West Coast University NURS 306 OB Final Exam (pdf) | 2026/2027 |
OB Q&A | Obstetric Nursing
1. A nurse is providing education to a client at 8 weeks of gestation. The
client asks why she must avoid certain medications. What is the nurse's best
response?
A) "The first 8 weeks are the period of organogenesis, when your baby is
most vulnerable to teratogens."
B) "The first 8 weeks are when the baby's sex is determined, which can be
affected by medications."
C) "The first 8 weeks are when the placenta is forming, so medications can
affect its development."
D) "The first 8 weeks are the period of fetal growth, and medications can
cause the baby to grow too quickly."
Correct Answer: "The first 8 weeks are the period of organogenesis, when
your baby is most vulnerable to teratogens."
Rationale: The embryonic period from weeks 2 through 8 is known as
organogenesis, when all major internal and external structures are forming.
This is the most critical time for teratogenic effects, as exposure can cause
major congenital anomalies. Sex determination occurs at conception, not
during this period.
2. A nurse is calculating the due date for a client whose last menstrual period
(LMP) began on May 4. Using Naegele's rule, what is the estimated due date?
A) February 11
B) February 9
C) January 28
D) March 4
Correct Answer: February 11
,Rationale: Naegele's rule calculates the estimated date of delivery by
subtracting 3 months from the first day of the last menstrual period and
adding 7 days. For an LMP of May 4, subtract 3 months to get February 4,
then add 7 days to get February 11.
3. A nurse is assessing a client at 28 weeks of gestation. The client has a
history of one elective abortion at 9 weeks, a twin birth at 36 weeks, and one
spontaneous abortion at 15 weeks. What is the correct GTPAL for this client?
A) G4 T0 P1 A2 L2
B) G4 T1 P0 A2 L2
C) G3 T1 P1 A1 L2
D) G4 T0 P2 A1 L2
Correct Answer: G4 T0 P1 A2 L2
Rationale: Gravida (G) is the total number of pregnancies, including the
current one. This client has had three previous pregnancies and is currently
pregnant, so G = 4. Term (T) is births at 37 weeks or more—none reported,
so T = 0. Preterm (P) is births from 20 to 36 6/7 weeks—the twin birth at 36
weeks counts as one preterm pregnancy, so P = 1. Abortions (A) are losses
before 20 weeks—the elective abortion at 9 weeks and the spontaneous
abortion at 15 weeks are two losses, so A = 2. Living children (L) is the
number currently alive—the twins are living, so L = 2.
4. Which of the following is considered a positive sign of pregnancy?
A) A positive home pregnancy test
B) Chadwick's sign
C) Fetal heart tones detected by ultrasound
D) Goodell's sign
,Correct Answer: Fetal heart tones detected by ultrasound
Rationale: Positive signs of pregnancy are those that can only be explained
by pregnancy. These include fetal heart tones detected by electronic device,
fetal movement felt by an examiner, and visualization of the fetus on
ultrasound. Positive pregnancy tests and probable signs such as Goodell's
and Chadwick's are not definitive.
5. A nurse is caring for a client who is 38 weeks of gestation with
polyhydramnios. Which of the following best describes this condition?
A) A deficiency of amniotic fluid
B) A normal amount of amniotic fluid
C) An excessive amount of amniotic fluid
D) An infection of the amniotic fluid
Correct Answer: An excessive amount of amniotic fluid
Rationale: Polyhydramnios is defined as an excessive amount of amniotic
fluid, typically greater than 2000 mL. It can be associated with maternal
diabetes, multiple gestations, and fetal gastrointestinal or neurologic
anomalies. Oligohydramnios is a deficiency of amniotic fluid.
6. A nurse is educating a client about the components of a standard prenatal
laboratory panel. Which of the following is included?
A) Blood type and Rh factor, CBC, HIV, Hepatitis B, RPR, Rubella titer
B) Only blood type and Rh factor
C) CBC, glucose tolerance test, and urinalysis
D) Genetic screening and amniocentesis
, Correct Answer: Blood type and Rh factor, CBC, HIV, Hepatitis B, RPR, Rubella
titer
Rationale: A standard prenatal laboratory panel includes blood type with Rh
factor, complete blood count (CBC), HIV screening, Hepatitis B surface
antigen, rapid plasma reagin (RPR) for syphilis, and rubella titer. These tests
are typically performed at the first prenatal visit.
7. A nurse is interpreting a fetal heart rate tracing and notes a deceleration
that mirrors the contraction, beginning at the onset and returning to baseline
by the end. How should the nurse document this finding?
A) Late deceleration
B) Variable deceleration
C) Early deceleration
D) Prolonged deceleration
Correct Answer: Early deceleration
Rationale: An early deceleration is a benign finding caused by fetal head
compression during a contraction. The onset, nadir, and recovery of the
deceleration occur at the same time as the contraction. No intervention is
required, and it is not a sign of fetal distress.
8. A nurse is caring for a client in labor and notes variable decelerations on
the fetal monitor. What is the priority nursing action?
A) Increase the rate of the IV infusion
B) Administer oxygen via face mask
C) Reposition the client
D) Prepare for an immediate cesarean birth
OB Q&A | Obstetric Nursing
1. A nurse is providing education to a client at 8 weeks of gestation. The
client asks why she must avoid certain medications. What is the nurse's best
response?
A) "The first 8 weeks are the period of organogenesis, when your baby is
most vulnerable to teratogens."
B) "The first 8 weeks are when the baby's sex is determined, which can be
affected by medications."
C) "The first 8 weeks are when the placenta is forming, so medications can
affect its development."
D) "The first 8 weeks are the period of fetal growth, and medications can
cause the baby to grow too quickly."
Correct Answer: "The first 8 weeks are the period of organogenesis, when
your baby is most vulnerable to teratogens."
Rationale: The embryonic period from weeks 2 through 8 is known as
organogenesis, when all major internal and external structures are forming.
This is the most critical time for teratogenic effects, as exposure can cause
major congenital anomalies. Sex determination occurs at conception, not
during this period.
2. A nurse is calculating the due date for a client whose last menstrual period
(LMP) began on May 4. Using Naegele's rule, what is the estimated due date?
A) February 11
B) February 9
C) January 28
D) March 4
Correct Answer: February 11
,Rationale: Naegele's rule calculates the estimated date of delivery by
subtracting 3 months from the first day of the last menstrual period and
adding 7 days. For an LMP of May 4, subtract 3 months to get February 4,
then add 7 days to get February 11.
3. A nurse is assessing a client at 28 weeks of gestation. The client has a
history of one elective abortion at 9 weeks, a twin birth at 36 weeks, and one
spontaneous abortion at 15 weeks. What is the correct GTPAL for this client?
A) G4 T0 P1 A2 L2
B) G4 T1 P0 A2 L2
C) G3 T1 P1 A1 L2
D) G4 T0 P2 A1 L2
Correct Answer: G4 T0 P1 A2 L2
Rationale: Gravida (G) is the total number of pregnancies, including the
current one. This client has had three previous pregnancies and is currently
pregnant, so G = 4. Term (T) is births at 37 weeks or more—none reported,
so T = 0. Preterm (P) is births from 20 to 36 6/7 weeks—the twin birth at 36
weeks counts as one preterm pregnancy, so P = 1. Abortions (A) are losses
before 20 weeks—the elective abortion at 9 weeks and the spontaneous
abortion at 15 weeks are two losses, so A = 2. Living children (L) is the
number currently alive—the twins are living, so L = 2.
4. Which of the following is considered a positive sign of pregnancy?
A) A positive home pregnancy test
B) Chadwick's sign
C) Fetal heart tones detected by ultrasound
D) Goodell's sign
,Correct Answer: Fetal heart tones detected by ultrasound
Rationale: Positive signs of pregnancy are those that can only be explained
by pregnancy. These include fetal heart tones detected by electronic device,
fetal movement felt by an examiner, and visualization of the fetus on
ultrasound. Positive pregnancy tests and probable signs such as Goodell's
and Chadwick's are not definitive.
5. A nurse is caring for a client who is 38 weeks of gestation with
polyhydramnios. Which of the following best describes this condition?
A) A deficiency of amniotic fluid
B) A normal amount of amniotic fluid
C) An excessive amount of amniotic fluid
D) An infection of the amniotic fluid
Correct Answer: An excessive amount of amniotic fluid
Rationale: Polyhydramnios is defined as an excessive amount of amniotic
fluid, typically greater than 2000 mL. It can be associated with maternal
diabetes, multiple gestations, and fetal gastrointestinal or neurologic
anomalies. Oligohydramnios is a deficiency of amniotic fluid.
6. A nurse is educating a client about the components of a standard prenatal
laboratory panel. Which of the following is included?
A) Blood type and Rh factor, CBC, HIV, Hepatitis B, RPR, Rubella titer
B) Only blood type and Rh factor
C) CBC, glucose tolerance test, and urinalysis
D) Genetic screening and amniocentesis
, Correct Answer: Blood type and Rh factor, CBC, HIV, Hepatitis B, RPR, Rubella
titer
Rationale: A standard prenatal laboratory panel includes blood type with Rh
factor, complete blood count (CBC), HIV screening, Hepatitis B surface
antigen, rapid plasma reagin (RPR) for syphilis, and rubella titer. These tests
are typically performed at the first prenatal visit.
7. A nurse is interpreting a fetal heart rate tracing and notes a deceleration
that mirrors the contraction, beginning at the onset and returning to baseline
by the end. How should the nurse document this finding?
A) Late deceleration
B) Variable deceleration
C) Early deceleration
D) Prolonged deceleration
Correct Answer: Early deceleration
Rationale: An early deceleration is a benign finding caused by fetal head
compression during a contraction. The onset, nadir, and recovery of the
deceleration occur at the same time as the contraction. No intervention is
required, and it is not a sign of fetal distress.
8. A nurse is caring for a client in labor and notes variable decelerations on
the fetal monitor. What is the priority nursing action?
A) Increase the rate of the IV infusion
B) Administer oxygen via face mask
C) Reposition the client
D) Prepare for an immediate cesarean birth
