OBSTETRIC NURSING I

Situation: Elena believes that she is pregnant since she missed her period for 2 months. She likewise is experiencing nausea
and vomiting with positive pregnant test result. Ultrasound revealed no fetal parts and no fetal heart activity. HCG titer
revealed abnormally high level.
1. An increasing titer of HCG after D&C may indicate:
A. Choriocarcinoma B. DIC C. Uterine rupture D. Rh incompatibility
2. Which prophylactic drug is most expected to be given to Elena?
A. Oxytocin B. Methergin C. Methothrexate D. Dexamethasone

Situation: Perena was diagnosed of ectopic pregnancy.

3. A positive Cullen’s sign may indicate:
A. softened cervix B. non-contractile uterus C. globular uterus D. hematoperitoneum
4. Laboratory tests in ectopic pregnancy would usually reveal:
A. low HCG, high progesterone C. low HCG, low progesterone
B. high HCG, high progesterone D. high HCG, low progesterone
5. A history of usage of this contraceptive method would predispose Perena to ectopic pregnancy.
A. Cervical cap B. Norplant C. IUD D. Diaphragm
6. To enhance absorption of residual tissues, the nurse would expect prescription of which of the following drugs?
A. Methotrexate B. Oxytocin C. Clomid D. Mifepristone
7. A postpartal client develops a temperature during her postpartal course. Which of the following temperatures indicate the
presence of postpartal infections?
a. 99.0 0 F 12 hours after delivery that decrease after 18 hours.
b. 100.2 0 F 24 hours after delivery that decreases the second postpartum day.
c. 100.4 0 F 24 hours after delivery that remains until the second postpartum day.
d. 100.6 0 F 48 hours after delivery that continues into the third postpartum day.
8. Semen analysis of Mrs. Lagdameo’s husband is requested. Which of the following should NOT be a part of the
instruction to be given to the husband?
a. Abstain from intercourse for several days then collect fresh ejaculate for testing
b. Immerse the specimen in a tumbler of ice cubes and transport it immediately to the testing facility
c. Keep the specimen warm by placing the container under the arm or close to the skin
d. Entire specimen is collected in a clean, dry container and immediately transported to the laboratory
9. Aimee, 31 year old woman has been pushing in the second stage of labor for 2 hours. The vertex is at the +2 station. Each
contraction is associated with a fetal bradycardia as low as 100 beats per minute (bpm) that lasts for 30 seconds. This clinical
scenario suggests which of the following situations?
a. Systemic fetal hypoxia c. An association with oligohydramnios
b. Poor fetal outcome d. Fetal head compression
10. Kim with ruptured membranes is in the active phase of labor and is 5-cm dilated with sustained, deep variable decelerations.
The decision is made to perform a cesarean section. Which of the following would not be an appropriate intrauterine
resuscitative measure done before the cesarean section?
a. Increase the intravenous fluids c. Start nasal oxygen
b. Place the client in supine position d. Start amnioinfusion
11. After having identified a fetus at risk in prolonged pregnancy, management should consist of:
a. Amniocentesis for maturity studies c. Fetal sampling of scalp pH
b. Delivery regardless of the status of the cervix d. Measurement of human chorionic somatomammotropin
12. Which of the following findings would be unexpected in the progression of a normal pregnancy?
a. A weight gain of 11 lbs at 20 weeks
b. Fetal heart tones at 13 weeks detected by Doppler ultrasound
c. The fundus of the uterus at the level of the umbilicus at 20 weeks
d. Real-time ultrasonographic evidence of fetal heart motion 4 weeks after the last menstrual period (LMP).
13. Bernadette who is known to use cocaine presents with seizures, a temperature of 1040F, and a blood pressure of 180/120.
She is 36 weeks pregnant. After a thorough evaluation, the physician excludes preeclampsia and intrauterine infection. The
diagnosis is cocaine toxicity. Action to be taken includes all of the following except:
a. delivering the infant expeditiously c. providing a cooling blanket
b. providing oxygen and considering intubation d. treating with intravenous propanolol
14. Factors that are important in the pathophysiology of pelvic inflammatory disease (PID) include all of the following except:
a. intrauterine device use b. sexual intercourse c. menstruation d. uterine fibroids
15. A class II cardiac patient Alena, who is 38 weeks pregnant presents to the hospital in labor with dyspnea on exertion and
chest rales. Proper management of this pregnant patient includes all of the following except:
a. epidural anesthesia b. diuretics c. cesarean delivery d. digitalis
16. Portia presents to the labor floor, she is in latent phase of labor and complaining of painful contractions that occur every 2
minutes. She is 2 cm dilated. Two hours later, she continues to complain of frequent painful contractions, but she is still only 2
cm dilated. What is the diagnosis that describes Portia’s condition?
a. False labor c. Hypotonic uterine dysfunction
b. Hypertonic uterine dysfunction d. Active phase of labor
17. Freda presents to the labor floor with contractions 8 to 12 minutes apart. She complains of lower abdominal discomfort with
her contractions, which last for only 20 seconds each. Sedation causes the contraction to be spaced at intervals of 15 to 20
minutes. According to the given situation , what is the condition being experienced by Freda?
a. False labor c. Hypotonic uterine dysfunction
b. Hypertonic uterine dysfunction d. Active phase of labor
Situation: Clarita, was diagnosed of mitral valve stenosis when she was 18 years old. She is now a primigravida in her 12
week AOG. She is classified under Class II
18. During history taking regarding the discomforts that Clarita is experiencing, nurse Bugs knows that these are expected signs
and symptoms of pregnancy EXCEPT:
A. peripheral edema B. transient systolic murmurs C. palpitations D. dysrhythmia
19. While conducting health education, which of the following statements from Clarita would need further teaching?
A. I eat a lot of papaya and avoid straining when I move my bowel
B. I refrain from going to crowd places since infection may complicate my condition
C. I take Warfarin religiously as ordered since it may not cross the placenta
D. I avoid eating tinapa, salted eggs, dried fish which may further aggravate my edema
20. Foods rich in Vit K should be avoided when taking anticoagulant since it may:
A. promote further bleeding C. oppose the action of the drug
B. predispose client to infection D. promote cardiac decompensation
21. Antibiotics are usually given as prophylaxis to:
A. Thrombophlebitis B. Cystic fibrosis C. Endocarditis D. Cardiomegaly
22. The most hemodynamically difficult status for this woman in labor is during_ period
A. latent prenatal B. active C. transition D. immediate post-partum
23. Combined contraceptive pills are usually not recommended since it makes the client at risk for:
A. Deep Vein Thrombosis B. PID C. Uterine myoma D. Cystic fibrosis
24. Breast engorgement can also cause temperature elevation, but does not last longer than how many hours?
a. 48 b. 12 c. 10 d. 24
25. Nurse Cindy in the prenatal clinic is taking a history from a prenatal client at 7 weeks gestation. The client states, “I don’t
know if I want this baby. How will I know if I’ll be a good mother?” What is the most appropriate response by Nurse Cindy?
a. “Ambivalence can be normal reaction to parenthood in the first trimester.”
b. “This would be the best time to consider an abortion or adoption.”
c. “This is a sign of depression, and I’d like you to see a mental health specialist.”
d. “This is an abnormal reaction, and I’d like you to speak with Family Services.”
26. Nurse Rizzelle is teaching a prenatal nutrition class. Which meal is highest in protein?
a. Toasted cheese sandwich, tomato soup, and iced tea c. Fortified cereal, toast, and orange juice
b. Peanut butter sandwich, pea soup, and lemonade d. Sausage and eggs with cheese, toast, and coffee
27. Increased incidence of neural tube defect is usually associated with deficiency of:
A. Iron B. Potassium C. Folic acid D. Magnesium
28. When performing Leopold's maneuvers, which of the following would the nurse ask the client to do to ensure optimal
comfort and accuracy?
a. Breathe deeply for 1 minute b. Empty her bladder c. Drink a full glass of water d. Lie on her left side
29. Mrs. Tomas asks the nurse how soon she can resume sexual intercourse after giving birth. The most appropriate response
would be:
a. “Usually as soon as lochia serosa stops & it is comfortable for you & your husband.”
b. “You will have to discuss this with your doctor.”
c. “It is advisable to wait at least 6 weeks after delivery.”
d. “Are you really concerned about sexual relations now?”
30. Mrs. Rowena, a 25 year old primigravida is seen for the first time in the antenatal clinic. She offers a history of 2 months
amenorrhea and a tingling sensation in her breast. She also stated that she has PUD (peptic ulcer disease). On examination, a
diagnosis of a probable pregnancy is made. To manage Mrs. Rowena’s care. It is most important at this time for the nurse to
assess her:
a. sexual history b. attitude toward the pregnancy c. nutritional status d. social and economic resources
31. Mrs. Lilia wants to know when her baby will be born. Her last menstrual period began August 10 and ended on August 17.
You calculate her delivery date to be:
a. May 17 b. May 24 c. May 10 d. May 7
32. At the next prenatal visit, a client (16 weeks pregnant), asks what her baby looks like now. What is the most accurate
answer?
a. embryonic organs are beginning to form c. the fetus weighs 3.5-4 lbs
b. major fetal organs are beginning to function d. the baby’s sex is now obvious
33. Gloria, a 30 year old multiparous woman is attending the antepartum clinic with her fourth pregnancy. Gloria explains to the
nurse that she must work to augment the family income, but her mother advised her to stop working after her seventh month. An
appropriate reply by the nurse would be:
a. “Your mother has more experience than you so why not follow her advice?”
b. “If you have to work, there is nothing anyone can do about it.”
c. “You can stop working after the seventh month.”
d. “You can work as long as possible, provided there are no complications or health hazards.”
34. Magnesium sulfate is one of the drugs used as a sedative, a diuretic, and anticonvulsant in patients with severe pre-
eclampsia. Before a repeat dose is given, which of the following is the most important to ascertain?
a. urinary output b. abdominal sounds c. level of blood pressure d. pulse rate
35. Mrs. Blass is scheduled for a caesarean section. The nurse enters and finds her in tears. When the nurse asked why she is
crying, Mrs. Blass states that she is afraid that the baby will die. Which of the following responses would be the most
appropriate?
a. Don’t worry Mrs. Blass; the doctors know what they are doing.”
b. “You have nothing to worry about, just leave everything up to the doctors.”
c. “Your baby is healthy, don’t worry nothing will happen.”
d. “What makes you afraid that the baby will die?”
36. A client tells the nurse that she was looking forward to breastfeeding the baby. Breast milk contains secretory
immunoglobulin A (IgA). Which of the following reduces the incidence of diarrhea in breastfed babies?
a. Lysozyme b. Interferon c. Lactoferrin d. Lactobacillus bifidus
37. A client is now 34 weeks pregnant and is admitted for observation and fetal assessment. Which of the following tests would
now be done to determine placental sufficiency and L/S ratio?
a. amniocentesis & estriol c. estriol levels & ultrasonic scanning
b. amniocentesis & ultrasonic scanning d. amniocentesis & blood sugar levels
38. Mrs. Manalo is in labor and her contractions are of 40 seconds duration with intervals of 8 minutes. Which of the following
contributes to stimulate labor process in a pregnant woman?
a. High fiber diet c. the position of the fetus in the uterus
b. Level of physical activity d. uterine muscle stretching
39. A ruptured uterus is a serious complication of oxytocin infusion. Which of the following is a warning sign of impending
uterine rupture?
a. once strong contraction are now sustained aide 30 seconds c. a retraction ring is noted at the lower uterine segment
b. contractions last 90 seconds d. contractions change from regular to irregular

Situation: Mrs. Bell, a 39 year old multipara, was admitted to the labor and delivery room in active labor. On palpitation it
was found out that the fetus was on breech position.
40. Mrs. Bell’s labor is progressing satisfactory, but the nurse must constantly be on alert for any sign of impending danger.
Which of the following, signs would be considered normal for Mrs. Bell?
a. meconium in the vagina c. fetal heart rate heard on the lower left quadrant of mothers abdomen
b. fetal heart rate below 100 beats/minute d. maternal diastolic pressure that rises 30 mm Hg during a contraction
41. The low-risk client, who is 16 weeks pregnant, should be told to return to the prenatal clinic in:
A. 1 week B. 2 weeks C. 3 weeks D. 4 weeks
42. The client has completed an at-home pregnancy test with positive results. Which of the following indicates that the client
understands the meaning of the test results?
A. ”I understand that this means I have ovulated in the past 24 hours.”
B. “I understand that this means I am not pregnant.”
C. “I understand that this means I might be pregnant.”
D. “I understand that this means I am pregnant.”
43. The client is pregnant and reports that her last menstrual period began July 10. Her expected date of birth is:
A. April 3 B. April 17 C. October 3 D. October 17
44. The pregnant client reports that she has a 3-year old child at home who was born at term, had a miscarriage at 10 weeks
gestation, and delivered a set of twin at 28 weeks gestation that died within 24 hours. In the prenatal record, the nurse should
record:
A. Gravida 2, para 1 B. Gravida 3, para 3 C. Gravida 4, para 2 D. Gravida 5, para 4
45. The client is considering having maternal alpha-fetoprotein (AFP) screening. She asks the nurse how a test on her blood can
indicate a fetal birth defect. The best reply by the nurse is:
A. “We aren’t sure why this test works, but it does.”
B. “Neutral tube defects are passed in genetic material so it is possible to know if it was passed to your baby by
examining the amount of alpha-fetoprotein in you DNA.”
C. “When babies have neutral tube defects, some of their alpha-fetoprotein leaks out and is absorbed into your blood
which causes your level to rise. This test detects that rise.”
D. “When a fetus has a neutral tube defect, not enough alpha-fetoprotein is produced so some of your alpha-
fetoprotein moves across the placenta into the baby’s circulation. This makes your level decrease, and that is
reflected in the level we measure in your body.”
46. The client’s test for syphilis has come back positive. In talking with the woman about how the infection is spread, the client
should be taught that syphilis can be contracted through:
A. Shaking, kissing, and oral-genital sexual contact.
B. Kissing and biting, oral-genital sexual contact.
C. Exposure to contaminated toilet seats and oral-genital sexual contact
D. Only oral-genital sexual contact.
47. In explaining to the client who has come in for her initial prenatal exam why it is important to test pregnant women for
gonorrhea, the nurse should tell the client that gonorrhea can cause neonatal:
A. Vaginal discharge B. Eye infections C. Liver damage D. Congenital anomalies.
48. Which of the following signs or symptoms would indicate a need for colposcopy and biopsy for human papillomavirus?
A. Rash on palms of the hands and soles of the feet
B. Chancre sore noted on the vulva
C. A crusted ulcer inside the vagina
D. 2 to 3 mm soft, papillary swellings either singly or in cluster noted on the genitalia
49. The client has come in for her initial prenatal visit. When the testing that will be done at this visit is explained, the client
asks why it all has to be done today. The nurse’s s best’s response is:
A. “We do it all on the first visit in case the patient does not come back.”
B. “Insurance won’t pay for testing unless it is done in the first trimester.”
C. “It is best to find any current problems so that they can be treated as early as possible.”
D. “You don’t need to worry about what we’re doing; your doctor knows what is best for you and your baby.”
50. A client continues to pass large amount of clots and bright red lochia despite the nurse’s attempt to massage the fundus.
Upon reexamination, the nurse finds that the client’s uterine fundus remains boggy. The nursing actions and oxytocin (Pitocin)
do not seem to be helping to keep the fundus firm. What second medication might the physician request the nurse to administer
to manage uterine atony?
A. Dinoprostone (Cervidil). C. Magnesium sulfate
 B. Terbutaline sulfate (Brethine) D. Carboprost (Protin 15-M or Hemabate)
51. A mother with mastitis is concerned about breast feeding while she has an active infection. The nurse should explain that:
A. The infant is protected from infection by immunoglobulins in the breast milk
B. The infant is not susceptible to the organism that cause mastitis
C. The organism that cause mastitis are not passed in the milk
D. The organism will be inactivated by gastric acid.
52. Which of the following prenatal laboratory test values would the nurse consider as significant?
a. Rubella titer less than 1:8 c. One hour glucose challenge test 110 g/dL
b. Hematocrit 33.5% d. White blood cells 8,000/mm3
53. In response to an expectant couple's questions, the nurse is explaining various hormones and their functions during
pregnancy. Which of the following should the nurse include in the discussion?
a. Estrogen maintains the growth of the endometrial lining of the uterus
b. Human chorionic gonadotropin ensures continued production of progesterone & estrogen
c. Progesterone contributes to mammary gland development & uterine growth
d. All of the above
54. A 36-year old primigravida at 12 weeks gestation asks the nurse, "What is the purpose of an alpha fetoprotein test?" the best
response by the nurse is to instruct the patient that this test can detect fetal:
a. Kidney defects b. Cardiac defects c. Neural tube defects d. Urinary tract defects
55. A multigravida at 36 weeks gestation is scheduled to undergo amniocentesis. The nurse determines that the patient needs
further explanation when the patient says:
a. "bout 3 teaspoons of amniotic fluid will be removed." c. "A sonogram will be done during the procedure."
b. "I should have a full bladder before the procedure. d. "I may feel pressure when the needle is inserted."
56. The nurse is caring for a primigravida who is scheduled for a fetal acoustic stimulation test (FAST). The nurse should
explain to the patient that the primary purpose of this test is to:
a. Shorten the contraction stress test C. Induce fetal heart rate accelerations
b. Induce contractions D. Determine fluid volume
57. A client’s amniotic fluid is greenish-tinged. The fetal presentation is vertex. Fetal heart rate (FHR) and uterine activity have
remained within normal limits. At the time of delivery, the nurse should anticipate the need for:
A. An infant laryngoscope and suction catheters C. A transport isolette
B. Forceps D. Emergency cesarean set-up
58. A client who is 34 weeks gestation has been having contractions every 10 minutes regularly. In addition to instructing her to
lie down and rest while continuing to time contractions, the nurse should also tell her:
A. Refrain from eating or drinking anything
B. Take slow deep breaths with each contraction
C. Go to the hospital if contractions continue for more than I hour.
D. Drinks 3 to 4 cups of water
59. A client has a temperature of 100.2 0F 4 hours after delivery. What is the appropriate action for the nurse to take?
A. Encourage increased fluid intake
B. Do nothing since this an expected finding at this time
C. Check the physician’s orders for an antibiotic to treat the client’s infection
D. Medicate the client for pain.
60. A client delivered 90 minutes ago. She is alert and physically active in bed. She states that she needs to go to the bathroom.
The nurse’s most appropriate response is:
A. “I’ll walk you to the bathroom and stay with you”
B. “I’ll get a bedpan for you”
C. “It’s important that you wipe yourself from front to back after urinating”
D. “Wipe the stitches back and forth to increase circulation.”
61. A client has an episiotomy and complains of perineal discomfort. She is also afraid to have bowel movement. Which of the
following nursing diagnoses is the highest priority for this client at this time?
A. Activity intolerance B. Deficient knowledge C. Pain D. Risk for constipation.
62. The client is a 36 year-old woman, gravida 6, para 6 who delivered a baby girl at 38 weeks gestation after 8 hours of labor.
The baby weighed 7 pounds 124 ounces. The client’s vital signs are stable, and her lochia is bright red, heavy, contains various
clots. The largest clot is about half-dollar size. The client is considered to be high risk for uterine atony because of which of the
following?
A. Grand multiparity B. Size of the baby C. Length of labor D. Client’s age
63. Introduction of radiopaque material into the uterus and fallopian tubes to assess tubal patency is known as which of the
following?
a. Hysterosalpingography b. Spinnbarkeit test c. Hysteroscopy d. Ferning test
64. Resabel, a student nurse, is asked by a patient, "What determines if my baby's lungs are mature?" The student's nurse correct
response is the:
a. Lecithin-sphingomyelin (L/S) ratio c. Nitrazine Test
b. Fern Test d. Maternal serum alpha fetoprotein
65. A 22-year old woman is pregnant with her first baby. During her 7th month, she complaints of backache. The nurse teaches
her to:
a. Perform Kegel exercises once/day C. Wear barefoot at least once/day
b. Wear low-heeled shoes D. Sleep on a soft mattress
66. Which of the following would cause a false-positive result on a pregnancy test?
a. The uterine sample was stored too long at room temperature
b. A spontaneous abortion or a missed abortion is impending
c. Taking oral contraceptive
d. All of the above
67. Which of the following additional assessment findings would be most suspicious and lead the nurse to suspect postpartum
"blues" in a client who is anxious and crying?
a. Loss of appetite, constipation, abdominal pain c. Mood lability, loss of appetite, difficulty sleeping
b. Increased appetite, urinary retention, diarrhea d. Poor concentration, constipation, diarrhea
68. Mrs. Isabel delivers a 7-lb (3.2 kg) girl. After the neonate is delivered, the physician instructs the nurse to add 10 untis of
oxytocin (Pitocin) to Mrs. Isabels' IV to:
a. Prevent DIC c. Contract the uterine muscles
b. Relax the uterine muscles d. Augment the clotting action of the platelets
69. A client pregnant with her third child is deciding about having tubal ligation after she delivers. When evaluating a client's
teaching plan about tubal ligation, which of the following client statements would indicate the need for additional teaching?
a. "The procedure requires a small surgical incision in my abdomen."
b. "I can have the procedure reversed if we change our mind and want more children."
c. "I can have the procedure done immediately after I deliver my baby."
d. "I still have to be careful about sexually transmitted diseases even after the procedure."
70. After having a vasectomy, Dan asks the nurse if he'll become sterile immediately. The nurse's best response is:
a. "You'll be sterile in 2 to 3 days."
b. "If the procedure is done correctly, you'll be sterile immediately."
c. "No, you'll remain fertile. This procedure doesn't make you infertile."
d. "It may take several weeks and as many as 10 to 20 ejaculations to remove all the live sperm."
71. Disseminated Intravascular Coagulation (DIC) is a possible complication of abruptio placenta. Which assessment finding
would indicate that the patient has developed DIC?
a. Bleeding of the nose and gums c. Increased central venous pressure
b. Joint pain d. Rapid clotting at venipuncture sites

Situation: Mrs Cass is in her 2nd trimester and admitted in USTH with a chief complaint of hypertension. With BP= 170/100.
Further assessment revealed edema on face and upper extremities. The client even verbalized “Ewan ko ba hindi na rin
magkasya wedding ring ko sa akin.”
72. To further confirm the medical impression of the physician, the nurse would expect prescription of what laboratory exam to
Mrs. Cass?
A. CBC B. Urinalysis C. SGPT D. BUN
73. The rationale for prescribing the above laboratory test is to determine presence of:
A. acetone B. sugar C. albumin D. bacteria
74. The nurse knows that edema in this case is initiated by degeneration of what specific organ?
A. lungs B liver C. kidneys D. brain
75. To further confirm the preliminary diagnosis and further assess its severity, the nurse would prepare the client to undergo the
following test.
A. abdominal ultrasound C. stool exam
B. Liver enzymes and CBC with platelet count D. BUN, creatine, glucose level, uric acid
76. Finally, Mrs. Cass is diagnosed of PIH. Which of the following statements is INCORRECT regarding this condition?
A. The exact cause is unknown
B. It usually occurs anytime after the 20-24th week AOG to six weeks postpartum
C. Danger of convulsion is present until 24 hours post-partum
D. Increased blood supply to kidneys
77. Aside from Mrs Cass’ blood pressure, these manifestations would classify her under Pre-eclampsia Severe.
A. 5 lbs weight gain per month, proteinuria 400 gms/L/d
B. 5 lbs weight gain per week, proteinuria 400 gms/L/d
C. 5 lbs weight gain per month, proteinuria 5000 mgs/L/d
D. 5 lbs weight gain per week, proteinuria 5000 mgs/L/d
78. To decrease Mrs Cass’ blood pressure, the nurse expects this drug to be most likely given to the client.
A. Aldomet B. NIfedipine C. Hydralazine D. Magnesium sulfate
79. The above manifestation would suggest affectation of which organ? (Epigastric pain)
A. liver B. kidney C. lungs D. brain
80. Increased liver enzymes is expected in worsening PIH. These enzymes would include
1 lactate dehydrogenase (LDH) A. 1 2 3
2 alanine aminotransferase (ALT) B. 2 3
3 aspartate aminotransferase (AST) C. 2 3 4
4 glucoronyl transferase (GLT) D. 1 3 4
81. Dr. Ibarra ordered this drug to decrease the reabsorption of Sodium and Chloride in the proximal renal tubules
A. Furosemide B. Lanoxin C. Duvadilan D. Calcium carbonate
82. Which of the following characterizes the orgasm stage of Human Sexual Response?
a. Physical & psychological stimulations cause PNS activation
b. Initial increase in vital signs
c. Shortest stage where vigorous contractions of pelvic muscles expel blood fluid
d. Genital organs return to pre-aroused state
83. A client tells you that she often feel painful menstruation. You would explicate to her that the physiologic cause of
dysmenorrhea is which of the following?
a. High levels of progesterone c. Increased uterine muscle contraction
b. Uterine ischemia d. Coitus during menses
84. Mrs. Perez and her husband are discussing family planning methods with the nurse. They are planning to have the
symptothermal method for birth control. The nurse teaches them that this method includes which of the following?
a. Basal body temperature and cervical mucus methods
 b. Menstrual cycle charting based on observable, physiologic changes and use of barrier contraception
c. The predictor test for ovulation
d. Fertility awareness technology
85. A client asks you about the hormone responsible for causing a rise in basal body temperature after ovulation. Which of the
following is the appropriate answer of the nurse?
a. Estrogen b. Oxytocin c. Prolactin d. Progesterone
86. After the 3rd stage of labor, you palpated the client’s uterine fundus to be soft and boggy. What must be your immediate
nursing management?
a. Initiate breastfeeding to stimulate let-down reflex
b. Infuse D5LRs 1 L + Oxytocin 10 units to run fast drip
c. Massage the fundus with the hand
d. Do nipple stimulation then refer to the OB-gyne on duty STAT

Situation: In the OB-ER, the outgoing nurse endorses to you a patient, Mrs. Maricar Ramos, for ultrasound with a clinical
impression of Abruptio Placenta. V/S: 150/100 mmHg, PR: 93/min, RR: 21/min.
87. As the nurse attending to Mrs. Ramos, which clinical manifestation would you not expect to find in your assessment?
a. couvelaire uterus b. (-) abdominal pain c. profuse vaginal bleeding d. tense uterus
88. In what position would you ask Mrs. Ramos to assume on the ER bed and while being transported to the ultrasound unit?
a. Lateral position b. Fowler’s position c. Supine position d. Trendelenburg
89. What would be an appropriate immediate management to a gravid woman in labor with an AOG >42 weeks and signs of
hypotonic uterine contractions?
a. Augmentation of labor c. Emergency CS
b. Induction of labor d. NSD with assisted forceps
90. Preferred method of delivery for a diabetic pregnant woman
A. forcep B. NSD C. CS D. induced
91. These are the management of diabetic gravid mother, EXCEPT:
A. encourage to eat complex form of carbohydates
B. administer oral hypoglycemic agent as ordered
C. inject insulin per SC prn
D.perform diagnostic procedures to determine fetal well being and placental insufficiency
92. The client, who is married for 3 years and sexually active but not yet ready to begin having children, has expressed a desire
to use a natural method of family planning. Based on this information, which of the following would be the best choice for this
client?
A.Total abstinence B.Basal body temperature method C. Male condoms D.Female condoms with a spermicide
93. Which of the following statement by a male client would indicate that he understands the instructions for use of a condom?
a.“I should lubricate the condom with an oil-based product to avoid friction that could rupture the condom.”
b.“I should unroll the condom and check it for hole before applying it.”
c.“I should hold the rim of the condom while withdrawing my penis from the vagina to avoid leakage.”
d.“ I should begin sexual intercourse without the condom and don the condom just before ejaculation.”
94. After counseling your client concerning several contraception options, the client tells you that she has decided to use female
condoms. You will know the client understood the information if she says:
A. “I understand that I shouldn’t apply the condom more than 1 hour before having sex.”
B. “I understand that if I develop a latex allergy I will need to find a different type of birth control.”
C. “I understand that this will provide protection against sexually transmitted diseases for me and my partner.”
D. “I understand that my doctor will measure me for the condoms, and then I will purchase them at the drug store.”
95. A woman at 7 months of pregnancy says that her 8-year-old daughter talk to the fetus and this calms the fetus when kicking
her in the ribs. She asks the nurse if this is her imagination. The best response by the nurse is:
A.“No, this may very well be the case because the fetus begins to hear at 24 weeks.”
B.“We really don’t know at what age the fetus begins to hear.”
C.“This is unlikely since the fetus doesn’t hear until 8 months gestation.”
D.“You are both right and wrong. The fetus is able to hear, but it is silly to think your daughter’s voice calms the fetus.”
96. A client at 8 months gestation is diagnosed with oligohydramnios. She asks the nurse if this can harm the fetus. The nurse’s
best response is:
A.“Yes, oligohydramnios can lead to umbilical cord compression.”
B.“Yes, it means the fetus swallowed too much fluid.”
C.“No, this commonly occurs toward the end of pregnancy.”
D.“No, this is a sign that the lungs are maturing.”
97. After delivery the nurse examines the umbilical cord. She expects to find a cord with:
A.One artery and two veins B.Two arteries and one vein C.Two arteries and two veins D.One artery and one vein
98. During a prenatal class the nurse explains weight gain in pregnancy. She explains that the amniotic fluid in the third
trimester weighs approximately:
A. 1.5 kilograms B. 150 grams C. 75 grams D. A kilogram
99. At a family planning clinic the nurse explains how a uterine pregnancy test works and tells the client that the test detects an
increase in the hormone:
A.Estriol B.Progesterone C.Human chorionic gonadotropin (hCG) D.Human placental lactogen (hPL)
100. During the client initial prenatal visits, which of the following would indicate a need for further assessment?
A.History of diabetes for 6 years C.Occasional use of over-the-counter pain relievers
B.Exercise three times a week D.Maternal age 30 years