1. Ms. Smith, a 24-year-old primigravida, is in her third trimester of pregnancy. She presents to the clinic
with complaints of contractions, pelvic pressure, and lower back pain.
A. What is the most appropriate action for the nurse to take first?
a) Perform a cervical exam to assess for cervical dilation and effacement
B. Ms. Smith's cervical exam reveals that she is 3 cm dilated and 50% effaced. What stage of labor is she
in?
a) First stage
C. The nurse should monitor Ms. Smith for signs of what complication?
d) Preterm labor
2. Mrs. Johnson, a 36-year-old G2P1, is admitted to the labor and delivery unit in active labor. She
reports that her first child was born via c-section due to failure to progress.
Question 1: What is the most appropriate action for the nurse to take first?
a) Obtain a history of Mrs. Johnson's previous c-section
Question 2: Based on Mrs. Johnson's history, what is her risk for uterine rupture during a vaginal birth
after c-section (VBAC)?
c) Moderately increased risk
Question 3: What is the nurse's priority intervention during a VBAC?
a) Monitor the fetal heart rate closely for signs of distress
3. A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal and the
estimated blood loss (EBL) was 1500 ml. When evaluating the woman’s vital signs, which finding would
be of greatest concern to the nurse?
-Temperature 37.9 C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and
blood pressure 90/50 mm Hg
4. Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during
the puerperium?
-Headaches
5. On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely
saturated a perineal pad within 15 minutes. What is the nurses highest priority at this time?
-Massaging the woman’s fundus
6. Rho immune globulin will be ordered postpartum if which situation occurs?
-Mother Rh, baby Rh+
, 7. Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the
right of the umbilicus?
-Assist the client in emptying her bladder.
8. A mother is changing the diaper of her newborn son and notices that his scrotum appears large and
swollen. The client is concerned. What is the best response from the nurse?
-A large scrotum and swelling indicate a hydrocele, which is a common finding in male newborns.
9. A mother expresses fear about changing her infants diaper after he is circumcised. What does the
client need to be taught to care for her newborn son?
-Gently cleanse the penis with water and apply petroleum jelly around the glans after each diaper
change.
10. What is the nurse’s initial action while caring for an infant with a slightly decreased temperature?
-Place a cap on the infants head, and have the mother perform kangaroo care.
11. Pain should be regularly assessed in all newborns. If the infant is displaying physiologic or behavioral
cues that indicate pain, then measures should be taken to manage the pain. Which interventions are
examples of nonpharmacologic pain management techniques? (Select all that apply.)
-Swaddling -Nonnutritive sucking -Skin-to-skin contact with the mother –Sucrose
12. As recently as 2005, the AAP revised safe sleep practices to assist in the prevention of SIDS. The
nurse should model these practices in the hospital and incorporate this information into the teaching
plan for new parents. Which practices are ideal for role modeling? (Select all that apply.)
-Fully supine position for all sleep -Tummy time for play -Infant sleep sacks or buntings
13. The nurse is circulating during a cesarean birth of a preterm infant. The obstetrician requests that
cord clamping be delayed. What is the rationale for this directive?
-To reduce the risk of intraventricular hemorrhage
14. A pregnant woman wants to breastfeed her infant; however, her husband is not convinced that
there are any scientific reasons to do so. The nurse can give the couple printed information comparing
breastfeeding and bottle feeding. Which statement regarding bottle feeding using commercially
prepared infant formulas might influence their choice?
-Bottle feeding using a commercially prepared formula increases the risk that the infant will develop
allergies.
15. A new mother wants to be sure that she is meeting her daughter’s needs while feeding the baby
commercially prepared infant formula. The nurse should evaluate the mother’s knowledge about
appropriate infant feeding techniques. Which statement by the client reassures the nurse that correct
learning has taken place?
-I burp my daughter during and after the feeding as needed.
16. Which statement is the best rationale for recommending formula over breastfeeding?
with complaints of contractions, pelvic pressure, and lower back pain.
A. What is the most appropriate action for the nurse to take first?
a) Perform a cervical exam to assess for cervical dilation and effacement
B. Ms. Smith's cervical exam reveals that she is 3 cm dilated and 50% effaced. What stage of labor is she
in?
a) First stage
C. The nurse should monitor Ms. Smith for signs of what complication?
d) Preterm labor
2. Mrs. Johnson, a 36-year-old G2P1, is admitted to the labor and delivery unit in active labor. She
reports that her first child was born via c-section due to failure to progress.
Question 1: What is the most appropriate action for the nurse to take first?
a) Obtain a history of Mrs. Johnson's previous c-section
Question 2: Based on Mrs. Johnson's history, what is her risk for uterine rupture during a vaginal birth
after c-section (VBAC)?
c) Moderately increased risk
Question 3: What is the nurse's priority intervention during a VBAC?
a) Monitor the fetal heart rate closely for signs of distress
3. A woman gave birth to a 7-pound, 6-ounce infant girl 1 hour ago. The birth was vaginal and the
estimated blood loss (EBL) was 1500 ml. When evaluating the woman’s vital signs, which finding would
be of greatest concern to the nurse?
-Temperature 37.9 C, heart rate 120 beats per minute (bpm), respirations 20 breaths per minute, and
blood pressure 90/50 mm Hg
4. Which condition, not uncommon in pregnancy, is likely to require careful medical assessment during
the puerperium?
-Headaches
5. On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely
saturated a perineal pad within 15 minutes. What is the nurses highest priority at this time?
-Massaging the woman’s fundus
6. Rho immune globulin will be ordered postpartum if which situation occurs?
-Mother Rh, baby Rh+
, 7. Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to the
right of the umbilicus?
-Assist the client in emptying her bladder.
8. A mother is changing the diaper of her newborn son and notices that his scrotum appears large and
swollen. The client is concerned. What is the best response from the nurse?
-A large scrotum and swelling indicate a hydrocele, which is a common finding in male newborns.
9. A mother expresses fear about changing her infants diaper after he is circumcised. What does the
client need to be taught to care for her newborn son?
-Gently cleanse the penis with water and apply petroleum jelly around the glans after each diaper
change.
10. What is the nurse’s initial action while caring for an infant with a slightly decreased temperature?
-Place a cap on the infants head, and have the mother perform kangaroo care.
11. Pain should be regularly assessed in all newborns. If the infant is displaying physiologic or behavioral
cues that indicate pain, then measures should be taken to manage the pain. Which interventions are
examples of nonpharmacologic pain management techniques? (Select all that apply.)
-Swaddling -Nonnutritive sucking -Skin-to-skin contact with the mother –Sucrose
12. As recently as 2005, the AAP revised safe sleep practices to assist in the prevention of SIDS. The
nurse should model these practices in the hospital and incorporate this information into the teaching
plan for new parents. Which practices are ideal for role modeling? (Select all that apply.)
-Fully supine position for all sleep -Tummy time for play -Infant sleep sacks or buntings
13. The nurse is circulating during a cesarean birth of a preterm infant. The obstetrician requests that
cord clamping be delayed. What is the rationale for this directive?
-To reduce the risk of intraventricular hemorrhage
14. A pregnant woman wants to breastfeed her infant; however, her husband is not convinced that
there are any scientific reasons to do so. The nurse can give the couple printed information comparing
breastfeeding and bottle feeding. Which statement regarding bottle feeding using commercially
prepared infant formulas might influence their choice?
-Bottle feeding using a commercially prepared formula increases the risk that the infant will develop
allergies.
15. A new mother wants to be sure that she is meeting her daughter’s needs while feeding the baby
commercially prepared infant formula. The nurse should evaluate the mother’s knowledge about
appropriate infant feeding techniques. Which statement by the client reassures the nurse that correct
learning has taken place?
-I burp my daughter during and after the feeding as needed.
16. Which statement is the best rationale for recommending formula over breastfeeding?
