Maternity & Women’s Health Care 12th Edition
Lowdermilk Test Bank EXAM with Questions
and Answers/Plus a Rationale Updated 2026
A+/Instant Download PDF
EXAM COVERAGE
1. Reproductive System and Genetics
2. Conception and Fetal Development
3. Antepartum Care: Assessment and Management
4. Intrapartum Care: Labor, Birth, and Fetal Monitoring
5. Postpartum Care and Newborn Adaptation
1. A primigravida at 34 weeks gestation presents to the triage unit complaining of persistent
headache, visual disturbances, and epigastric pain. After assessing blood pressure at 160/110
mmHg and noting 3+ proteinuria, which nursing intervention is the highest priority?
A. Administering an oral analgesic for the headache
B. Initiating an intravenous infusion of magnesium sulfate
C. Assisting the client to a side-lying position and dimming the lights
D. Encouraging the client to void to obtain a clean-catch urine specimen
Answer: B
Rationale: The client is exhibiting classic signs of severe preeclampsia. Magnesium sulfate is the
standard of care to prevent eclamptic seizures by acting as a central nervous system depressant.
While positioning is important, the immediate pharmacological stabilization to prevent seizures
takes priority over symptom management or routine diagnostics.
CORRECT ANSWER : B
,2. During the active phase of labor, the fetal heart rate (FHR) monitor shows repetitive late
decelerations. What is the most appropriate initial nursing action?
A. Increase the IV fluid rate to 250 mL/hr
B. Reposition the client to a lateral or knee-chest position
C. Prepare the client for an emergency cesarean section
D. Administer oxygen via non-rebreather mask at 10 L/min
Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency. Repositioning the client to
the lateral position increases perfusion to the placenta by relieving pressure on the vena cava.
While fluids and oxygen may follow, repositioning is the most direct intervention to improve fetal
oxygenation.
CORRECT ANSWER : B
3. A postpartum client, 4 hours post-vaginal delivery, is found to have a boggy fundus and
excessive vaginal bleeding. After performing fundal massage and noting no significant firming,
what is the nurse's next most appropriate action?
A. Notify the physician and prepare for a bimanual exam
B. Assess the client's bladder for distention and assist with voiding
C. Administer methylergonovine maleate (Methergine) as ordered
D. Increase the rate of IV pitocin infusion
Answer: B
Rationale: A distended bladder is a primary cause of uterine atony, as it displaces the uterus and
prevents effective contractions. Addressing the bladder is a simple, non-invasive intervention
that often allows the uterus to involute properly before progressing to pharmacological
interventions.
CORRECT ANSWER : B
4. A nurse is counseling a couple regarding autosomal recessive inheritance. If both parents are
carriers of a cystic fibrosis mutation, what is the probability that their future offspring will be
affected?
A. 0%
, B. 25%
C. 50%
D. 75%
Answer: B
Rationale: In an autosomal recessive condition, each parent has one mutant allele and one
normal allele. According to Mendelian principles, there is a 25% chance of the offspring being
homozygous recessive (affected), a 50% chance of being a carrier, and a 25% chance of being
homozygous dominant (unaffected).
CORRECT ANSWER : B
5. A client at 38 weeks gestation is suspected of having placenta previa based on painless, bright
red vaginal bleeding. Which assessment finding should the nurse strictly avoid?
A. External fetal monitoring
B. Performing a digital vaginal examination
C. Assessment of fundal height
D. Monitoring maternal vital signs
Answer: B
Rationale: A digital vaginal examination can puncture the placenta in cases of placenta previa,
leading to catastrophic, life-threatening hemorrhage for both mother and fetus. Ultrasound is the
only safe method to diagnose placenta location.
CORRECT ANSWER : B
6. Regarding the management of a neonate born to a mother with gestational diabetes, what is the
primary complication to monitor for within the first hour of life?
A. Hyperglycemia
B. Hypoglycemia
C. Respiratory alkalosis
D. Polycythemia
Answer: B
, Rationale: In utero, the fetus is exposed to high maternal glucose levels and produces excess
insulin. Once the umbilical cord is cut, this high insulin supply persists, leading to rapid
hypoglycemia in the newborn. Constant monitoring and early feeding are required.
CORRECT ANSWER : B
7. A postpartum client expresses concern about "afterpains" while breastfeeding. What is the
physiological basis for this discomfort?
A. Excessive production of estrogen
B. Release of oxytocin from the posterior pituitary
C. The stretching of pelvic ligaments
D. Increased uterine prolapse risk
Answer: B
Rationale: Breastfeeding stimulates the release of endogenous oxytocin, which causes uterine
contractions. This is a normal physiological process that aids in involution and reduces
postpartum hemorrhage, though it is often perceived as painful by the mother.
CORRECT ANSWER : B
8. When interpreting a non-stress test (NST), which finding indicates a "reactive" result?
A. Two decelerations of at least 15 bpm for 15 seconds in 20 minutes
B. Two accelerations of at least 15 bpm above baseline for 15 seconds in 20 minutes
C. A baseline fetal heart rate of 140 bpm with no variability
D. Absence of uterine activity during the testing period
Answer: B
Rationale: A reactive NST demonstrates fetal well-being. The fetus must exhibit at least two
accelerations in a 20-minute window that meet specific criteria for duration and amplitude,
indicating a functioning nervous system and adequate oxygenation.
CORRECT ANSWER : B
9. Which clinical manifestation is the most reliable indicator of true labor?
A. Rupture of membranes (ROM)
Lowdermilk Test Bank EXAM with Questions
and Answers/Plus a Rationale Updated 2026
A+/Instant Download PDF
EXAM COVERAGE
1. Reproductive System and Genetics
2. Conception and Fetal Development
3. Antepartum Care: Assessment and Management
4. Intrapartum Care: Labor, Birth, and Fetal Monitoring
5. Postpartum Care and Newborn Adaptation
1. A primigravida at 34 weeks gestation presents to the triage unit complaining of persistent
headache, visual disturbances, and epigastric pain. After assessing blood pressure at 160/110
mmHg and noting 3+ proteinuria, which nursing intervention is the highest priority?
A. Administering an oral analgesic for the headache
B. Initiating an intravenous infusion of magnesium sulfate
C. Assisting the client to a side-lying position and dimming the lights
D. Encouraging the client to void to obtain a clean-catch urine specimen
Answer: B
Rationale: The client is exhibiting classic signs of severe preeclampsia. Magnesium sulfate is the
standard of care to prevent eclamptic seizures by acting as a central nervous system depressant.
While positioning is important, the immediate pharmacological stabilization to prevent seizures
takes priority over symptom management or routine diagnostics.
CORRECT ANSWER : B
,2. During the active phase of labor, the fetal heart rate (FHR) monitor shows repetitive late
decelerations. What is the most appropriate initial nursing action?
A. Increase the IV fluid rate to 250 mL/hr
B. Reposition the client to a lateral or knee-chest position
C. Prepare the client for an emergency cesarean section
D. Administer oxygen via non-rebreather mask at 10 L/min
Answer: B
Rationale: Late decelerations indicate uteroplacental insufficiency. Repositioning the client to
the lateral position increases perfusion to the placenta by relieving pressure on the vena cava.
While fluids and oxygen may follow, repositioning is the most direct intervention to improve fetal
oxygenation.
CORRECT ANSWER : B
3. A postpartum client, 4 hours post-vaginal delivery, is found to have a boggy fundus and
excessive vaginal bleeding. After performing fundal massage and noting no significant firming,
what is the nurse's next most appropriate action?
A. Notify the physician and prepare for a bimanual exam
B. Assess the client's bladder for distention and assist with voiding
C. Administer methylergonovine maleate (Methergine) as ordered
D. Increase the rate of IV pitocin infusion
Answer: B
Rationale: A distended bladder is a primary cause of uterine atony, as it displaces the uterus and
prevents effective contractions. Addressing the bladder is a simple, non-invasive intervention
that often allows the uterus to involute properly before progressing to pharmacological
interventions.
CORRECT ANSWER : B
4. A nurse is counseling a couple regarding autosomal recessive inheritance. If both parents are
carriers of a cystic fibrosis mutation, what is the probability that their future offspring will be
affected?
A. 0%
, B. 25%
C. 50%
D. 75%
Answer: B
Rationale: In an autosomal recessive condition, each parent has one mutant allele and one
normal allele. According to Mendelian principles, there is a 25% chance of the offspring being
homozygous recessive (affected), a 50% chance of being a carrier, and a 25% chance of being
homozygous dominant (unaffected).
CORRECT ANSWER : B
5. A client at 38 weeks gestation is suspected of having placenta previa based on painless, bright
red vaginal bleeding. Which assessment finding should the nurse strictly avoid?
A. External fetal monitoring
B. Performing a digital vaginal examination
C. Assessment of fundal height
D. Monitoring maternal vital signs
Answer: B
Rationale: A digital vaginal examination can puncture the placenta in cases of placenta previa,
leading to catastrophic, life-threatening hemorrhage for both mother and fetus. Ultrasound is the
only safe method to diagnose placenta location.
CORRECT ANSWER : B
6. Regarding the management of a neonate born to a mother with gestational diabetes, what is the
primary complication to monitor for within the first hour of life?
A. Hyperglycemia
B. Hypoglycemia
C. Respiratory alkalosis
D. Polycythemia
Answer: B
, Rationale: In utero, the fetus is exposed to high maternal glucose levels and produces excess
insulin. Once the umbilical cord is cut, this high insulin supply persists, leading to rapid
hypoglycemia in the newborn. Constant monitoring and early feeding are required.
CORRECT ANSWER : B
7. A postpartum client expresses concern about "afterpains" while breastfeeding. What is the
physiological basis for this discomfort?
A. Excessive production of estrogen
B. Release of oxytocin from the posterior pituitary
C. The stretching of pelvic ligaments
D. Increased uterine prolapse risk
Answer: B
Rationale: Breastfeeding stimulates the release of endogenous oxytocin, which causes uterine
contractions. This is a normal physiological process that aids in involution and reduces
postpartum hemorrhage, though it is often perceived as painful by the mother.
CORRECT ANSWER : B
8. When interpreting a non-stress test (NST), which finding indicates a "reactive" result?
A. Two decelerations of at least 15 bpm for 15 seconds in 20 minutes
B. Two accelerations of at least 15 bpm above baseline for 15 seconds in 20 minutes
C. A baseline fetal heart rate of 140 bpm with no variability
D. Absence of uterine activity during the testing period
Answer: B
Rationale: A reactive NST demonstrates fetal well-being. The fetus must exhibit at least two
accelerations in a 20-minute window that meet specific criteria for duration and amplitude,
indicating a functioning nervous system and adequate oxygenation.
CORRECT ANSWER : B
9. Which clinical manifestation is the most reliable indicator of true labor?
A. Rupture of membranes (ROM)
