Western Governors University's D447 OA
(Women’s & Children’s Health Nursing
Multiple Choice Questions & Answers (2026
Update) – Version 3
1. A client in labor is at 7 cm dilation, 90% effaced, and experiencing strong
contractions every 2-3 minutes. She is irritable and reports an urge to push. In
which phase of labor is this client?
A. Latent phase
B. Active phase
C. Transition phase
D. Second stage
Answer: C. The transition phase is characterized by 8-10 cm dilation, strong
contractions, and symptoms like irritability, nausea, and an urge to push.
2. The nurse notes recurrent variable decelerations on the fetal heart rate tracing.
What is the nurse's priority action?
A. Turn the client to her left side.
B. Administer oxygen via face mask.
C. Discontinue the oxytocin infusion.
D. Prepare the client for an emergency cesarean section.
Answer: A. Variable decelerations indicate cord compression. Repositioning the mother
(e.g., to her side, knee-chest) is the first-line intervention to relieve pressure on the
cord .
3. A nurse is caring for a client receiving an epidural for pain management. Which
assessment finding requires immediate intervention?
A. Maternal blood pressure of 90/50 mmHg
B. Numbness in the lower extremities
C. Loss of the urge to push
D. Maternal temperature of 99.2°F (37.3°C)
Answer: A. Hypotension is a common and serious side effect of epidural anesthesia,
reducing placental perfusion. The nurse should increase IV fluids and notify the provider.
, 4. A client is at 39 weeks of gestation and reports sudden, painless, bright red
vaginal bleeding. What is the nurse's priority intervention?
A. Perform a sterile vaginal exam to assess dilation.
B. Assess fetal heart rate and maternal vital signs.
C. Apply an external fetal monitor.
D. Prepare the client for an immediate cesarean birth.
Answer: B. The classic sign of placenta previa is painless, bright red bleeding. A vaginal
exam is strictly contraindicated as it can cause catastrophic hemorrhage. The priority is
to assess the mother and fetus for stability .
5. Which of the following findings in a client with severe preeclampsia indicates
potential magnesium toxicity?
A. Respiratory rate of 18 breaths/min
B. Urine output of 30 mL/hr
C. Deep tendon reflexes 2+
D. Deep tendon reflexes 1+
Answer: D. Loss of deep tendon reflexes (1+ or absent) is the earliest sign of
magnesium toxicity and precedes respiratory depression. The antidote is calcium
gluconate .
6. The provider orders a 4 g loading dose of Magnesium Sulfate to infuse over 30
minutes. The available solution is 40 g in 500 mL of Lactated Ringer's. At what rate
in mL/hr should the nurse set the pump?
A. 100 mL/hr
B. 150 mL/hr
C. 200 mL/hr
D. 250 mL/hr
Answer: A.
1. Concentration: 40 g / 500 mL = 0.08 g/mL
2. Volume for 4 g: 4 g / 0.08 g/mL = 50 mL
3. Rate: 50 mL / 0.5 hr = 100 mL/hr
7. A client is admitted with a diagnosis of placental abruption. Which clinical
manifestation is consistent with this diagnosis?
A. Soft, non-tender uterus
B. Painless bleeding
C. Fundal height below gestational age
D. A rigid, board-like abdomen
Answer: D. Placental abruption is characterized by painful vaginal bleeding and a firm,
, tender uterus that may feel "board-like." Painless bleeding is more indicative of placenta
previa .
8. A client with a positive GBS status is receiving Penicillin G 500,000 units IVPB in
100 mL NS, to infuse over 30 minutes. What rate will the nurse set the pump for?
A. 100 mL/hr
B. 150 mL/hr
C. 200 mL/hr
D. 300 mL/hr
Answer: C. 100 mL / 0.5 hr = 200 mL/hr .
9. A laboring client's cervix is 4 cm dilated, and membranes are intact. The nurse
applies an external fetal monitor. The rationale for this action is to:
A. Determine the frequency and duration of contractions.
B. Assess the resting tone of the uterus.
C. Continuously monitor the fetal heart rate.
D. Measure the strength of uterine contractions.
Answer: C. An external fetal monitor allows for continuous assessment of the fetal heart
rate and uterine activity. An internal fetal scalp electrode would be used for more
accurate FHR monitoring if membranes are ruptured .
10. A client is experiencing a precipitate delivery. Which action should the nurse
take?
A. Encourage the client to push with every contraction.
B. Use a controlled delivery of the fetal head.
C. Perform a routine episiotomy.
D. Apply suprapubic pressure.
Answer: B. Precipitous labor can lead to rapid fetal descent and maternal trauma. The
nurse should use a hand to control the delivery of the head to prevent perineal
lacerations and fetal injury .
11. A nurse is providing discharge teaching to a postpartum client who is Rh-
negative. Which statement indicates the client understands the teaching about
Rho(D) immunoglobulin?
A. "This injection will protect my baby from becoming Rh-positive."
B. "This medication is given to treat my baby's jaundice."
C. "It prevents my body from making antibodies that could harm a future baby."
D. "I will need this injection if my baby is Rh-negative."
(Women’s & Children’s Health Nursing
Multiple Choice Questions & Answers (2026
Update) – Version 3
1. A client in labor is at 7 cm dilation, 90% effaced, and experiencing strong
contractions every 2-3 minutes. She is irritable and reports an urge to push. In
which phase of labor is this client?
A. Latent phase
B. Active phase
C. Transition phase
D. Second stage
Answer: C. The transition phase is characterized by 8-10 cm dilation, strong
contractions, and symptoms like irritability, nausea, and an urge to push.
2. The nurse notes recurrent variable decelerations on the fetal heart rate tracing.
What is the nurse's priority action?
A. Turn the client to her left side.
B. Administer oxygen via face mask.
C. Discontinue the oxytocin infusion.
D. Prepare the client for an emergency cesarean section.
Answer: A. Variable decelerations indicate cord compression. Repositioning the mother
(e.g., to her side, knee-chest) is the first-line intervention to relieve pressure on the
cord .
3. A nurse is caring for a client receiving an epidural for pain management. Which
assessment finding requires immediate intervention?
A. Maternal blood pressure of 90/50 mmHg
B. Numbness in the lower extremities
C. Loss of the urge to push
D. Maternal temperature of 99.2°F (37.3°C)
Answer: A. Hypotension is a common and serious side effect of epidural anesthesia,
reducing placental perfusion. The nurse should increase IV fluids and notify the provider.
, 4. A client is at 39 weeks of gestation and reports sudden, painless, bright red
vaginal bleeding. What is the nurse's priority intervention?
A. Perform a sterile vaginal exam to assess dilation.
B. Assess fetal heart rate and maternal vital signs.
C. Apply an external fetal monitor.
D. Prepare the client for an immediate cesarean birth.
Answer: B. The classic sign of placenta previa is painless, bright red bleeding. A vaginal
exam is strictly contraindicated as it can cause catastrophic hemorrhage. The priority is
to assess the mother and fetus for stability .
5. Which of the following findings in a client with severe preeclampsia indicates
potential magnesium toxicity?
A. Respiratory rate of 18 breaths/min
B. Urine output of 30 mL/hr
C. Deep tendon reflexes 2+
D. Deep tendon reflexes 1+
Answer: D. Loss of deep tendon reflexes (1+ or absent) is the earliest sign of
magnesium toxicity and precedes respiratory depression. The antidote is calcium
gluconate .
6. The provider orders a 4 g loading dose of Magnesium Sulfate to infuse over 30
minutes. The available solution is 40 g in 500 mL of Lactated Ringer's. At what rate
in mL/hr should the nurse set the pump?
A. 100 mL/hr
B. 150 mL/hr
C. 200 mL/hr
D. 250 mL/hr
Answer: A.
1. Concentration: 40 g / 500 mL = 0.08 g/mL
2. Volume for 4 g: 4 g / 0.08 g/mL = 50 mL
3. Rate: 50 mL / 0.5 hr = 100 mL/hr
7. A client is admitted with a diagnosis of placental abruption. Which clinical
manifestation is consistent with this diagnosis?
A. Soft, non-tender uterus
B. Painless bleeding
C. Fundal height below gestational age
D. A rigid, board-like abdomen
Answer: D. Placental abruption is characterized by painful vaginal bleeding and a firm,
, tender uterus that may feel "board-like." Painless bleeding is more indicative of placenta
previa .
8. A client with a positive GBS status is receiving Penicillin G 500,000 units IVPB in
100 mL NS, to infuse over 30 minutes. What rate will the nurse set the pump for?
A. 100 mL/hr
B. 150 mL/hr
C. 200 mL/hr
D. 300 mL/hr
Answer: C. 100 mL / 0.5 hr = 200 mL/hr .
9. A laboring client's cervix is 4 cm dilated, and membranes are intact. The nurse
applies an external fetal monitor. The rationale for this action is to:
A. Determine the frequency and duration of contractions.
B. Assess the resting tone of the uterus.
C. Continuously monitor the fetal heart rate.
D. Measure the strength of uterine contractions.
Answer: C. An external fetal monitor allows for continuous assessment of the fetal heart
rate and uterine activity. An internal fetal scalp electrode would be used for more
accurate FHR monitoring if membranes are ruptured .
10. A client is experiencing a precipitate delivery. Which action should the nurse
take?
A. Encourage the client to push with every contraction.
B. Use a controlled delivery of the fetal head.
C. Perform a routine episiotomy.
D. Apply suprapubic pressure.
Answer: B. Precipitous labor can lead to rapid fetal descent and maternal trauma. The
nurse should use a hand to control the delivery of the head to prevent perineal
lacerations and fetal injury .
11. A nurse is providing discharge teaching to a postpartum client who is Rh-
negative. Which statement indicates the client understands the teaching about
Rho(D) immunoglobulin?
A. "This injection will protect my baby from becoming Rh-positive."
B. "This medication is given to treat my baby's jaundice."
C. "It prevents my body from making antibodies that could harm a future baby."
D. "I will need this injection if my baby is Rh-negative."
