1. A nurse is caring for a client in labor who is experiencing back labor. Which
position should the nurse encourage to relieve the client's pain?
A) Lithotomy position
B) Kneeling with the head and shoulders supported
C) Squatting
D) Hands and knees position
Answer: D) Hands and knees position
Rationale: Back labor is caused by the baby’s position (usually occiput posterior) pressing
against the mother's sacrum. The hands and knees position helps alleviate pressure on the sacrum
and can relieve back pain.
2. A nurse is assessing a newborn immediately after delivery. Which of the
following findings should the nurse report to the healthcare provider?
A) Heart rate of 130 bpm
B) Respiratory rate of 40 breaths/min
C) Acrocyanosis
D) Grunting respirations
Answer: D) Grunting respirations
Rationale: Grunting respirations can indicate respiratory distress and require further assessment
and intervention. The other findings are normal for a newborn.
3. The nurse is teaching a prenatal class about nutrition. Which of the following
statements by the client indicates a need for further teaching?
A) "I need to take prenatal vitamins that include folic acid."
B) "I should increase my intake of calcium to 1,000 mg daily."
C) "I can avoid iron supplements if I eat iron-rich foods."
D) "I need to consume extra calories in the second trimester."
Answer: C) "I can avoid iron supplements if I eat iron-rich foods."
Rationale: Pregnant women are often advised to take iron supplements to prevent anemia, even
if they consume iron-rich foods, due to the increased iron needs during pregnancy.
,4. A nurse is providing discharge teaching to a new mother who is breastfeeding.
Which statement indicates that the mother understands proper latch-on
technique?
A) "My baby’s lips should be curled in during breastfeeding."
B) "I should feel pain during the first few minutes of nursing."
C) "The baby’s nose should be touching my breast."
D) "The baby’s mouth should cover most of the areola."
Answer: D) "The baby’s mouth should cover most of the areola."
Rationale: Proper latch-on involves the baby covering most of the areola with their mouth to
ensure effective milk transfer and prevent nipple pain.
5. The nurse is caring for a client who is 6 hours postpartum and is experiencing
heavy lochia. Which of the following actions should the nurse take first?
A) Perform a vaginal exam to check for retained placenta
B) Administer an oxytocic medication
C) Assess the client's vital signs
D) Massage the uterus
Answer: D) Massage the uterus
Rationale: A boggy uterus is the most common cause of heavy lochia postpartum, and uterine
massage should be the first intervention to stimulate uterine contraction.
6. A nurse is caring for a pregnant client at 28 weeks gestation. The client reports
sudden, severe abdominal pain. Which of the following conditions is the nurse
most concerned about?
A) Round ligament pain
B) Ectopic pregnancy
C) Placental abruption
D) Preterm labor
Answer: C) Placental abruption
Rationale: Sudden, severe abdominal pain in pregnancy may indicate placental abruption, a life-
threatening emergency where the placenta separates prematurely from the uterine wall.
, 7. A nurse is assessing a newborn’s reflexes. Which of the following reflexes
should the nurse expect to find at birth?
A) Moro reflex
B) Babinski reflex
C) Rooting reflex
D) All of the above
Answer: D) All of the above
Rationale: All of these reflexes—Moro, Babinski, and rooting—are normal neonatal reflexes
and should be present at birth.
8. A nurse is caring for a postpartum client who is experiencing constipation.
Which of the following interventions should the nurse suggest?
A) Increase intake of caffeinated beverages
B) Use a stool softener as prescribed
C) Avoid fiber-rich foods
D) Limit fluid intake to 1 liter per day
Answer: B) Use a stool softener as prescribed
Rationale: Stool softeners are often prescribed postpartum to help prevent constipation.
Increasing fluid and fiber intake can also be helpful.
9. A nurse is caring for a client in labor. The client requests an epidural block for
pain relief. Which of the following is a contraindication for an epidural block?
A) Hypotension
B) Active herpes simplex virus infection
C) Positive urine culture for E. coli
D) Platelet count of 100,000/mm3
Answer: B) Active herpes simplex virus infection
Rationale: An active herpes simplex infection is a contraindication for an epidural block due to
the potential for transmission of the virus to the fetus.
10. A nurse is caring for a postpartum client who is breastfeeding. The nurse
observes that the client's nipples are cracked and bleeding. Which of the
following interventions is most appropriate?
position should the nurse encourage to relieve the client's pain?
A) Lithotomy position
B) Kneeling with the head and shoulders supported
C) Squatting
D) Hands and knees position
Answer: D) Hands and knees position
Rationale: Back labor is caused by the baby’s position (usually occiput posterior) pressing
against the mother's sacrum. The hands and knees position helps alleviate pressure on the sacrum
and can relieve back pain.
2. A nurse is assessing a newborn immediately after delivery. Which of the
following findings should the nurse report to the healthcare provider?
A) Heart rate of 130 bpm
B) Respiratory rate of 40 breaths/min
C) Acrocyanosis
D) Grunting respirations
Answer: D) Grunting respirations
Rationale: Grunting respirations can indicate respiratory distress and require further assessment
and intervention. The other findings are normal for a newborn.
3. The nurse is teaching a prenatal class about nutrition. Which of the following
statements by the client indicates a need for further teaching?
A) "I need to take prenatal vitamins that include folic acid."
B) "I should increase my intake of calcium to 1,000 mg daily."
C) "I can avoid iron supplements if I eat iron-rich foods."
D) "I need to consume extra calories in the second trimester."
Answer: C) "I can avoid iron supplements if I eat iron-rich foods."
Rationale: Pregnant women are often advised to take iron supplements to prevent anemia, even
if they consume iron-rich foods, due to the increased iron needs during pregnancy.
,4. A nurse is providing discharge teaching to a new mother who is breastfeeding.
Which statement indicates that the mother understands proper latch-on
technique?
A) "My baby’s lips should be curled in during breastfeeding."
B) "I should feel pain during the first few minutes of nursing."
C) "The baby’s nose should be touching my breast."
D) "The baby’s mouth should cover most of the areola."
Answer: D) "The baby’s mouth should cover most of the areola."
Rationale: Proper latch-on involves the baby covering most of the areola with their mouth to
ensure effective milk transfer and prevent nipple pain.
5. The nurse is caring for a client who is 6 hours postpartum and is experiencing
heavy lochia. Which of the following actions should the nurse take first?
A) Perform a vaginal exam to check for retained placenta
B) Administer an oxytocic medication
C) Assess the client's vital signs
D) Massage the uterus
Answer: D) Massage the uterus
Rationale: A boggy uterus is the most common cause of heavy lochia postpartum, and uterine
massage should be the first intervention to stimulate uterine contraction.
6. A nurse is caring for a pregnant client at 28 weeks gestation. The client reports
sudden, severe abdominal pain. Which of the following conditions is the nurse
most concerned about?
A) Round ligament pain
B) Ectopic pregnancy
C) Placental abruption
D) Preterm labor
Answer: C) Placental abruption
Rationale: Sudden, severe abdominal pain in pregnancy may indicate placental abruption, a life-
threatening emergency where the placenta separates prematurely from the uterine wall.
, 7. A nurse is assessing a newborn’s reflexes. Which of the following reflexes
should the nurse expect to find at birth?
A) Moro reflex
B) Babinski reflex
C) Rooting reflex
D) All of the above
Answer: D) All of the above
Rationale: All of these reflexes—Moro, Babinski, and rooting—are normal neonatal reflexes
and should be present at birth.
8. A nurse is caring for a postpartum client who is experiencing constipation.
Which of the following interventions should the nurse suggest?
A) Increase intake of caffeinated beverages
B) Use a stool softener as prescribed
C) Avoid fiber-rich foods
D) Limit fluid intake to 1 liter per day
Answer: B) Use a stool softener as prescribed
Rationale: Stool softeners are often prescribed postpartum to help prevent constipation.
Increasing fluid and fiber intake can also be helpful.
9. A nurse is caring for a client in labor. The client requests an epidural block for
pain relief. Which of the following is a contraindication for an epidural block?
A) Hypotension
B) Active herpes simplex virus infection
C) Positive urine culture for E. coli
D) Platelet count of 100,000/mm3
Answer: B) Active herpes simplex virus infection
Rationale: An active herpes simplex infection is a contraindication for an epidural block due to
the potential for transmission of the virus to the fetus.
10. A nurse is caring for a postpartum client who is breastfeeding. The nurse
observes that the client's nipples are cracked and bleeding. Which of the
following interventions is most appropriate?
