RNSG 1517 A Maternity Final Exam
Questions & Correct Answers Verified
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1. A 32-week pregnant patient presents with painless vaginal bleeding. Which
condition should the nurse suspect first?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Uterine rupture
Answer: A. Placenta previa
Explanation: Painless vaginal bleeding in the third trimester is the classic presentation of
placenta previa, where the placenta implants over or near the cervical os. Abruptio
placentae typically presents with painful bleeding and uterine rigidity. Preterm labor
presents with regular contractions and cervical changes. Uterine rupture is associated
with severe pain and fetal distress.
2. A patient at 39 weeks gestation is experiencing regular contractions every 4
minutes, lasting 60 seconds. Her cervix is 5 cm dilated and 90% effaced. The nurse
should document this patient as being in which phase of labor?
A. Latent phase
B. Active phase
C. Transition phase
D. Second stage
,Answer: B. Active phase
Explanation: The active phase of the first stage of labor is characterized by cervical
dilation from 4-7 cm, more frequent contractions (every 3-5 minutes), and stronger
contractions lasting 40-70 seconds. The latent phase is 0-3 cm dilation, and transition is
8-10 cm. The second stage begins with complete dilation (10 cm).
3. A newborn is 5 minutes old. The nurse notes a heart rate of 120 bpm,
respiratory effort with irregular breathing, some flexion of extremities, a cry in
response to suctioning, and pink body with blue extremities. What is this
newborn's Apgar score?
A. 6
B. 7
C. 8
D. 9
Answer: C. 8
Explanation: The Apgar score evaluates heart rate (2 points for >100 bpm), respiratory
effort (1 point for irregular breathing), muscle tone (1 point for some flexion), reflex
irritability (2 points for cry), and color (1 point for pink body, blue extremities). Total =
2+1+1+2+1 = 8.
4. A postpartum patient reports that her lochia is bright red and contains small
clots. She is 2 hours post-delivery. Which action should the nurse take?
A. Notify the healthcare provider immediately
B. Massage the fundus and continue monitoring
C. Administer prescribed oxytocin
D. Apply ice packs to the perineum
Answer: B. Massage the fundus and continue monitoring
,Explanation: Bright red lochia with small clots is normal in the immediate postpartum
period (rubra). The nurse should assess the fundus to ensure it is firm and at the
umbilicus. If the uterus is firm, this is expected. If the uterus is boggy, massage would be
indicated. There is no need to notify the provider for this normal finding.
5. Which assessment finding indicates that a pregnant patient at 36 weeks
gestation may be experiencing preterm labor?
A. Contractions every 10 minutes
B. Cervical dilation of 2 cm
C. Regular uterine contractions with cervical change
D. Fetal heart rate of 140 bpm
Answer: C. Regular uterine contractions with cervical change
Explanation: Preterm labor is defined as regular uterine contractions resulting in
progressive cervical dilation and effacement between 20 and 37 weeks gestation. While
contractions every 10 minutes may occur, they must be accompanied by cervical change
to diagnose preterm labor. Cervical dilation of 2 cm can be a normal finding in late
pregnancy without true labor.
6. The nurse is assessing a patient with preeclampsia. Which finding would
indicate progression to severe preeclampsia?
A. Blood pressure of 150/92 mmHg
B. Proteinuria of 300 mg/24 hours
C. Platelet count of 95,000/mm³
D. Mild headache
Answer: C. Platelet count of 95,000/mm³
Explanation: Severe preeclampsia is diagnosed when there is severe blood pressure
elevation (≥160/110 mmHg), proteinuria >5 g/24 hours, or evidence of end-organ
dysfunction. Thrombocytopenia (platelets <100,000/mm³) is a manifestation of severe
, disease. A blood pressure of 150/92 mmHg and proteinuria of 300 mg are features of
mild preeclampsia.
7. A patient with gestational diabetes is undergoing a nonstress test. The nurse
observes two accelerations in fetal heart rate of 15 bpm lasting 20 seconds each
over 20 minutes. What is the appropriate interpretation?
A. Reactive nonstress test
B. Nonreactive nonstress test
C. Unsatisfactory test
D. Positive test
Answer: A. Reactive nonstress test
Explanation: A reactive nonstress test requires two or more accelerations of fetal heart
rate of at least 15 bpm above baseline, lasting at least 15 seconds, within a 20-minute
period. A nonreactive test lacks these criteria. This is a reassuring finding indicating fetal
well-being.
8. Which medication is considered the first-line treatment for postpartum
hemorrhage due to uterine atony?
A. Methylergonovine (Methergine)
B. Carboprost (Hemabate)
C. Oxytocin (Pitocin)
D. Misoprostol (Cytotec)
Answer: C. Oxytocin (Pitocin)
Explanation: Oxytocin is the first-line pharmacological agent for postpartum
hemorrhage caused by uterine atony. It stimulates uterine contractions and helps
control bleeding. Methylergonovine is second-line and contraindicated in hypertensive
patients. Carboprost is used for refractory hemorrhage. Misoprostol is a prostaglandin
analog used when other medications are unavailable or contraindicated.
Questions & Correct Answers Verified
Plus Rationales 2026 | Instant Download
1. A 32-week pregnant patient presents with painless vaginal bleeding. Which
condition should the nurse suspect first?
A. Placenta previa
B. Abruptio placentae
C. Preterm labor
D. Uterine rupture
Answer: A. Placenta previa
Explanation: Painless vaginal bleeding in the third trimester is the classic presentation of
placenta previa, where the placenta implants over or near the cervical os. Abruptio
placentae typically presents with painful bleeding and uterine rigidity. Preterm labor
presents with regular contractions and cervical changes. Uterine rupture is associated
with severe pain and fetal distress.
2. A patient at 39 weeks gestation is experiencing regular contractions every 4
minutes, lasting 60 seconds. Her cervix is 5 cm dilated and 90% effaced. The nurse
should document this patient as being in which phase of labor?
A. Latent phase
B. Active phase
C. Transition phase
D. Second stage
,Answer: B. Active phase
Explanation: The active phase of the first stage of labor is characterized by cervical
dilation from 4-7 cm, more frequent contractions (every 3-5 minutes), and stronger
contractions lasting 40-70 seconds. The latent phase is 0-3 cm dilation, and transition is
8-10 cm. The second stage begins with complete dilation (10 cm).
3. A newborn is 5 minutes old. The nurse notes a heart rate of 120 bpm,
respiratory effort with irregular breathing, some flexion of extremities, a cry in
response to suctioning, and pink body with blue extremities. What is this
newborn's Apgar score?
A. 6
B. 7
C. 8
D. 9
Answer: C. 8
Explanation: The Apgar score evaluates heart rate (2 points for >100 bpm), respiratory
effort (1 point for irregular breathing), muscle tone (1 point for some flexion), reflex
irritability (2 points for cry), and color (1 point for pink body, blue extremities). Total =
2+1+1+2+1 = 8.
4. A postpartum patient reports that her lochia is bright red and contains small
clots. She is 2 hours post-delivery. Which action should the nurse take?
A. Notify the healthcare provider immediately
B. Massage the fundus and continue monitoring
C. Administer prescribed oxytocin
D. Apply ice packs to the perineum
Answer: B. Massage the fundus and continue monitoring
,Explanation: Bright red lochia with small clots is normal in the immediate postpartum
period (rubra). The nurse should assess the fundus to ensure it is firm and at the
umbilicus. If the uterus is firm, this is expected. If the uterus is boggy, massage would be
indicated. There is no need to notify the provider for this normal finding.
5. Which assessment finding indicates that a pregnant patient at 36 weeks
gestation may be experiencing preterm labor?
A. Contractions every 10 minutes
B. Cervical dilation of 2 cm
C. Regular uterine contractions with cervical change
D. Fetal heart rate of 140 bpm
Answer: C. Regular uterine contractions with cervical change
Explanation: Preterm labor is defined as regular uterine contractions resulting in
progressive cervical dilation and effacement between 20 and 37 weeks gestation. While
contractions every 10 minutes may occur, they must be accompanied by cervical change
to diagnose preterm labor. Cervical dilation of 2 cm can be a normal finding in late
pregnancy without true labor.
6. The nurse is assessing a patient with preeclampsia. Which finding would
indicate progression to severe preeclampsia?
A. Blood pressure of 150/92 mmHg
B. Proteinuria of 300 mg/24 hours
C. Platelet count of 95,000/mm³
D. Mild headache
Answer: C. Platelet count of 95,000/mm³
Explanation: Severe preeclampsia is diagnosed when there is severe blood pressure
elevation (≥160/110 mmHg), proteinuria >5 g/24 hours, or evidence of end-organ
dysfunction. Thrombocytopenia (platelets <100,000/mm³) is a manifestation of severe
, disease. A blood pressure of 150/92 mmHg and proteinuria of 300 mg are features of
mild preeclampsia.
7. A patient with gestational diabetes is undergoing a nonstress test. The nurse
observes two accelerations in fetal heart rate of 15 bpm lasting 20 seconds each
over 20 minutes. What is the appropriate interpretation?
A. Reactive nonstress test
B. Nonreactive nonstress test
C. Unsatisfactory test
D. Positive test
Answer: A. Reactive nonstress test
Explanation: A reactive nonstress test requires two or more accelerations of fetal heart
rate of at least 15 bpm above baseline, lasting at least 15 seconds, within a 20-minute
period. A nonreactive test lacks these criteria. This is a reassuring finding indicating fetal
well-being.
8. Which medication is considered the first-line treatment for postpartum
hemorrhage due to uterine atony?
A. Methylergonovine (Methergine)
B. Carboprost (Hemabate)
C. Oxytocin (Pitocin)
D. Misoprostol (Cytotec)
Answer: C. Oxytocin (Pitocin)
Explanation: Oxytocin is the first-line pharmacological agent for postpartum
hemorrhage caused by uterine atony. It stimulates uterine contractions and helps
control bleeding. Methylergonovine is second-line and contraindicated in hypertensive
patients. Carboprost is used for refractory hemorrhage. Misoprostol is a prostaglandin
analog used when other medications are unavailable or contraindicated.
