OB Nursing / Obstetric Nursing 2026/2027 | Obstetric Nursing Study Guide,
Practice Questions & Answers, OB Nursing Exam Prep, Comprehensive Maternal-
Newborn Review, Maternity Nursing, Pregnancy & Prenatal Care, Antepartum
Assessment, High-Risk Pregnancy, Labor & Delivery, Intrapartum Nursing, Fetal
Monitoring, Postpartum Care, Newborn Assessment & Care, Pregnancy
Complications, Preeclampsia & Eclampsia, Gestational Diabetes, Placental
Disorders, Obstetric Hemorrhage, Breastfeeding, Contraception & Family Planning,
Reproductive Health, Obstetric Pharmacology, Clinical Judgment, Prioritization,
NCLEX-Style Practice & Detailed Rationales
Question 1: A primigravida at 38 weeks' gestation presents with
painless, bright red vaginal bleeding. Her uterus is relaxed and non-
tender. Which condition should the nurse suspect first?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Cervical polyps
CORRECT ANSWER: A. Placenta previa
Rationale: Placenta previa classically presents with painless, bright red
vaginal bleeding in late pregnancy, with a relaxed, non-tender uterus.
Abruptio placentae typically presents with painful bleeding and a rigid,
tender uterus.
Question 2: A client at 34 weeks' gestation presents with painful vaginal
bleeding and a board-like, tender uterus. Which complication is most
likely?
A. Placenta previa
B. Abruptio placentae
C. Vasa previa
D. Uterine fibroids
CORRECT ANSWER: B. Abruptio placentae
Rationale: Abruptio placentae is characterized by premature separation of
the placenta, causing painful vaginal bleeding, uterine tenderness, and a
rigid or board-like abdomen. Placenta previa is typically painless.
Question 3: Which assessment finding is most characteristic of severe
preeclampsia?
,A. Blood pressure 130/80 mmHg
B. Proteinuria of 1+
C. Blood pressure 170/110 mmHg with 3+ proteinuria
D. Mild ankle edema
CORRECT ANSWER: C. Blood pressure 170/110 mmHg with 3+
proteinuria
Rationale: Severe preeclampsia is diagnosed with systolic BP ≥160 mmHg
or diastolic ≥110 mmHg on two occasions, plus proteinuria ≥3+, along with
other end-organ dysfunction signs.
Question 4: A client with preeclampsia is receiving magnesium sulfate.
Which finding indicates magnesium toxicity?
A. Respiratory rate of 18 breaths/min
B. Deep tendon reflexes 2+
C. Urine output of 50 mL/hr
D. Loss of deep tendon reflexes
CORRECT ANSWER: D. Loss of deep tendon reflexes
Rationale: Loss of deep tendon reflexes is an early sign of magnesium
sulfate toxicity, followed by respiratory depression and cardiac arrest. The
antidote is calcium gluconate.
Question 5: What is the priority nursing action when magnesium
toxicity is suspected?
A. Increase the infusion rate
B. Administer calcium gluconate
C. Administer oxytocin
D. Position the client supine
CORRECT ANSWER: B. Administer calcium gluconate
Rationale: Calcium gluconate is the antidote for magnesium sulfate
toxicity. The infusion should be stopped immediately, and calcium
gluconate administered IV as ordered.
Question 6: A client in the first stage of labor has cervical dilation of 4
cm and contractions every 3 minutes lasting 50 seconds. Which phase
of labor is she in?
,A. Latent phase
B. Active phase
C. Transition phase
D. Second stage
CORRECT ANSWER: B. Active phase
Rationale: The active phase of the first stage of labor is characterized by
cervical dilation from about 4 to 7 cm, with stronger, more frequent
contractions. The latent phase is 0–3 cm, and transition is 8–10 cm.
Question 7: Which fetal heart rate pattern indicates uteroplacental
insufficiency?
A. Early decelerations
B. Accelerations
C. Late decelerations
D. Variable decelerations
CORRECT ANSWER: C. Late decelerations
Rationale: Late decelerations are caused by uteroplacental insufficiency
and are a non-reassuring pattern. Early decelerations are benign,
accelerations are reassuring, and variable decelerations suggest cord
compression.
Question 8: What is the most appropriate initial nursing intervention for
late decelerations?
A. Continue monitoring without change
B. Reposition the client to the left lateral position
C. Increase oxytocin infusion
D. Encourage the client to push
CORRECT ANSWER: B. Reposition the client to the left lateral position
Rationale: Left lateral positioning improves uterine perfusion by relieving
inferior vena cava compression. Other measures include stopping
oxytocin, administering oxygen, and increasing IV fluids.
Question 9: Variable decelerations on the fetal monitor are most
commonly caused by which condition?
, A. Head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Maternal fever
CORRECT ANSWER: B. Umbilical cord compression
Rationale: Variable decelerations have an abrupt onset and are caused by
umbilical cord compression. Nursing interventions include repositioning
the mother and amnioinfusion if ordered.
Question 10: A client's fetal heart rate shows a baseline of 170 beats
per minute. This is best described as:
A. Bradycardia
B. Normal baseline
C. Tachycardia
D. Sinusoidal pattern
CORRECT ANSWER: C. Tachycardia
Rationale: A fetal heart rate baseline above 160 beats per minute for at
least 10 minutes is fetal tachycardia. Causes include maternal fever,
infection, dehydration, and fetal hypoxia.
Question 11: Which medication is used to ripen the cervix before
induction of labor?
A. Oxytocin
B. Misoprostol
C. Magnesium sulfate
D. Terbutaline
CORRECT ANSWER: B. Misoprostol
Rationale: Misoprostol (prostaglandin E1) is used for cervical ripening and
labor induction. Oxytocin is used for augmentation, magnesium sulfate for
seizure prophylaxis, and terbutaline for tocolysis.
Question 12: What is the antidote for magnesium sulfate toxicity?
A. Naloxone
B. Calcium gluconate
Practice Questions & Answers, OB Nursing Exam Prep, Comprehensive Maternal-
Newborn Review, Maternity Nursing, Pregnancy & Prenatal Care, Antepartum
Assessment, High-Risk Pregnancy, Labor & Delivery, Intrapartum Nursing, Fetal
Monitoring, Postpartum Care, Newborn Assessment & Care, Pregnancy
Complications, Preeclampsia & Eclampsia, Gestational Diabetes, Placental
Disorders, Obstetric Hemorrhage, Breastfeeding, Contraception & Family Planning,
Reproductive Health, Obstetric Pharmacology, Clinical Judgment, Prioritization,
NCLEX-Style Practice & Detailed Rationales
Question 1: A primigravida at 38 weeks' gestation presents with
painless, bright red vaginal bleeding. Her uterus is relaxed and non-
tender. Which condition should the nurse suspect first?
A. Placenta previa
B. Abruptio placentae
C. Uterine rupture
D. Cervical polyps
CORRECT ANSWER: A. Placenta previa
Rationale: Placenta previa classically presents with painless, bright red
vaginal bleeding in late pregnancy, with a relaxed, non-tender uterus.
Abruptio placentae typically presents with painful bleeding and a rigid,
tender uterus.
Question 2: A client at 34 weeks' gestation presents with painful vaginal
bleeding and a board-like, tender uterus. Which complication is most
likely?
A. Placenta previa
B. Abruptio placentae
C. Vasa previa
D. Uterine fibroids
CORRECT ANSWER: B. Abruptio placentae
Rationale: Abruptio placentae is characterized by premature separation of
the placenta, causing painful vaginal bleeding, uterine tenderness, and a
rigid or board-like abdomen. Placenta previa is typically painless.
Question 3: Which assessment finding is most characteristic of severe
preeclampsia?
,A. Blood pressure 130/80 mmHg
B. Proteinuria of 1+
C. Blood pressure 170/110 mmHg with 3+ proteinuria
D. Mild ankle edema
CORRECT ANSWER: C. Blood pressure 170/110 mmHg with 3+
proteinuria
Rationale: Severe preeclampsia is diagnosed with systolic BP ≥160 mmHg
or diastolic ≥110 mmHg on two occasions, plus proteinuria ≥3+, along with
other end-organ dysfunction signs.
Question 4: A client with preeclampsia is receiving magnesium sulfate.
Which finding indicates magnesium toxicity?
A. Respiratory rate of 18 breaths/min
B. Deep tendon reflexes 2+
C. Urine output of 50 mL/hr
D. Loss of deep tendon reflexes
CORRECT ANSWER: D. Loss of deep tendon reflexes
Rationale: Loss of deep tendon reflexes is an early sign of magnesium
sulfate toxicity, followed by respiratory depression and cardiac arrest. The
antidote is calcium gluconate.
Question 5: What is the priority nursing action when magnesium
toxicity is suspected?
A. Increase the infusion rate
B. Administer calcium gluconate
C. Administer oxytocin
D. Position the client supine
CORRECT ANSWER: B. Administer calcium gluconate
Rationale: Calcium gluconate is the antidote for magnesium sulfate
toxicity. The infusion should be stopped immediately, and calcium
gluconate administered IV as ordered.
Question 6: A client in the first stage of labor has cervical dilation of 4
cm and contractions every 3 minutes lasting 50 seconds. Which phase
of labor is she in?
,A. Latent phase
B. Active phase
C. Transition phase
D. Second stage
CORRECT ANSWER: B. Active phase
Rationale: The active phase of the first stage of labor is characterized by
cervical dilation from about 4 to 7 cm, with stronger, more frequent
contractions. The latent phase is 0–3 cm, and transition is 8–10 cm.
Question 7: Which fetal heart rate pattern indicates uteroplacental
insufficiency?
A. Early decelerations
B. Accelerations
C. Late decelerations
D. Variable decelerations
CORRECT ANSWER: C. Late decelerations
Rationale: Late decelerations are caused by uteroplacental insufficiency
and are a non-reassuring pattern. Early decelerations are benign,
accelerations are reassuring, and variable decelerations suggest cord
compression.
Question 8: What is the most appropriate initial nursing intervention for
late decelerations?
A. Continue monitoring without change
B. Reposition the client to the left lateral position
C. Increase oxytocin infusion
D. Encourage the client to push
CORRECT ANSWER: B. Reposition the client to the left lateral position
Rationale: Left lateral positioning improves uterine perfusion by relieving
inferior vena cava compression. Other measures include stopping
oxytocin, administering oxygen, and increasing IV fluids.
Question 9: Variable decelerations on the fetal monitor are most
commonly caused by which condition?
, A. Head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Maternal fever
CORRECT ANSWER: B. Umbilical cord compression
Rationale: Variable decelerations have an abrupt onset and are caused by
umbilical cord compression. Nursing interventions include repositioning
the mother and amnioinfusion if ordered.
Question 10: A client's fetal heart rate shows a baseline of 170 beats
per minute. This is best described as:
A. Bradycardia
B. Normal baseline
C. Tachycardia
D. Sinusoidal pattern
CORRECT ANSWER: C. Tachycardia
Rationale: A fetal heart rate baseline above 160 beats per minute for at
least 10 minutes is fetal tachycardia. Causes include maternal fever,
infection, dehydration, and fetal hypoxia.
Question 11: Which medication is used to ripen the cervix before
induction of labor?
A. Oxytocin
B. Misoprostol
C. Magnesium sulfate
D. Terbutaline
CORRECT ANSWER: B. Misoprostol
Rationale: Misoprostol (prostaglandin E1) is used for cervical ripening and
labor induction. Oxytocin is used for augmentation, magnesium sulfate for
seizure prophylaxis, and terbutaline for tocolysis.
Question 12: What is the antidote for magnesium sulfate toxicity?
A. Naloxone
B. Calcium gluconate
