OB EXAM 1 GALEN COLLEGE OF NURSING STUDY
GUIDE 2026 300+ PRACTICE QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES MATERNAL
NEWBORN NURSING COMPREHENSIVE OBSTETRICS
EXAM 1 REVIEW - 208 Questions and Answers Already Graded
A+ Premium Exam Tested And Verified
Subject Area OB EXAM 1 GALEN COLLEGE OF NURSING STUDY GUIDE 2026 300+
PRACTICE QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES MATERNAL NEWBORN NURSING COMPREHENSIVE
OBSTETRICS EXAM 1 REVIEW
Description Comprehensive examination on OB EXAM 1 GALEN COLLEGE OF NURSING
STUDY GUIDE 2026 300+ PRACTICE QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES MATERNAL NEWBORN
NURSING COMPREHENSIVE OBSTETRICS EXAM 1 REVIEW.
Expected Grade A+
Total Questions 208
Duration 3 hours
Learning Outcomes 1. Demonstrate mastery of core concepts
Accreditation Aligned with US university standards.
Page 1
,1. A patient at 38 weeks gestation presents with a sudden onset of severe abdominal
pain and vaginal bleeding. The uterus is firm and tender to palpation. What is the
priority intervention?
A. Administer oxytocin to augment labor
B. Prepare for immediate cesarean delivery
C. Apply external fetal monitor and observe
D. Perform a vaginal exam to assess dilation
Answer: B. Prepare for immediate cesarean delivery
The presentation suggests placental abruption with a firm, tender uterus and bleeding.
Immediate cesarean delivery is indicated to prevent fetal and maternal compromise,
especially if the fetus is still viable. Oxytocin could worsen the abruption, vaginal exam
may increase bleeding, and observation delays life-saving intervention.
2. A patient with preeclampsia develops a blood pressure of 170/110 mmHg and a
severe frontal headache. Which medication should be administered first?
A. Magnesium sulfate 4 g IV bolus
B. Labetalol 20 mg IV push
C. Hydralazine 5 mg IV push
D. Nifedipine 10 mg oral
Answer: B. Labetalol 20 mg IV push
In severe hypertension with symptoms, IV labetalol is first-line due to rapid onset and
safety in pregnancy. Magnesium sulfate is for seizure prophylaxis, not acute
hypertension. Hydralazine is second-line due to unpredictable response. Oral nifedipine
is slower and less titratable.
Page 2
,3. A patient at 28 weeks gestation with a history of two prior preterm births presents
with painless spotting. Transvaginal ultrasound reveals the placenta covering the
internal cervical os. What is the most appropriate management?
A. Administer betamethasone and schedule cesarean at 34 weeks
B. Perform cervical cerclage immediately
C. Advise strict bed rest with pelvic rest and serial ultrasounds
D. Induce labor at 37 weeks after confirming fetal lung maturity
Answer: C. Advise strict bed rest with pelvic rest and serial ultrasounds
This is placenta previa. Management includes activity restriction, pelvic rest, and serial
ultrasounds to monitor placental location. Betamethasone is given if preterm delivery is
imminent, but not routinely at 28 weeks without contractions. Cerclage is for cervical
insufficiency, not previa. Cesarean is indicated if previa persists near term, but
induction is contraindicated.
4. A patient in active labor has contractions every 2-3 minutes, lasting 60 seconds.
The baseline fetal heart rate is 140 bpm with moderate variability and no
decelerations. A prolapsed cord is detected on vaginal exam. What action should the
nurse take first?
A. Place the patient in Trendelenburg position
B. Apply upward pressure on the presenting part with a gloved hand
C. Administer oxygen via non-rebreather mask
D. Prepare for immediate vaginal delivery
Answer: B. Apply upward pressure on the presenting part with a gloved hand
In cord prolapse, the priority is to relieve pressure on the cord by elevating the
presenting part off the cord. This is done manually. Trendelenburg or knee-chest
position helps but is secondary. Oxygen is supportive but not the first action. Vaginal
delivery is contraindicated unless fully dilated and immediate; usually cesarean is
needed.
Page 3
, 5. A patient at 35 weeks gestation with a diagnosis of gestational diabetes mellitus
has a fasting blood glucose of 95 mg/dL and a 2-hour postprandial glucose of 140
mg/dL. She is on a 2000-calorie diabetic diet. What is the best nursing action?
A. Initiate insulin therapy as prescribed
B. Reinforce dietary compliance and recommend increased physical activity
C. Schedule a nonstress test to assess fetal well-being
D. Administer oral hypoglycemic agent as ordered
Answer: B. Reinforce dietary compliance and recommend increased physical
activity
Fasting glucose of 95 mg/dL is within target (95) and 2-hour postprandial of 140 mg/dL
is also acceptable (140). No pharmacological therapy is indicated. Dietary
reinforcement and exercise are appropriate. Nonstress test is not needed solely based on
these values. Oral agents are not first-line for GDM in pregnancy.
6. A patient is admitted for induction of labor at 41 weeks gestation. The Bishop
score is 4. Which induction method is most appropriate initially?
A. Intravenous oxytocin
B. Intracervical prostaglandin E2 gel
C. Artificial rupture of membranes
D. Misoprostol oral tablets
Answer: B. Intracervical prostaglandin E2 gel
A Bishop score of 4 indicates an unfavorable cervix. Prostaglandin E2 (dinoprostone) is
used for cervical ripening. Oxytocin is more effective after ripening. ARM requires
favorable cervix and is not initial. Misoprostol is used but is off-label and associated
with hyperstimulation; dinoprostone is standard.
Page 4
GUIDE 2026 300+ PRACTICE QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES MATERNAL
NEWBORN NURSING COMPREHENSIVE OBSTETRICS
EXAM 1 REVIEW - 208 Questions and Answers Already Graded
A+ Premium Exam Tested And Verified
Subject Area OB EXAM 1 GALEN COLLEGE OF NURSING STUDY GUIDE 2026 300+
PRACTICE QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES MATERNAL NEWBORN NURSING COMPREHENSIVE
OBSTETRICS EXAM 1 REVIEW
Description Comprehensive examination on OB EXAM 1 GALEN COLLEGE OF NURSING
STUDY GUIDE 2026 300+ PRACTICE QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES MATERNAL NEWBORN
NURSING COMPREHENSIVE OBSTETRICS EXAM 1 REVIEW.
Expected Grade A+
Total Questions 208
Duration 3 hours
Learning Outcomes 1. Demonstrate mastery of core concepts
Accreditation Aligned with US university standards.
Page 1
,1. A patient at 38 weeks gestation presents with a sudden onset of severe abdominal
pain and vaginal bleeding. The uterus is firm and tender to palpation. What is the
priority intervention?
A. Administer oxytocin to augment labor
B. Prepare for immediate cesarean delivery
C. Apply external fetal monitor and observe
D. Perform a vaginal exam to assess dilation
Answer: B. Prepare for immediate cesarean delivery
The presentation suggests placental abruption with a firm, tender uterus and bleeding.
Immediate cesarean delivery is indicated to prevent fetal and maternal compromise,
especially if the fetus is still viable. Oxytocin could worsen the abruption, vaginal exam
may increase bleeding, and observation delays life-saving intervention.
2. A patient with preeclampsia develops a blood pressure of 170/110 mmHg and a
severe frontal headache. Which medication should be administered first?
A. Magnesium sulfate 4 g IV bolus
B. Labetalol 20 mg IV push
C. Hydralazine 5 mg IV push
D. Nifedipine 10 mg oral
Answer: B. Labetalol 20 mg IV push
In severe hypertension with symptoms, IV labetalol is first-line due to rapid onset and
safety in pregnancy. Magnesium sulfate is for seizure prophylaxis, not acute
hypertension. Hydralazine is second-line due to unpredictable response. Oral nifedipine
is slower and less titratable.
Page 2
,3. A patient at 28 weeks gestation with a history of two prior preterm births presents
with painless spotting. Transvaginal ultrasound reveals the placenta covering the
internal cervical os. What is the most appropriate management?
A. Administer betamethasone and schedule cesarean at 34 weeks
B. Perform cervical cerclage immediately
C. Advise strict bed rest with pelvic rest and serial ultrasounds
D. Induce labor at 37 weeks after confirming fetal lung maturity
Answer: C. Advise strict bed rest with pelvic rest and serial ultrasounds
This is placenta previa. Management includes activity restriction, pelvic rest, and serial
ultrasounds to monitor placental location. Betamethasone is given if preterm delivery is
imminent, but not routinely at 28 weeks without contractions. Cerclage is for cervical
insufficiency, not previa. Cesarean is indicated if previa persists near term, but
induction is contraindicated.
4. A patient in active labor has contractions every 2-3 minutes, lasting 60 seconds.
The baseline fetal heart rate is 140 bpm with moderate variability and no
decelerations. A prolapsed cord is detected on vaginal exam. What action should the
nurse take first?
A. Place the patient in Trendelenburg position
B. Apply upward pressure on the presenting part with a gloved hand
C. Administer oxygen via non-rebreather mask
D. Prepare for immediate vaginal delivery
Answer: B. Apply upward pressure on the presenting part with a gloved hand
In cord prolapse, the priority is to relieve pressure on the cord by elevating the
presenting part off the cord. This is done manually. Trendelenburg or knee-chest
position helps but is secondary. Oxygen is supportive but not the first action. Vaginal
delivery is contraindicated unless fully dilated and immediate; usually cesarean is
needed.
Page 3
, 5. A patient at 35 weeks gestation with a diagnosis of gestational diabetes mellitus
has a fasting blood glucose of 95 mg/dL and a 2-hour postprandial glucose of 140
mg/dL. She is on a 2000-calorie diabetic diet. What is the best nursing action?
A. Initiate insulin therapy as prescribed
B. Reinforce dietary compliance and recommend increased physical activity
C. Schedule a nonstress test to assess fetal well-being
D. Administer oral hypoglycemic agent as ordered
Answer: B. Reinforce dietary compliance and recommend increased physical
activity
Fasting glucose of 95 mg/dL is within target (95) and 2-hour postprandial of 140 mg/dL
is also acceptable (140). No pharmacological therapy is indicated. Dietary
reinforcement and exercise are appropriate. Nonstress test is not needed solely based on
these values. Oral agents are not first-line for GDM in pregnancy.
6. A patient is admitted for induction of labor at 41 weeks gestation. The Bishop
score is 4. Which induction method is most appropriate initially?
A. Intravenous oxytocin
B. Intracervical prostaglandin E2 gel
C. Artificial rupture of membranes
D. Misoprostol oral tablets
Answer: B. Intracervical prostaglandin E2 gel
A Bishop score of 4 indicates an unfavorable cervix. Prostaglandin E2 (dinoprostone) is
used for cervical ripening. Oxytocin is more effective after ripening. ARM requires
favorable cervix and is not initial. Misoprostol is used but is off-label and associated
with hyperstimulation; dinoprostone is standard.
Page 4
