lRPN Post Review Test (A):
1. A 23-year old primigravida arrives at the clinic for a check up. She is complaining of nausea and
vomiting upon rising and increase urination. She reports that her last menstrual period was 2 months
ago. A blood test confirms that she is pregnant. Which of the following finding would be considered
abnormal?
a. A bluish tinge to the vagina upon cervical exam
b. A white, non-malodorous discharge from the vagina
c. Mild contractions radiating from the back to the abdomen
d. Increase vascularity, sensitivity, and fullness of the breasts
Answer: A –a bluish tinge to the vagina may indicate bleeding during the early part of pregnancy
2. The doctor wants to perform an amniocentesis on a client. She wants to know what this test is used for.
The PN explains:
a. It is used to identify chromosomal aberrations
b. It is used to confirm position and lie of the fetus
c. It is used to identify gestational sacs and number of fetuses present
d. It is used to determine gestational diabetes
Answer: A- Down syndrome can be detected from the amniotic fluid.
3. A nursing student is working with Labor and Delivery RPNs. During the monitoring of a patient in
labor, the student asks, what is the normal range for a fetal heart rate? The RPN responds by saying:
a. 160 to 180 BPM
b. 100 to 120 BPM
c. 120 to 160 BPM
d. 80 to 150 BPM
Answer: C-this is the normal range of FHT
4. The PN is providing a postpartum patient a teaching session, includes instructions on self-breast exam.
Which of the following instructions would not be correct?
a. Do not do self-breast exams during lactation.
b. Perform self-breast exams while lying flat on back.
c. Check breasts in circular motion and assess for lumps or bumps.
d. Examine the breast between the 4th and 7th day of menses.
Answer: A—the breasts are full during lactation which may affect the exams.
5. During a teaching session with a 16 year old mother, the PN notes that the following statement made
by the adolescent confirms her understanding of proper feeding methods.
a. “I will heat the milk in microwave and shake it well to be sure not to burn the baby.”
b. “I will burp the baby every 10 minutes, during feedings.”
c. “I will let my baby sleep after every 1& ½ ounces of formula”.
d. “I will hold the bottle so that the nipple is always full of formula.”
Answer: D—prevent the baby to swallow air
6. Which of the following would alert the nurse to call the doctor in a newborn of an Rh-negative
mother?
a. Negative direct Coombs
b. Resting HR of 160
c. Pallor
d. RR of 32
Answer: C—pallor is an abnormal finding
7. A 30-year-old, primigravida is in labor and doing well. Her membranes ruptured and she is 3 cm
dilated. The fetal heart suddenly drops to 86 BPM and a prolapsed cord is suspected. The most
appropriate nursing action would be to:
, a. Open up the IV line and give a fluid bolus.
b. Place the woman in a knee chest position.
c. Give oxygen.
d. Call for an emergency C-Section.
Answer: B—this will reduce the pressure on the cord causing good perfusion.
8. A laboring patient has a sudden drop in blood pressure and becomes tachycardic. What is the first
action the PN should take?
a. Notify MD.
b. Open up IV line and bolus with fluids.
c. Give oxygen.
d. Turn patient to left side.
Answer: D – the left side promotes perfusion of the fetus.
9. A 16-year-old girl in the adolescent clinic thinks she may be pregnant since her LMP was 8 weeks ago.
Which of the following would be considered a probable sign of pregnancy?
a. Urinary frequency.
b. Morning Sickness.
c. A positive pregnancy test.
d. Fetal heart tones.
Answer: C—this is a probable sign; urinary frequency is presumptive sign; morning sickness is
presumptive; fetal heart tone is positive sign.
10. A 37-year-old Gravida 4, para 3, complains of severe pain and edema of the left leg and thigh the day
after a c-section. Which of the following signs would indicate that she might have thrombophlebitis?
a. Babinski’s sign.
b. Trousseau’s sign.
c. Chvostek’s sign.
d. Homan’s sign.
Answer: D – this is to assess for thromboplebitis; Babinki’s is normal in infants and it is a sign of increased
ICP in adult; Trousseau’s and Chvostek’s are signs of hypocalcemia.
11. A client is diagnosed with thrombophlebitis and 5, 000 units of heparin are ordered Q 12h, SQ. The
client asks why she is on heparin. The PN explains:
a. This will decrease your risk of developing disseminated intravascular coagulation.
b. This will prevent additional clot formation.
c. This will cause the clot to dissolve.
d. This will increase the clotting factors in your blood.
Answer: B – heparin delays bleeding time and prevent clot formation.
12. A 25-year-old G2P1 decides to breast-feed and asks if it would be a good idea to breast feed right after
the delivery. Which of the following would NOT be a benefit of initiating breast feeding soon after
delivery?
a. Enhance uterine involution.
b. Decreased need for erythromycin eye ointment for the infant, as the immunity from the
colostrums will protect the baby from all infections.
c. Enhanced maternal-infant bonding.
d. Decreased risk of erythroblastosis fetalis.
Answer: B – this is not related to breast feeding.
13. The patient is breast feeding successfully. During a routine visit, the client tells the PN that she gets
strong abdominal pains and milk seeping from her other breast while breast-feeding. The PN explains
to the client:
a. This is abnormal you should stop breast-feeding.
b. You may be breast feeding for too long, reduce the amount of time on each breast to 5 minutes.
, c. During nursing the hormone oxytocin is released and this causes a “let down” reflex and
also causes uterine involution.
d. Estrogen release during nursing will cause these harmless symptoms.
Answer: C – sucking promotes secretion of milk (let-down reflex).
14. A 15-year-old G1P0 is HIV+ has just delivered a pre-term infant. She is asymptomatic and wants to
know how best she can protect her baby from contracting HIV. The PN explains:
a. Keep the baby in respiratory isolation for 2 weeks.
b. Avoid breast-feeding the baby.
c. Wash her hands before and after handling the baby.
d. Wear gloves to change the diapers.
Answer: B – the HIV virus can be transferred via breast milk.
15. A pregnant woman who is HIV+ is receiving retrovir. The PN knows the effects of retrovir are:
a. Suppression of bone marrow activity.
b. Prevention of viral replication.
c. Decrease in production of CD4 cells.
d. Increased development of immunodeficiency syndrome.
Answer: B – this is the action of Retrovir.
16. A 6 lb. 7 oz male neonate is born to a 32 year old G3 P3. The PN assigns an Apgar score of 8 at 1
minute and 9 at 5 minutes. This score indicates:
a. The neonate required some resuscitation.
b. The neonate’s muscle tone was flaccid.
c. The neonate’s heart rate was less than 60.
d. The neonate had some cyanosis of the hands and feet.
Answer: D – this is a reflection of acrocyanosis.
17. Upon performing the initial assessment at birth the PN hears a click while abducting the neonate’s
hips. Which of the following is the most appropriate action:
a. Notify the MD.
b. Double diaper the baby.
c. Document findings and continue to monitor.
d. Avoid swaddling the baby.
Answer: B – this is necessary to promote abduction of the hip.
18. A baby girl develops a caput succedaneum. Which of the following nursing actions would you expect
to be included in the care of the infant?
a. Explanation to the parents about the cause/prognosis.
b. Instruct the parents to rub the caput in a clockwise motion to decrease the size.
c. Set up for aspiration of the blood from the subdural space.
d. Apply warm soaks to the affected area.
Answer: A – caput succedaneum is self limiting.
19. Encouraging the parents to hold their infant immediately following delivery is appropriate practice
because:
a. The neonate is usually stable right after birth and therefore it is safe to leave the baby with the
parents.
b. The neonate is in an alert stat immediately following the birth and bonding can take place.
c. The presence of the neonate to the mother will stimulate the release of oxytocin.
d. Holding the infant at this time decreases the chance of postpartum depression.
Answer: B –this promotes bonding.
20. The mother of 6-lb. 2-oz baby girl asks the PN what is the normal weight loss for a newborn. The PN
explains:
a. The baby should only lose a few ounces.
, b. The baby should not lose any weight.
c. The baby should lose less than 5% of the birth weight.
d. The baby should lose between 5 and 10% of the birth weight.
Answer: D --
21. A baby is fed 3 hours after delivery. She gags and regurgitates the feeding. The PN recognizes this as a
sign of:
a. Esophageal atresia.
b. Intusseption.
c. Spina Bifida.
d. Pyloric Stenosis.
Answer: A – gagging is a symptom of esophageal atresia.
22. A newborn being discharged from the well baby nursery is being given a follow-up appointment to
return for immunizations. The baby would be scheduled to return in
a. 2 weeks.
b. 2 months.
c. 4 months.
d. 1 year.
Answer: B—immunization starts at age 2 months.
23. A G1P1 mother is caring for her newborn. Which of the following statements made by the mother
would indicate that she understands newborn care?
a. “Once the cord is dry, my baby can have a tub bath.”
b. “The foreskin for the penis should not be retracted during cleaning.”
c. “When washing the face the outer aspects should be washed first.”
d. “The baby should always be placed on his belly after feeding.”
Answer: A – this is appropriate.
24. To prevent constipation in a pregnant woman who is taking iron supplements the PN would instruct the
patient to:
a. Eat more raw fruits and vegetables.
b. Eat more cooked fruits and vegetables.
c. Take Colace (stool softener).
d. Eat more bananas.
Answer: A – Vit C from fruits and vegetables makes iron available for formation of heme.
25. A neonate born to a diabetic mother weighed 9 lbs. 10 oz. One hour after birth the baby begins to
tremble. The most likely cause of this symptom is:
a. Neurological immaturity.
b. Low Potassium.
c. Hypoglycemia.
d. Cold stress.
Answer: C – this is a sign of hypoglycemia.
26. During pregnancy a diabetic’s need for insulin typically:
a. Increases during the entire pregnancy.
b. Decreases during the entire pregnancy.
c. Decreases during the first trimester and increases in the second and third.
d. Increases during the first trimester and decreases during the second and third.
Answer: C – this is the typical pattern of insulin adjustment in pregnancy.
27. As part of a teaching plan for a pregnant diabetic the PN discusses self-monitoring of blood glucose.
The goal of monitoring is to:
a. Identify maternal retinopathy.
b. Identify potential macrosomia.
1. A 23-year old primigravida arrives at the clinic for a check up. She is complaining of nausea and
vomiting upon rising and increase urination. She reports that her last menstrual period was 2 months
ago. A blood test confirms that she is pregnant. Which of the following finding would be considered
abnormal?
a. A bluish tinge to the vagina upon cervical exam
b. A white, non-malodorous discharge from the vagina
c. Mild contractions radiating from the back to the abdomen
d. Increase vascularity, sensitivity, and fullness of the breasts
Answer: A –a bluish tinge to the vagina may indicate bleeding during the early part of pregnancy
2. The doctor wants to perform an amniocentesis on a client. She wants to know what this test is used for.
The PN explains:
a. It is used to identify chromosomal aberrations
b. It is used to confirm position and lie of the fetus
c. It is used to identify gestational sacs and number of fetuses present
d. It is used to determine gestational diabetes
Answer: A- Down syndrome can be detected from the amniotic fluid.
3. A nursing student is working with Labor and Delivery RPNs. During the monitoring of a patient in
labor, the student asks, what is the normal range for a fetal heart rate? The RPN responds by saying:
a. 160 to 180 BPM
b. 100 to 120 BPM
c. 120 to 160 BPM
d. 80 to 150 BPM
Answer: C-this is the normal range of FHT
4. The PN is providing a postpartum patient a teaching session, includes instructions on self-breast exam.
Which of the following instructions would not be correct?
a. Do not do self-breast exams during lactation.
b. Perform self-breast exams while lying flat on back.
c. Check breasts in circular motion and assess for lumps or bumps.
d. Examine the breast between the 4th and 7th day of menses.
Answer: A—the breasts are full during lactation which may affect the exams.
5. During a teaching session with a 16 year old mother, the PN notes that the following statement made
by the adolescent confirms her understanding of proper feeding methods.
a. “I will heat the milk in microwave and shake it well to be sure not to burn the baby.”
b. “I will burp the baby every 10 minutes, during feedings.”
c. “I will let my baby sleep after every 1& ½ ounces of formula”.
d. “I will hold the bottle so that the nipple is always full of formula.”
Answer: D—prevent the baby to swallow air
6. Which of the following would alert the nurse to call the doctor in a newborn of an Rh-negative
mother?
a. Negative direct Coombs
b. Resting HR of 160
c. Pallor
d. RR of 32
Answer: C—pallor is an abnormal finding
7. A 30-year-old, primigravida is in labor and doing well. Her membranes ruptured and she is 3 cm
dilated. The fetal heart suddenly drops to 86 BPM and a prolapsed cord is suspected. The most
appropriate nursing action would be to:
, a. Open up the IV line and give a fluid bolus.
b. Place the woman in a knee chest position.
c. Give oxygen.
d. Call for an emergency C-Section.
Answer: B—this will reduce the pressure on the cord causing good perfusion.
8. A laboring patient has a sudden drop in blood pressure and becomes tachycardic. What is the first
action the PN should take?
a. Notify MD.
b. Open up IV line and bolus with fluids.
c. Give oxygen.
d. Turn patient to left side.
Answer: D – the left side promotes perfusion of the fetus.
9. A 16-year-old girl in the adolescent clinic thinks she may be pregnant since her LMP was 8 weeks ago.
Which of the following would be considered a probable sign of pregnancy?
a. Urinary frequency.
b. Morning Sickness.
c. A positive pregnancy test.
d. Fetal heart tones.
Answer: C—this is a probable sign; urinary frequency is presumptive sign; morning sickness is
presumptive; fetal heart tone is positive sign.
10. A 37-year-old Gravida 4, para 3, complains of severe pain and edema of the left leg and thigh the day
after a c-section. Which of the following signs would indicate that she might have thrombophlebitis?
a. Babinski’s sign.
b. Trousseau’s sign.
c. Chvostek’s sign.
d. Homan’s sign.
Answer: D – this is to assess for thromboplebitis; Babinki’s is normal in infants and it is a sign of increased
ICP in adult; Trousseau’s and Chvostek’s are signs of hypocalcemia.
11. A client is diagnosed with thrombophlebitis and 5, 000 units of heparin are ordered Q 12h, SQ. The
client asks why she is on heparin. The PN explains:
a. This will decrease your risk of developing disseminated intravascular coagulation.
b. This will prevent additional clot formation.
c. This will cause the clot to dissolve.
d. This will increase the clotting factors in your blood.
Answer: B – heparin delays bleeding time and prevent clot formation.
12. A 25-year-old G2P1 decides to breast-feed and asks if it would be a good idea to breast feed right after
the delivery. Which of the following would NOT be a benefit of initiating breast feeding soon after
delivery?
a. Enhance uterine involution.
b. Decreased need for erythromycin eye ointment for the infant, as the immunity from the
colostrums will protect the baby from all infections.
c. Enhanced maternal-infant bonding.
d. Decreased risk of erythroblastosis fetalis.
Answer: B – this is not related to breast feeding.
13. The patient is breast feeding successfully. During a routine visit, the client tells the PN that she gets
strong abdominal pains and milk seeping from her other breast while breast-feeding. The PN explains
to the client:
a. This is abnormal you should stop breast-feeding.
b. You may be breast feeding for too long, reduce the amount of time on each breast to 5 minutes.
, c. During nursing the hormone oxytocin is released and this causes a “let down” reflex and
also causes uterine involution.
d. Estrogen release during nursing will cause these harmless symptoms.
Answer: C – sucking promotes secretion of milk (let-down reflex).
14. A 15-year-old G1P0 is HIV+ has just delivered a pre-term infant. She is asymptomatic and wants to
know how best she can protect her baby from contracting HIV. The PN explains:
a. Keep the baby in respiratory isolation for 2 weeks.
b. Avoid breast-feeding the baby.
c. Wash her hands before and after handling the baby.
d. Wear gloves to change the diapers.
Answer: B – the HIV virus can be transferred via breast milk.
15. A pregnant woman who is HIV+ is receiving retrovir. The PN knows the effects of retrovir are:
a. Suppression of bone marrow activity.
b. Prevention of viral replication.
c. Decrease in production of CD4 cells.
d. Increased development of immunodeficiency syndrome.
Answer: B – this is the action of Retrovir.
16. A 6 lb. 7 oz male neonate is born to a 32 year old G3 P3. The PN assigns an Apgar score of 8 at 1
minute and 9 at 5 minutes. This score indicates:
a. The neonate required some resuscitation.
b. The neonate’s muscle tone was flaccid.
c. The neonate’s heart rate was less than 60.
d. The neonate had some cyanosis of the hands and feet.
Answer: D – this is a reflection of acrocyanosis.
17. Upon performing the initial assessment at birth the PN hears a click while abducting the neonate’s
hips. Which of the following is the most appropriate action:
a. Notify the MD.
b. Double diaper the baby.
c. Document findings and continue to monitor.
d. Avoid swaddling the baby.
Answer: B – this is necessary to promote abduction of the hip.
18. A baby girl develops a caput succedaneum. Which of the following nursing actions would you expect
to be included in the care of the infant?
a. Explanation to the parents about the cause/prognosis.
b. Instruct the parents to rub the caput in a clockwise motion to decrease the size.
c. Set up for aspiration of the blood from the subdural space.
d. Apply warm soaks to the affected area.
Answer: A – caput succedaneum is self limiting.
19. Encouraging the parents to hold their infant immediately following delivery is appropriate practice
because:
a. The neonate is usually stable right after birth and therefore it is safe to leave the baby with the
parents.
b. The neonate is in an alert stat immediately following the birth and bonding can take place.
c. The presence of the neonate to the mother will stimulate the release of oxytocin.
d. Holding the infant at this time decreases the chance of postpartum depression.
Answer: B –this promotes bonding.
20. The mother of 6-lb. 2-oz baby girl asks the PN what is the normal weight loss for a newborn. The PN
explains:
a. The baby should only lose a few ounces.
, b. The baby should not lose any weight.
c. The baby should lose less than 5% of the birth weight.
d. The baby should lose between 5 and 10% of the birth weight.
Answer: D --
21. A baby is fed 3 hours after delivery. She gags and regurgitates the feeding. The PN recognizes this as a
sign of:
a. Esophageal atresia.
b. Intusseption.
c. Spina Bifida.
d. Pyloric Stenosis.
Answer: A – gagging is a symptom of esophageal atresia.
22. A newborn being discharged from the well baby nursery is being given a follow-up appointment to
return for immunizations. The baby would be scheduled to return in
a. 2 weeks.
b. 2 months.
c. 4 months.
d. 1 year.
Answer: B—immunization starts at age 2 months.
23. A G1P1 mother is caring for her newborn. Which of the following statements made by the mother
would indicate that she understands newborn care?
a. “Once the cord is dry, my baby can have a tub bath.”
b. “The foreskin for the penis should not be retracted during cleaning.”
c. “When washing the face the outer aspects should be washed first.”
d. “The baby should always be placed on his belly after feeding.”
Answer: A – this is appropriate.
24. To prevent constipation in a pregnant woman who is taking iron supplements the PN would instruct the
patient to:
a. Eat more raw fruits and vegetables.
b. Eat more cooked fruits and vegetables.
c. Take Colace (stool softener).
d. Eat more bananas.
Answer: A – Vit C from fruits and vegetables makes iron available for formation of heme.
25. A neonate born to a diabetic mother weighed 9 lbs. 10 oz. One hour after birth the baby begins to
tremble. The most likely cause of this symptom is:
a. Neurological immaturity.
b. Low Potassium.
c. Hypoglycemia.
d. Cold stress.
Answer: C – this is a sign of hypoglycemia.
26. During pregnancy a diabetic’s need for insulin typically:
a. Increases during the entire pregnancy.
b. Decreases during the entire pregnancy.
c. Decreases during the first trimester and increases in the second and third.
d. Increases during the first trimester and decreases during the second and third.
Answer: C – this is the typical pattern of insulin adjustment in pregnancy.
27. As part of a teaching plan for a pregnant diabetic the PN discusses self-monitoring of blood glucose.
The goal of monitoring is to:
a. Identify maternal retinopathy.
b. Identify potential macrosomia.
