1 Which of the following is the most common kind of placental adherence seen in pregnant women?

A. Accreta

B. Placenta previa

C. Percreta

D. Increta

2 While assessing a primipara during the immediate postpartum period, the nurse in charge plans to use
both hands to assess the client’s fundus to:

A. Prevent uterine inversion.

B. Promote uterine involution.

C. Hasten the puerperium period.

D. Determine the size of the fundus

3 The multigravida mother with a history of rapid labor who is in active labor calls out to the nurse, “The
baby is coming!” Which of the following would be the nurse’s first action?

A. Inspect the perineum.

B. Time the contractions.

C. Auscultate the fetal heart rate.

D. Contact the birth attendant

4 A client with eclampsia begins to experience a seizure. Which of the following would the nurse in
charge do first?

A. Pad the side rails.

B. Place a pillow under the left buttock.

C. Insert a padded tongue blade into the mouth.

D. Maintain a patent airway.

5 When preparing a teaching plan for a client who is to receive a rubella vaccine during the postpartum
period, the nurse in charge should include which of the following?

A. The vaccine prevents a future fetus from developing congenital anomalies.

B. Pregnancy should be avoided for 3 months after the immunization.

C. The client should avoid contact with children diagnosed with rubella.

D. The injection will provide immunity against the 7-day measles

6 After teaching a pregnant woman who is in labor about the purpose of the episiotomy, which of the
following purposes stated by the client would indicate to the nurse that the teaching was effective?

A. Shortens the second stage of labor.

B. Enlarges the pelvic inlet.

C. Prevents perineal edema.

D. Ensures quick placenta delivery

7 What is the approximate time that the blastocyst spends traveling to the uterus for implantation?

A. 2 days

B. 7 days

C. 10 days

D. 14 weeks
8 When administering magnesium sulfate to a client with preeclampsia, the nurse understands that this
drug is given to:

A. Prevent seizures.

B. Reduce blood pressure.

C. Slow the process of labor.

D. Increase diuresis.

9 Which change would the nurse identify as a progressive physiological change in the postpartum
period?

A. Lactation

B. Lochia

C. Uterine involution

D. Diuresis

10 The nurse in charge is caring for a postpartum client who had a vaginal delivery with a midline
episiotomy. Which nursing diagnosis takes priority for this client?

A. Risk for deficient fluid volume related to hemorrhage.

B. Risk for infection related to the type of delivery.

C. Pain related to the type of incision.

D. Urinary retention related to periurethral edema.

11 The nurse is caring for a client in labor. The external fetal monitor shows a pattern of variable
decelerations in fetal heart rate. What should the nurse do first?
A. Change the client’s position.

B. Prepare for an emergency cesarean section.

C. Check for placenta previa.

D. Administer oxygen.

12 A client who’s admitted to labor and delivery has the following assessment findings: gravida 2 para 1,
estimated 40 weeks gestation, contractions 2 minutes apart, lasting 45 seconds, vertex +4 station.
Which of the following would be the priority at this time?

A. Placing the client in bed to begin fetal monitoring.

B. Preparing for immediate delivery.

C. Checking for ruptured membranes.

D. Providing comfort measures

13 A client who is 36 weeks pregnant comes to the clinic for a prenatal checkup. To assess the client’s
preparation for parenting, the nurse might ask which question?

A. “Are you planning to have epidural anesthesia?”

B. “Have you begun prenatal classes?”

C. “What changes have you made at home to get ready for the baby?”

D. “Can you tell me about the meals you typically eat each day?”

14 A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate the health of her
fetus. Her BPP score is 8. What does this score indicate?

A. The fetus should be delivered within 24 hours.

B. The client should repeat the test in 24 hours.

C. The fetus isn’t in distress at this time.

D. The client should repeat the test in 1 week.

15 During a prenatal visit at 4 months gestation, a pregnant client asks whether tests can be done to
identify fetal abnormalities. Between 18 and 40 weeks gestation, which procedure is used to detect fetal
anomalies?

A. Amniocentesis

B. Chorionic villi sampling

C. Fetoscopy

D. Ultrasound

16 Which of the following would be inappropriate to assess in a mother who’s breastfeeding?

A. The attachment of the baby to the breast.

B. The mother’s comfort level with positioning the baby.

C. Audible swallowing.

D. The baby’s lips smacking

17 After completing a second vaginal examination of a client in labor, the nurse-midwife determines that
the fetus is in the right occiput anterior position and at (–1) station. Based on these findings, the nurse-
midwife knows that the fetal presenting part is:

A. 1 cm below the ischial spines.

B. Directly in line with the ischial spines.

C. 1 cm above the ischial spines.

D. In no relationship to the ischial spines.

18 When evaluating a client’s knowledge of symptoms to report during her pregnancy, which statement
would indicate to the nurse in charge that the client understands the information given to her?

A. “I’ll report increased frequency of urination.”

B. “If I have blurred or double vision, I should call the clinic immediately.”

C. “If I feel tired after resting, I should report it immediately.”

D. “Nausea should be reported immediately.”

19 An adult female patient is using the rhythm (calendar-basal body temperature) method of family
planning. In this method, the unsafe period for sexual intercourse is indicated by:

A. Return preovulatory basal body temperature.

B. Basal body temperature increase of 0.1 degrees to 0.2 degrees on the 2nd or 3rd day of cycle.

C. 3 full days of elevated basal body temperature and clear, thin cervical mucus.

D. Breast tenderness and mittelschmerz

20 A patient is in her last trimester of pregnancy. Nurse Vickie should instruct her to notify her primary
health care provider immediately if she notices:

A. Blurred vision

B. Hemorrhoids

C. Increased vaginal mucus

D. Shortness of breath on exertion

21 A patient is in the second stage of labor. During this stage, how frequently should the nurse in charge
assess her uterine contractions?
A. Every 5 minutes.

B. Every 15 minutes.

C. Every 30 minutes.

D. Every 60 minutes.

22 Accompanied by her husband, a patient seeks admission to the labor and delivery area. The client
states that she is in labor and says she attended the hospital clinic for prenatal care. Which question
should the nurse ask her first?

A. “Do you have any chronic illness?”

B. “Do you have any allergies?”

C. “What is your expected due date?”

D. “Who will be with you during labor?”

23 Normal lochial findings in the first 24 hours post-delivery include:

A. Bright red blood

B. Large clots or tissue fragments

C. A foul odor

D. The complete absence of lochia

24 The nurse is developing a teaching plan for a patient who is 8 weeks pregnant. The nurse should tell
the patient that she can expect to feel the fetus move at which time?

A. Between 10 and 12 weeks’ gestation

B. Between 16 and 20 weeks’ gestation.

C. Between 21 and 23 weeks’ gestation.

D. Between 24 and 26 weeks’ gestation.

25 After 3 days of breastfeeding, a postpartum patient reports nipple soreness. To relieve her
discomfort, the nurse should suggest that she:

A. Apply warm compresses to her nipples just before feeding.

B. Lubricate her nipples with expressed milk before feeding.

C. Dry her nipples with a soft towel after feeding.

D. Apply soap directly to her nipples, and then rinse.

26 Five hours after birth, a neonate is transferred to the nursery, where the nurse intervenes to prevent
hypothermia. What is a common source of radiant heat loss?

A. Low room humidity

B. Cold weight scale

C. Cool incubator walls

D. Cool room temperature

27 Because cervical effacement and dilation are not progressing in a patient in labor, the doctor orders
I.V. administration of oxytocin (Pitocin). Why should the nurse monitor the patient’s fluid intake and
output closely during oxytocin administration?

A. Oxytocin causes water intoxication.

B. Oxytocin causes excessive thirst.

C. Oxytocin is toxic to the kidneys.

D. Oxytocin has a diuretic effect

28 A patient with pregnancy-induced hypertension probably exhibits which of the following symptoms?

A. Proteinuria, headaches, vaginal bleeding

B. Headaches, double vision, vaginal bleeding

C. Proteinuria, headaches, double vision

D. Proteinuria, double vision, uterine contractions

29 A female adult patient is taking a progestin-only oral contraceptive or mini pill. Progestin use may
increase the patient’s risk for:

A. Endometriosis

B. Female hypogonadism

C. Premenstrual syndrome

D. Tubal or ectopic pregnancy

30 A patient in her 14th week of pregnancy has presented with abdominal cramping and vaginal
bleeding for the past 8 hours. She has passed several clots. What is the primary nursing diagnosis for this
patient?

A. Knowledge deficit

B. Fluid volume deficit

C. Anticipatory grieving

D. Pain

31 A pregnant patient asks the nurse if she can take castor oil for her constipation. How should the
nurse respond?
A. “Yes, it produces no adverse effect.”

B. “No, it can initiate premature uterine contractions.”

C. “No, it can promote sodium retention.”

D. “No, it can lead to increased absorption of fat-soluble vitamins.”

32 While the client is in active labor with twins and the cervix is 5 cm dilated, the nurse observes
contractions occurring at a rate of every 7 to 8 minutes in a 30-minute period. Which of the following
would be the nurse’s most appropriate action?

A. Note the fetal heart rate patterns.

B. Notify the physician immediately.

C. Administer oxygen at 6 liters by mask.

D. Have the client pant-blow during the contractions.

33 Which of the following would the nurse most likely expect to find when assessing a pregnant client
with abruption placenta?

A. Excessive vaginal bleeding

B. Rigid, board-like abdomen

C. Tetanic uterine contractions

D. Premature rupture of membranes

34 The nurse plans to instruct the postpartum client about methods to prevent breast engorgement.
Which of the following measures would the nurse include in the teaching plan?

A. Feeding the neonate a maximum of 5 minutes per side on the first day.

B. Wearing a supportive brassiere with nipple shields.

C. Breastfeeding the neonate at frequent intervals.

D. Decreasing fluid intake for the first 24 to 48 hours.

35 A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells
the client that the usual treatment for partial placenta previa is which of the following?

A. Activity limited to bed rest.

B. Platelet infusion.

C. Immediate cesarean delivery.

D. Labor induction with oxytocin.

36 A primigravida in active labor is about 9 days post-term. The client desires a bilateral pudendal block
anesthesia before delivery. After the nurse explains this type of anesthesia to the client, which of the
following locations identified by the client as the area of relief would indicate to the nurse that the
teaching was effective?

A. Back

B. Abdomen

C. Fundus

D. Perineum

37 While the postpartum client is receiving heparin for thrombophlebitis, which of the following drugs
would the nurse expect to administer if the client develops complications related to heparin therapy?

A. Calcium gluconate

B. Protamine sulfate
C. Methylergonovine (Methergine)

D. Nitrofurantoin (Macrodantin)

38 Which of the following assessment findings would the nurse expect if the client develops DVT?

A. Mid Calf pain, tenderness, and redness along the vein.

B. Chills, fever, malaise, occurring 2 weeks after delivery.

C. Muscle pain, the presence of Homans sign, and swelling in the affected limb.

D. Chills, fever, stiffness, and pain occurring 10 to 14 days after delivery

39 The nurse assesses the postpartum vaginal discharge (lochia) on four clients. Which of the following
assessments would warrant notification of the physician?

A. A dark red discharge on a 2-day postpartum client.

B. A pink to brownish discharge on a client who is 5 days postpartum.

C. Almost colorless to creamy discharge on a client 2 weeks after delivery.

D. A bright red discharge 5 days after delivery

40 A postpartum client has a temperature of 101.4ºF, with a uterus that is tender when palpated,
remains unusually large, and not descending as normally expected. Which of the following should the
nurse assess next?

A. Lochia

B. Breasts

C. Incision

D. Urine
41 When developing a plan of care for a client newly diagnosed with gestational diabetes, which of the
following instructions would be the priority?

A. Dietary intake

B. Medication

C. Exercise

D. Glucose monitoring

42 When preparing to listen to the fetal heart rate at 12 weeks’ gestation, the nurse would use which of
the following?

A. Stethoscope placed midline at the umbilicus.

B. Doppler placed midline at the suprapubic region.

C. Fetoscope placed midway between the umbilicus and the xiphoid process.

D. External electronic fetal monitor placed at the umbilicus.

43 Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?

A. Risk for infection

B. Pain

C. Knowledge Deficit

D. Anticipatory Grieving

44 Cervical softening and uterine souffle are classified as which of the following?
A. Diagnostic signs

B. Presumptive signs

C. Probable signs

D. Positive signs

45 One hour following a normal vaginal delivery, a newborn infant boy’s axillary temperature is 96° F, his
lower lip is shaking and, when the nurse assesses for a Moro reflex, the boy’s hands shake. Which
intervention should the nurse implement first?

A. Stimulate the infant to cry.

B. Wrap the infant in warm blankets.

C. Feed the infant formula.

D. Obtain a serum glucose level.

46 When preparing a client for cesarean delivery, which of the following key concepts should be
considered when implementing nursing care?

A. Instruct the mother’s support person to remain in the family lounge until after the delivery.

B. Arrange for a staff member of the anesthesia department to explain what to expect postoperatively.

C. Modify preoperative teaching to meet the needs of either a planned or emergency cesarean birth.

D. Explain the surgery, expected outcome, and kind of anesthetics.

47 Which of the following statements best describes hyperemesis gravidarum?

A. Severe anemia leading to an electrolyte, metabolic, and nutritional imbalances in the absence of
other medical problems.

B. Severe nausea and vomiting leading to an electrolyte, metabolic, and nutritional imbalances in the
absence of other medical problems
C. Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately
decreasing maternal nutrients.

D. Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal bleeding.

48 A new breast-feeding mother experiencing breast engorgement is provided with instructions

regarding care for the condition. Which statement by the mother indicates to the nurse that she
possesses an understanding of the measures that will provide comfort for the engorgement?

1. “I will breast-feed using only one breast.”

2. “I will apply cold compresses to my breasts.”

3. “I will avoid the use of a bra while my breasts are engorged.”

4. “I will massage my breasts before feeding to stimulate letdown.”

49 .W/ro Almaz comes to health center at which you are working as Midwives at MCH. She is 28 weeks
of pregnancy. Her BP 150/100mmhg, PR 86/MIN on urine analysis there is no protein in the urine then
what is her diagnosis?

A. Chronic hypertension

B. Gestational hypertension

C. eclampsia

D. severe preeclampsia15

50. The drug choice for the management of severe preeclampsia/eclampsia is

A. Diazepam B. Calcium gluconate C. Magnesium sulphate

51. The drug used to treat the toxicity of Magnesium sulphate

A. Diazepam B. Calcium gluconate C. Hyralize16

52 W/ro Chaltu comes to health center at which you are working as Midwife at MCH Clinic on physical
examination fundal height 30 weeks, BP 140/90 mmhg , PR 90 bpm, on urine analysis protein 2+ , she
has no convulsion , then what is her diagnosis?16

16A. Chronic hypertension

B. Gestational hypertension

C. Pregnancy induced hypertension

D. Mild preeclampsia16

53 A 28 year old pregnant women complains vaginal bleeding for 03 days. She was amenorrhic
for the last 3 months. When the nurse checks the fetal heart beat it was positive and the Cx was
closed. Her vital sign was Bp: 110/70mmhg. What is the most likely diagnosis ?

A. Threatened abortion

B. Ectopic pregnancy

C. Incomplete abortion

D. Vaginal lech

54 A 26 year old Term prmigravida women come to health center with a complain of gush of
fluid and vaginal bleeding. When the nurse checks her vital sign; BP 110/70mmhg, pulse
85beat/min, Temperature 37.2oc. Her cervix was 4 cm dilated, presentation vertex abd
membrane intact. What is most the likely priority nursing intervention ?

A. Ask the women to walk around

B. Follow up the labor with parthograph

C. Send the women back to hospital

D. Advice C/s

55 Your patient who is 18 weeks gestation describes to you she has been feeling the baby
move. Which terms describes this movement?

A Quickening
B Braxton Hick's contractions
C Ballottement
D Effacement

56 A 24 years woman who has 10th week gestational age came in your MCH clinic with
complains of gush of fluid. On examination, cervix is open. What will be your possible diagnosis

A Inevitable abortion
B Threatened abortion
C Complete abortion
D Septic abortion