OB/NB SU Exam 2 Questions and Verified
Answers with Rationale | Latest Edition
2026/2027
QUESTION 1
A nurse is caring for a client at 28 weeks gestation who presents
with painless vaginal bleeding. Ultrasound confirms a complete
placenta previa. Which of the following nursing interventions is
the absolute highest priority for this client?
A. Perform a gentle digital vaginal examination to assess
cervical dilation.
B. Maintain strict pelvic rest with no vaginal examinations and
continuous fetal monitoring.
C. Administer an oxytocin infusion to encourage safe, rapid
delivery.
D. Encourage the client to ambulate frequently to prevent deep
vein thrombosis.
CORRECT ANSWER: B
RATIONALE:
Digital vaginal examinations are strictly contraindicated in
clients with placenta previa because manipulating the cervix can
disrupt the placenta and cause catastrophic hemorrhage. Strict
pelvic rest, avoidance of all vaginal examinations, and
,continuous electronic fetal monitoring are essential to ensure
safety.
QUESTION 2
A nurse is caring for a laboring client who has an epidural
catheter in place for pain management. Shortly after the
initiation of the block, the client's blood pressure drops from
120/80 mm Hg to 86/50 mm Hg, and the fetal monitor shows
late decelerations. Which of the following nursing actions
should be performed first?
A. Position the client flat on her back and prepare for rapid
cesarean delivery.
B. Turn the client onto her side and administer a rapid
intravenous fluid bolus.
C. Administer a stat dose of subcutaneous terbutaline to halt
contractions.
D. Increase the oxytocin infusion rate to speed up labor
progress.
CORRECT ANSWER: B
RATIONALE:
Sympathetic blockade from epidural anesthesia frequently leads
to maternal hypotension and compromised uteroplacental
perfusion. Immediate interventions include positioning the client
laterally to relieve aortocaval compression and administering an
intravenous fluid bolus to expand vascular volume.
,QUESTION 3
A nurse is assessing a postpartum client 6 hours after a normal
spontaneous vaginal delivery and notes that the uterine fundus is
boggy, soft, and displaced to the right of the umbilicus, with
moderate lochia rubra. Which of the following actions should
the nurse take first?
A. Administer methylergonovine intramuscularly as prescribed.
B. Assist the client to empty her bladder immediately.
C. Increase the rate of intravenous maintenance fluids.
D. Document the finding as a normal postpartum variant.
CORRECT ANSWER: B
RATIONALE:
A boggy and laterally displaced fundus is almost always caused
by a distended urinary bladder, which pushes the uterus out of
alignment and prevents effective myometrial contraction.
Assisting the client to empty her bladder should precede
massage or uterotonic medications.
QUESTION 4
A nurse is preparing to administer magnesium sulfate via
continuous intravenous infusion to a client with severe
preeclampsia. Which of the following medications must be
immediately available at the bedside as an emergency antidote?
A. Protamine sulfate
, B. Calcium gluconate
C. Naloxone hydrochloride
D. Flumazenil
CORRECT ANSWER: B
RATIONALE:
Calcium gluconate is the specific physiological antidote for
magnesium sulfate toxicity. It reverses central nervous system
depression, respiratory arrest, and cardiac arrhythmias caused by
excessive serum magnesium levels.
QUESTION 5
A nurse is caring for a newborn infant immediately after
delivery and notes a heart rate of 150 beats per minute, a
vigorous cry, active limb flexion, a strong sneeze response to
suctioning, and a completely pink body. What Apgar score
should the nurse assign?
A. 7
B. 8
C. 9
D. 10
CORRECT ANSWER: D
RATIONALE:
Answers with Rationale | Latest Edition
2026/2027
QUESTION 1
A nurse is caring for a client at 28 weeks gestation who presents
with painless vaginal bleeding. Ultrasound confirms a complete
placenta previa. Which of the following nursing interventions is
the absolute highest priority for this client?
A. Perform a gentle digital vaginal examination to assess
cervical dilation.
B. Maintain strict pelvic rest with no vaginal examinations and
continuous fetal monitoring.
C. Administer an oxytocin infusion to encourage safe, rapid
delivery.
D. Encourage the client to ambulate frequently to prevent deep
vein thrombosis.
CORRECT ANSWER: B
RATIONALE:
Digital vaginal examinations are strictly contraindicated in
clients with placenta previa because manipulating the cervix can
disrupt the placenta and cause catastrophic hemorrhage. Strict
pelvic rest, avoidance of all vaginal examinations, and
,continuous electronic fetal monitoring are essential to ensure
safety.
QUESTION 2
A nurse is caring for a laboring client who has an epidural
catheter in place for pain management. Shortly after the
initiation of the block, the client's blood pressure drops from
120/80 mm Hg to 86/50 mm Hg, and the fetal monitor shows
late decelerations. Which of the following nursing actions
should be performed first?
A. Position the client flat on her back and prepare for rapid
cesarean delivery.
B. Turn the client onto her side and administer a rapid
intravenous fluid bolus.
C. Administer a stat dose of subcutaneous terbutaline to halt
contractions.
D. Increase the oxytocin infusion rate to speed up labor
progress.
CORRECT ANSWER: B
RATIONALE:
Sympathetic blockade from epidural anesthesia frequently leads
to maternal hypotension and compromised uteroplacental
perfusion. Immediate interventions include positioning the client
laterally to relieve aortocaval compression and administering an
intravenous fluid bolus to expand vascular volume.
,QUESTION 3
A nurse is assessing a postpartum client 6 hours after a normal
spontaneous vaginal delivery and notes that the uterine fundus is
boggy, soft, and displaced to the right of the umbilicus, with
moderate lochia rubra. Which of the following actions should
the nurse take first?
A. Administer methylergonovine intramuscularly as prescribed.
B. Assist the client to empty her bladder immediately.
C. Increase the rate of intravenous maintenance fluids.
D. Document the finding as a normal postpartum variant.
CORRECT ANSWER: B
RATIONALE:
A boggy and laterally displaced fundus is almost always caused
by a distended urinary bladder, which pushes the uterus out of
alignment and prevents effective myometrial contraction.
Assisting the client to empty her bladder should precede
massage or uterotonic medications.
QUESTION 4
A nurse is preparing to administer magnesium sulfate via
continuous intravenous infusion to a client with severe
preeclampsia. Which of the following medications must be
immediately available at the bedside as an emergency antidote?
A. Protamine sulfate
, B. Calcium gluconate
C. Naloxone hydrochloride
D. Flumazenil
CORRECT ANSWER: B
RATIONALE:
Calcium gluconate is the specific physiological antidote for
magnesium sulfate toxicity. It reverses central nervous system
depression, respiratory arrest, and cardiac arrhythmias caused by
excessive serum magnesium levels.
QUESTION 5
A nurse is caring for a newborn infant immediately after
delivery and notes a heart rate of 150 beats per minute, a
vigorous cry, active limb flexion, a strong sneeze response to
suctioning, and a completely pink body. What Apgar score
should the nurse assign?
A. 7
B. 8
C. 9
D. 10
CORRECT ANSWER: D
RATIONALE:
