of fetal distress
positive baby.
C. Rh-negative mother with an Rh-
negative baby.
D. Rh-positive mother with an Rh-
negative baby.

30. A nurse caring for a client with

abruptio placenta should prioritize
which action?
A. Perform a vaginal examination.
B. Administer an oxytocin infusion.
C. Monitor for signs of fetal distress.
D. Prepare for a vaginal delivery.

ANSWER KEY
1. D. Luteinizing Hormone (LH)
2. C. Cesarean section
3. A. “The cord contains one artery and two veins.”
4. B. December 22, 2024
5. C. Chadwick’s sign
6. A. 4-1-1-1-2
7. C. Pica, which may indicate iron deficiency
8. B. “Notify the doctor if you experience any
leakage of fluid.”
9. B. Reposition the mother and reassess
10. C. Ectopic pregnancy
11. B. Monitor the client for signs of hypovolemic
shock
12. B. 4–7 cm
13. B. False labor
14. B. Reposition the mother to the left lateral
position
15. B. Insert two fingers to lift the presenting part
off the cord
16. B. Assess the uterine fundus and perform
fundal massage
17. B. "Breastfeed frequently and empty both
breasts completely."
18. C. Administer oxygen and stimulate the
newborn
19. B. Prepare the newborn for phototherapy
20. B. Axillary temperature of 36.3°C
21. C. Uterine hypertonicity with contractions
lasting >90 seconds
22. B. Prevent hemorrhagic disorders
23. A. Respiratory rate of 10 breaths/min
24. C. Vaginal laceration
25. C. The cervix is not yet ready for induction
26. B. "Insulin needs typically increase during the
second and third trimesters."
27. C. Reposition the client
28. B. Encouraging the use of breathing techniques

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