NUR 130 – Obstetric Nursing Comprehensive Obstetric Nursing
Study Guide: Maternal Care, Labor Management, Fetal
Monitoring, Women's Health, and Examination Preparation
Practice Questions with Answers and Detailed Rationales
Question 1
A patient who is 38 weeks pregnant is admitted to the labor and delivery unit with
contractions every 3 minutes and a cervical exam of 4 cm dilation, 80%
effacement, and station 0. Which finding should the nurse prioritize?
A. Fetal heart rate 120 bpm with moderate variability
B. Maternal blood pressure 145/92 mmHg
C. Contractions lasting 60 seconds
D. Maternal respiratory rate 22 breaths/min
Answer: B
Rationale: A blood pressure of 145/92 mmHg indicates hypertension, which in a
laboring patient is a concern for preeclampsia and requires immediate evaluation.
The fetal heart rate of 120 bpm with moderate variability is a normal finding.
Contractions lasting 60 seconds are normal for active labor. A respiratory rate of
22 breaths/min is normal for a laboring patient.
Question 2
The nurse is assessing a patient at 12 weeks gestation. The patient reports nausea
and vomiting that is worse in the morning. Which nursing intervention is most
appropriate?
A. Encourage large, heavy meals
B. Advise eating small, frequent meals and crackers before rising
C. Recommend lying flat after meals
D. Suggest drinking large amounts of fluids with meals
Answer: B
Rationale: Nausea and vomiting in early pregnancy (morning sickness) can be
managed by eating small, frequent meals and eating dry crackers before rising.
,Large meals worsen nausea. Lying flat after meals can exacerbate reflux. Large
fluid intake with meals can cause gastric distension.
Question 3
A patient at 36 weeks gestation with a history of gestational diabetes is scheduled
for a biophysical profile. Which components are included in the biophysical
profile? Select all that apply.
A. Fetal breathing movements
B. Fetal movement
C. Fetal tone
D. Amniotic fluid volume
E. Non-stress test
Answer: A, B, C, D, E
Rationale: The biophysical profile (BPP) is a comprehensive fetal assessment that
includes five components: fetal breathing movements, fetal movement, fetal tone,
amniotic fluid volume, and non-stress test. Each component is scored 0 or 2 for a
maximum of 10. A score of 8-10 is reassuring. It is used to evaluate fetal well-
being in high-risk pregnancies.
Question 4
A patient at 20 weeks gestation reports that she has not felt fetal movement yet.
Which is the most appropriate nursing response?
A. "This is concerning; we need to do an ultrasound."
B. "Fetal movement is often not felt until 18-22 weeks, especially in first-time
pregnancies."
C. "You should have felt movement by now."
D. "You must be counting wrong."
Answer: B
Rationale: Primigravida patients typically feel fetal movement (quickening)
between 18-22 weeks. Multiparous patients may feel it earlier (16-18 weeks). The
patient is within the normal range, and the nurse should reassure her while
continuing to monitor. It is not concerning at 20 weeks.
,Question 5
A patient at 28 weeks gestation presents with painless, bright red vaginal bleeding.
The nurse should prepare for which diagnosis?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Vasa previa
Answer: B
Rationale: Painless, bright red vaginal bleeding in the third trimester is
characteristic of placenta previa. Placental abruption presents with painful, dark
vaginal bleeding and uterine tenderness. Uterine rupture causes severe abdominal
pain and fetal distress. Vasa previa is rare and presents with fetal hemorrhage.
Question 6
A patient at 34 weeks gestation with preeclampsia is receiving magnesium sulfate.
The nurse should assess for which sign of magnesium toxicity?
A. Absent deep tendon reflexes
B. Increased urine output
C. Flushing and warmth
D. Blood pressure 140/90 mmHg
Answer: A
Rationale: Magnesium toxicity is characterized by loss of deep tendon reflexes,
respiratory depression, and decreased urine output. The therapeutic range is 4-7
mEq/L. Absent DTRs indicate toxicity and require immediate action. Calcium
gluconate is the antidote for magnesium toxicity. Increased urine output and
flushing are not signs of toxicity.
Question 7
A patient at 39 weeks gestation presents with rupture of membranes. The fluid is
clear and has no odor. Which is the most appropriate nursing action?
, A. Perform a vaginal examination
B. Assess fetal heart rate and maternal vital signs
C. Administer prophylactic antibiotics
D. Prepare for immediate delivery
Answer: B
Rationale: The priority is to assess fetal heart rate and maternal vital signs to
ensure fetal well-being and monitor for signs of infection. Vaginal examination
should be limited to reduce infection risk. Antibiotics are not indicated unless there
is evidence of infection. Immediate delivery is not necessary if the patient is not in
labor.
Question 8
A patient is scheduled for a 1-hour glucose tolerance test for gestational diabetes.
The nurse should instruct the patient to:
A. Drink the glucose solution and have blood drawn one hour later
B. Fast for 12 hours before the test
C. Drink the glucose solution and have blood drawn immediately
D. Eat a high-carbohydrate meal before the test
Answer: A
Rationale: The 1-hour glucose tolerance test (GCT) involves drinking a 50-gram
glucose solution and having blood drawn one hour later. Fasting is not required for
the 1-hour test, but the patient should not eat for 1-2 hours before the test. The
blood draw should be exactly one hour after consuming the glucose solution.
Question 9
A patient at 32 weeks gestation reports back pain. The nurse should recommend
which intervention?
A. Bed rest in the supine position
B. Pelvic tilt exercises and warm compresses
C. High-heeled shoes
D. Heavy lifting exercise
Answer: B
Study Guide: Maternal Care, Labor Management, Fetal
Monitoring, Women's Health, and Examination Preparation
Practice Questions with Answers and Detailed Rationales
Question 1
A patient who is 38 weeks pregnant is admitted to the labor and delivery unit with
contractions every 3 minutes and a cervical exam of 4 cm dilation, 80%
effacement, and station 0. Which finding should the nurse prioritize?
A. Fetal heart rate 120 bpm with moderate variability
B. Maternal blood pressure 145/92 mmHg
C. Contractions lasting 60 seconds
D. Maternal respiratory rate 22 breaths/min
Answer: B
Rationale: A blood pressure of 145/92 mmHg indicates hypertension, which in a
laboring patient is a concern for preeclampsia and requires immediate evaluation.
The fetal heart rate of 120 bpm with moderate variability is a normal finding.
Contractions lasting 60 seconds are normal for active labor. A respiratory rate of
22 breaths/min is normal for a laboring patient.
Question 2
The nurse is assessing a patient at 12 weeks gestation. The patient reports nausea
and vomiting that is worse in the morning. Which nursing intervention is most
appropriate?
A. Encourage large, heavy meals
B. Advise eating small, frequent meals and crackers before rising
C. Recommend lying flat after meals
D. Suggest drinking large amounts of fluids with meals
Answer: B
Rationale: Nausea and vomiting in early pregnancy (morning sickness) can be
managed by eating small, frequent meals and eating dry crackers before rising.
,Large meals worsen nausea. Lying flat after meals can exacerbate reflux. Large
fluid intake with meals can cause gastric distension.
Question 3
A patient at 36 weeks gestation with a history of gestational diabetes is scheduled
for a biophysical profile. Which components are included in the biophysical
profile? Select all that apply.
A. Fetal breathing movements
B. Fetal movement
C. Fetal tone
D. Amniotic fluid volume
E. Non-stress test
Answer: A, B, C, D, E
Rationale: The biophysical profile (BPP) is a comprehensive fetal assessment that
includes five components: fetal breathing movements, fetal movement, fetal tone,
amniotic fluid volume, and non-stress test. Each component is scored 0 or 2 for a
maximum of 10. A score of 8-10 is reassuring. It is used to evaluate fetal well-
being in high-risk pregnancies.
Question 4
A patient at 20 weeks gestation reports that she has not felt fetal movement yet.
Which is the most appropriate nursing response?
A. "This is concerning; we need to do an ultrasound."
B. "Fetal movement is often not felt until 18-22 weeks, especially in first-time
pregnancies."
C. "You should have felt movement by now."
D. "You must be counting wrong."
Answer: B
Rationale: Primigravida patients typically feel fetal movement (quickening)
between 18-22 weeks. Multiparous patients may feel it earlier (16-18 weeks). The
patient is within the normal range, and the nurse should reassure her while
continuing to monitor. It is not concerning at 20 weeks.
,Question 5
A patient at 28 weeks gestation presents with painless, bright red vaginal bleeding.
The nurse should prepare for which diagnosis?
A. Placental abruption
B. Placenta previa
C. Uterine rupture
D. Vasa previa
Answer: B
Rationale: Painless, bright red vaginal bleeding in the third trimester is
characteristic of placenta previa. Placental abruption presents with painful, dark
vaginal bleeding and uterine tenderness. Uterine rupture causes severe abdominal
pain and fetal distress. Vasa previa is rare and presents with fetal hemorrhage.
Question 6
A patient at 34 weeks gestation with preeclampsia is receiving magnesium sulfate.
The nurse should assess for which sign of magnesium toxicity?
A. Absent deep tendon reflexes
B. Increased urine output
C. Flushing and warmth
D. Blood pressure 140/90 mmHg
Answer: A
Rationale: Magnesium toxicity is characterized by loss of deep tendon reflexes,
respiratory depression, and decreased urine output. The therapeutic range is 4-7
mEq/L. Absent DTRs indicate toxicity and require immediate action. Calcium
gluconate is the antidote for magnesium toxicity. Increased urine output and
flushing are not signs of toxicity.
Question 7
A patient at 39 weeks gestation presents with rupture of membranes. The fluid is
clear and has no odor. Which is the most appropriate nursing action?
, A. Perform a vaginal examination
B. Assess fetal heart rate and maternal vital signs
C. Administer prophylactic antibiotics
D. Prepare for immediate delivery
Answer: B
Rationale: The priority is to assess fetal heart rate and maternal vital signs to
ensure fetal well-being and monitor for signs of infection. Vaginal examination
should be limited to reduce infection risk. Antibiotics are not indicated unless there
is evidence of infection. Immediate delivery is not necessary if the patient is not in
labor.
Question 8
A patient is scheduled for a 1-hour glucose tolerance test for gestational diabetes.
The nurse should instruct the patient to:
A. Drink the glucose solution and have blood drawn one hour later
B. Fast for 12 hours before the test
C. Drink the glucose solution and have blood drawn immediately
D. Eat a high-carbohydrate meal before the test
Answer: A
Rationale: The 1-hour glucose tolerance test (GCT) involves drinking a 50-gram
glucose solution and having blood drawn one hour later. Fasting is not required for
the 1-hour test, but the patient should not eat for 1-2 hours before the test. The
blood draw should be exactly one hour after consuming the glucose solution.
Question 9
A patient at 32 weeks gestation reports back pain. The nurse should recommend
which intervention?
A. Bed rest in the supine position
B. Pelvic tilt exercises and warm compresses
C. High-heeled shoes
D. Heavy lifting exercise
Answer: B
