COMPLETE OBSTETRIC NURSING EXAM REVIEW QUESTIONS AND
ANSWERS 2026/2027
A woman is experiencing back labor and complains of intense pain in her lower back. An effective relief
measure would be to use:
A. Effleurage
B. Counterpressure against the sacrum
C. Conscious relaxation or guided imagery
D. Pant-blow (breaths and puffs) breathing techniques - ANS ✔✔B. Counterpressure against the sacrum
Rationale: Counterpressure is steady pressure applied by a support person to the sacral area with the fist
or heel of the hand. This technique helps the woman cope with the sensations of internal pressure and
pain in the lower back.
The patient received a narcotic analgesic during the transition stage of labor. Which of the following will
the nurse assess for in the newborn?
A. Respiratory depression.
B. Bradycardia.
C. Acrocyanosis.
D. Tachypnea. - ANS ✔✔A. Respiratory depression.
Rationale: An infant delivered within 1 to 4 hours of maternal analgesic administration is at risk for
respiratory depression from the sedative effects of the narcotic.
The patient has shared a copy of her birth plan with the nurse. When is the best time for the nurse to
review the birth plan and discuss the patient's options for pharmacologic pain relief in labor?
A. The second stage of labor.
B. During a uterine contraction.
C. The third stage of labor.
D. Before a uterine contraction. - ANS ✔✔D. Before a uterine contraction.
Rationale: Before a contraction,, the mother is able to focus and ask appropriate questions regarding her
care.
The nurse caring for a pregnant client knows that her health teaching regarding fetal circulation has been
effective when the client reports that she has been sleeping:
A. With her head elevated on two pillows.
B. On her back with a pillow under her knees.
C. On her abdomen.
D. In a side-lying position. - ANS ✔✔D. In a side-lying position.
Rationale: Optimal circulation is achieved when the woman is lying at rest on her side. Decreased uterine
circulation may lead to intrauterine growth restriction. Previously it was believed that the left lateral
position promoted maternal cardiac output, thereby enhancing blood flow to the fetus. However, it is
now known that either side-lying position enhances uteroplacental blood flow.
A woman has requested an epidural for her pain. She is 5 cm dilated and 100% effaced. The nurse
reviews the client's laboratory values and notes that the woman's hemoglobin is 14 g/dl, hematocrit is
39%, platelets are 67,000, and white blood cells (WBCs) are 11,000/mm3. Which factor would
contraindicate an epidural for the woman?
, A. She has thrombocytopenia
B. She is anemic.
C. She is too far dilated.
D. She is septic. - ANS ✔✔A. She has thrombocytopenia
Rationale: The patient has thrombocytopenia and the epidural is contraindicated.
A woman who is pregnant for the first time is dilated 3 cm and having contractions every 5 minutes. She
is groaning and perspiring excessively; she states that she did not attend childbirth classes. The most
important nursing action is to:
A. Notify the woman's health care provider
B. Assist her with simple breathing and relaxation instructions
C. Assure her that her labor will be over soon
D. Administer the prescribed narcotic analgesic - ANS ✔✔B. Assist her with simple breathing and
relaxation instructions
Rationale: By reducing tension and stress, focusing and relaxation techniques allow the woman in labor
to rest and conserve energy for the task of giving birth. For those who have had no preparation,
instruction in simple breathing and relaxation can be given in early labor and often is successful.
A major advantage of nonpharmacologic pain management is that:
A. A slower labor decreases the risk of complications.
B. Elimination of pain is possible.
C. The woman remains fully alert at all times.
D. There are no side effects or risks to the fetus. - ANS ✔✔D. There are no side effects or risks to the
fetus.
Rationale: Because nonpharmacologic pain management does not include analgesics, adjunct drugs, or
anesthesia, it is harmless to the mother and the fetus.
The nurse is taking an advice call from woman at 40 weeks' gestation. The nurse instructs the patient to
go to the hospital to be evaluated when the patient states which of the following?
A. "The baby has been moving."
B. "I passed the mucous plug."
C. "I have had irregular contractions for the last hour."
D. "I have a trickle of fluid leaking from my vagina." - ANS ✔✔D. "I have a trickle of fluid leaking from my
vagina."
Immediately following administration of epidural anesthesia of the patient, the nurse must monitor the
mother for which of the following?
A. Paresthesia in her feet and leg
B. Decrease in her blood pressure
C. Increase in her central venous pressure
D. Fetal heart rate accelerations - ANS ✔✔B. Decrease in her blood pressure
Rationale: After epidural administration, the mother will show signs of hypotension if no other
therapeutic interventions are performed. This decrease in blood pressure is due to the dilation of the
vessels in the pelvis and the increased compression of the vena cava.