1 | Page
WEST COAST UNIVERSITY NURS 306 – OBSTETRIC
AND MATERNITY NURSING COMPREHENSIVE
PRACTICE EXAM 2 QUESTIONS WITH ANSWERS AND
RATIONALES |100% PASS |GRADED A+ 2026/27
1. The nurse is caring for a client in active labor. Which assessment
finding should be reported to the provider immediately?
a) Fetal heart rate variability of 6-10 bpm
b) Contractions lasting 60 seconds every 3 minutes
c) Moderate variability and accelerations
d) Late decelerations
Verified Answer: d
Rationale: Late decelerations indicate uteroplacental insufficiency and
are a non-reassuring fetal heart rate pattern. They require immediate
intervention (e.g., change maternal position, administer oxygen, notify
provider). Moderate variability (6-25 bpm) and accelerations are
reassuring. Contractions lasting 60 seconds every 3 minutes are within
normal limits for active labor.
2. A client at 38 weeks of gestation is admitted with a diagnosis of
preeclampsia. The nurse should monitor for which sign of impending
eclampsia?
a) Epigastric pain and headache
b) Peripheral edema
,2 | Page
c) Weight loss
d) Polyuria
Verified Answer: a
Rationale: Epigastric pain (right upper quadrant) and severe headache
are signs of impending eclampsia, indicating liver capsule distension and
cerebral edema. These are warning signs that require immediate
intervention (e.g., magnesium sulfate administration, seizure
precautions). Peripheral edema and weight gain are common in normal
pregnancy. Polyuria is not a sign of preeclampsia.
3. The nurse is performing Leopold's maneuvers on a client at 36 weeks
gestation. The nurse feels a hard, round mass at the fundus. Which
presentation is indicated?
a) Cephalic (vertex)
b) Breech
c) Transverse lie
d) Face presentation
Verified Answer: b
Rationale: Leopold's maneuvers are used to determine fetal presentation
and position. A hard, round mass at the fundus indicates the fetal head,
which means the fetus is in a breech presentation (buttocks or feet are in
the maternal pelvis). In cephalic presentation, the head is felt in the
lower uterus (pelvic inlet), not the fundus.
,3 | Page
4. A client who is 28 weeks pregnant presents with painless vaginal
bleeding. The nurse should suspect which condition?
a) Placenta previa
b) Abruptio placentae
c) Preterm labor
d) Labor onset
Verified Answer: a
Rationale: Painless vaginal bleeding in the second or third trimester is
the classic sign of placenta previa (placenta covers the cervical os). It is
painless because the bleeding is from the placental implantation site, not
from uterine contractions. Abruptio placentae presents with painful
vaginal bleeding (uterine hypertonicity, abdominal pain).
5. The nurse is caring for a client who is 6 hours postpartum. The nurse
notes a fundus that is firm and midline, but at the umbilicus. What
should the nurse do next?
a) Massage the fundus
b) Notify the provider
c) Document the finding and continue to monitor
d) Administer oxytocin
Verified Answer: c
Rationale: The fundus should be at the level of the umbilicus at
approximately 6-12 hours postpartum and then descends approximately
1 cm (one fingerbreadth) per day. A firm, midline fundus at the
, 4 | Page
umbilicus at 6 hours postpartum is a normal finding. No intervention is
needed.
6. The nurse is caring for a client in the transition phase of labor. Which
nursing action is a priority?
a) Encourage the client to push
b) Provide frequent encouragement and maintain a calm environment
c) Increase IV fluids
d) Prepare for an epidural
Verified Answer: b
Rationale: The transition phase (8-10 cm dilation) is the most intense
and difficult phase of labor. The client may feel an urge to push (but
should not push until fully dilated), and may experience nausea,
irritability, and shaking. Providing encouragement, maintaining a calm
environment, and coaching breathing are essential. Pushing is not
appropriate until complete dilation (10 cm).
7. A client who is 20 weeks pregnant is diagnosed with gestational
diabetes. Which complication is associated with this condition?
a) Fetal macrosomia
b) Placental abruption
c) Gestational hypertension
d) Oligohydramnios
Verified Answer: a
WEST COAST UNIVERSITY NURS 306 – OBSTETRIC
AND MATERNITY NURSING COMPREHENSIVE
PRACTICE EXAM 2 QUESTIONS WITH ANSWERS AND
RATIONALES |100% PASS |GRADED A+ 2026/27
1. The nurse is caring for a client in active labor. Which assessment
finding should be reported to the provider immediately?
a) Fetal heart rate variability of 6-10 bpm
b) Contractions lasting 60 seconds every 3 minutes
c) Moderate variability and accelerations
d) Late decelerations
Verified Answer: d
Rationale: Late decelerations indicate uteroplacental insufficiency and
are a non-reassuring fetal heart rate pattern. They require immediate
intervention (e.g., change maternal position, administer oxygen, notify
provider). Moderate variability (6-25 bpm) and accelerations are
reassuring. Contractions lasting 60 seconds every 3 minutes are within
normal limits for active labor.
2. A client at 38 weeks of gestation is admitted with a diagnosis of
preeclampsia. The nurse should monitor for which sign of impending
eclampsia?
a) Epigastric pain and headache
b) Peripheral edema
,2 | Page
c) Weight loss
d) Polyuria
Verified Answer: a
Rationale: Epigastric pain (right upper quadrant) and severe headache
are signs of impending eclampsia, indicating liver capsule distension and
cerebral edema. These are warning signs that require immediate
intervention (e.g., magnesium sulfate administration, seizure
precautions). Peripheral edema and weight gain are common in normal
pregnancy. Polyuria is not a sign of preeclampsia.
3. The nurse is performing Leopold's maneuvers on a client at 36 weeks
gestation. The nurse feels a hard, round mass at the fundus. Which
presentation is indicated?
a) Cephalic (vertex)
b) Breech
c) Transverse lie
d) Face presentation
Verified Answer: b
Rationale: Leopold's maneuvers are used to determine fetal presentation
and position. A hard, round mass at the fundus indicates the fetal head,
which means the fetus is in a breech presentation (buttocks or feet are in
the maternal pelvis). In cephalic presentation, the head is felt in the
lower uterus (pelvic inlet), not the fundus.
,3 | Page
4. A client who is 28 weeks pregnant presents with painless vaginal
bleeding. The nurse should suspect which condition?
a) Placenta previa
b) Abruptio placentae
c) Preterm labor
d) Labor onset
Verified Answer: a
Rationale: Painless vaginal bleeding in the second or third trimester is
the classic sign of placenta previa (placenta covers the cervical os). It is
painless because the bleeding is from the placental implantation site, not
from uterine contractions. Abruptio placentae presents with painful
vaginal bleeding (uterine hypertonicity, abdominal pain).
5. The nurse is caring for a client who is 6 hours postpartum. The nurse
notes a fundus that is firm and midline, but at the umbilicus. What
should the nurse do next?
a) Massage the fundus
b) Notify the provider
c) Document the finding and continue to monitor
d) Administer oxytocin
Verified Answer: c
Rationale: The fundus should be at the level of the umbilicus at
approximately 6-12 hours postpartum and then descends approximately
1 cm (one fingerbreadth) per day. A firm, midline fundus at the
, 4 | Page
umbilicus at 6 hours postpartum is a normal finding. No intervention is
needed.
6. The nurse is caring for a client in the transition phase of labor. Which
nursing action is a priority?
a) Encourage the client to push
b) Provide frequent encouragement and maintain a calm environment
c) Increase IV fluids
d) Prepare for an epidural
Verified Answer: b
Rationale: The transition phase (8-10 cm dilation) is the most intense
and difficult phase of labor. The client may feel an urge to push (but
should not push until fully dilated), and may experience nausea,
irritability, and shaking. Providing encouragement, maintaining a calm
environment, and coaching breathing are essential. Pushing is not
appropriate until complete dilation (10 cm).
7. A client who is 20 weeks pregnant is diagnosed with gestational
diabetes. Which complication is associated with this condition?
a) Fetal macrosomia
b) Placental abruption
c) Gestational hypertension
d) Oligohydramnios
Verified Answer: a
