OB/NB SU Exam V1 Questions and Verified
Answers with Rationale | Latest Edition
2026/2027
QUESTION 1
A nurse is assessing a postpartum client who delivered a term
infant vaginally 2 hours ago. Which of the following findings
requires immediate nursing intervention?
A. Moderate lochia rubra on the perineal pad
B. Fundus firm, midline, and located two centimeters below
the umbilicus
C. A continuous trickle of bright red blood from the vagina
with a firm fundus
D. Mild afterpains experienced during breastfeeding
Correct Answer: C
Rationale: A continuous trickle of bright red blood in the
presence of a firm, contracted uterus is a classic indicator of
lacerations of the cervix or vagina. While uterine atony typically
causes a boggy uterus and heavy bleeding, steady bright red
bleeding with a firm fundus points toward unrepaired soft tissue
trauma requiring immediate physician notification and repair.
Moderate lochia rubra and a firm fundus two centimeters below
the umbilicus are normal expected postpartum findings at two
,hours. Mild afterpains during breastfeeding are also normal due
to oxytocin release causing uterine contractions.
QUESTION 2
A nurse is caring for a client at 32 weeks of gestation who is
admitted with suspected placental abruption. Which of the
following clinical manifestations should the nurse expect to
find?
A. Painless, bright red vaginal bleeding
B. Rigid, board-like abdomen with severe abdominal pain
C. Hypertonic uterine activity with fetal tachycardia
D. Soft, non-tender uterus with a non-reassuring fetal heart
rate
Correct Answer: B
Rationale: Placental abruption is characterized by premature
separation of a normally implanted placenta, leading to bleeding
behind the placenta. This results in severe abdominal pain and a
rigid, board-like abdomen due to concealed or revealed
hemorrhage entering the myometrium. Painless, bright red
vaginal bleeding is characteristic of placenta previa, not
placental abruption. While uterine irritability can occur, the
hallmark physical exam finding distinguishing abruption from
previa is uterine tenderness and rigidity.
QUESTION 3
,A laboring client at 39 weeks of gestation receives an epidural
block for pain management. Shortly after placement, the client's
blood pressure drops from 120/80 mmHg to 84/50 mmHg, and
the fetal heart rate tracing shows late decelerations. Which of the
following is the priority nursing action?
A. Administer oxygen via non-rebreather mask at 10 L/min
B. Position the client in a lateral tilt or left lateral position
C. Increase the rate of the primary intravenous fluid infusion
D. Notify the anesthesia provider and obstetrician
immediately
Correct Answer: B
Rationale: Maternal hypotension is the most common and
significant side effect of regional epidural anesthesia due to
sympathetic blockade causing vasodilation. Positioning the
client in a left lateral tilt relieves aortocaval compression by the
gravid uterus, which immediately improves venous return and
cardiac output, correcting maternal blood pressure. While
oxygen administration, fluid boluses, and notifying the provider
are essential secondary steps, relieving vena caval compression
through repositioning is the most rapid and effective primary
intervention to restore uteroplacental perfusion.
QUESTION 4
A nurse is evaluating a newborn infant who was delivered one
minute ago. The infant has a heart rate of 130 beats per minute,
cries vigorously when stimulated, exhibits well-flexed
, extremities, actively withdraws to a stimulus, and has a
completely pink body and extremities. What is the Apgar score
for this newborn?
A. 7
B. 8
C. 9
D. 10
Correct Answer: D
Rationale: The Apgar score evaluates five newborn parameters
at one and five minutes of life, each scored from 0 to 2: heart
rate, respiratory effort, muscle tone, reflex irritability, and color.
A heart rate above 100 beats per minute scores 2. A vigorous cry
indicates a good respiratory effort, scoring 2. Well-flexed
extremities demonstrate good muscle tone, scoring 2. Active
withdrawal to stimulation shows strong reflex irritability,
scoring 2. A completely pink body and extremities indicate
normal oxygenation without acrocyanosis, scoring 2. The total
score is 2 plus 2 plus 2 plus 2 plus 2, equaling 10.
QUESTION 5
A nurse is caring for a client diagnosed with mild preeclampsia
at 36 weeks of gestation. Which of the following assessment
findings should the nurse identify as a sign of disease
progression to severe preeclampsia?
A. Blood pressure of 142/90 mmHg
Answers with Rationale | Latest Edition
2026/2027
QUESTION 1
A nurse is assessing a postpartum client who delivered a term
infant vaginally 2 hours ago. Which of the following findings
requires immediate nursing intervention?
A. Moderate lochia rubra on the perineal pad
B. Fundus firm, midline, and located two centimeters below
the umbilicus
C. A continuous trickle of bright red blood from the vagina
with a firm fundus
D. Mild afterpains experienced during breastfeeding
Correct Answer: C
Rationale: A continuous trickle of bright red blood in the
presence of a firm, contracted uterus is a classic indicator of
lacerations of the cervix or vagina. While uterine atony typically
causes a boggy uterus and heavy bleeding, steady bright red
bleeding with a firm fundus points toward unrepaired soft tissue
trauma requiring immediate physician notification and repair.
Moderate lochia rubra and a firm fundus two centimeters below
the umbilicus are normal expected postpartum findings at two
,hours. Mild afterpains during breastfeeding are also normal due
to oxytocin release causing uterine contractions.
QUESTION 2
A nurse is caring for a client at 32 weeks of gestation who is
admitted with suspected placental abruption. Which of the
following clinical manifestations should the nurse expect to
find?
A. Painless, bright red vaginal bleeding
B. Rigid, board-like abdomen with severe abdominal pain
C. Hypertonic uterine activity with fetal tachycardia
D. Soft, non-tender uterus with a non-reassuring fetal heart
rate
Correct Answer: B
Rationale: Placental abruption is characterized by premature
separation of a normally implanted placenta, leading to bleeding
behind the placenta. This results in severe abdominal pain and a
rigid, board-like abdomen due to concealed or revealed
hemorrhage entering the myometrium. Painless, bright red
vaginal bleeding is characteristic of placenta previa, not
placental abruption. While uterine irritability can occur, the
hallmark physical exam finding distinguishing abruption from
previa is uterine tenderness and rigidity.
QUESTION 3
,A laboring client at 39 weeks of gestation receives an epidural
block for pain management. Shortly after placement, the client's
blood pressure drops from 120/80 mmHg to 84/50 mmHg, and
the fetal heart rate tracing shows late decelerations. Which of the
following is the priority nursing action?
A. Administer oxygen via non-rebreather mask at 10 L/min
B. Position the client in a lateral tilt or left lateral position
C. Increase the rate of the primary intravenous fluid infusion
D. Notify the anesthesia provider and obstetrician
immediately
Correct Answer: B
Rationale: Maternal hypotension is the most common and
significant side effect of regional epidural anesthesia due to
sympathetic blockade causing vasodilation. Positioning the
client in a left lateral tilt relieves aortocaval compression by the
gravid uterus, which immediately improves venous return and
cardiac output, correcting maternal blood pressure. While
oxygen administration, fluid boluses, and notifying the provider
are essential secondary steps, relieving vena caval compression
through repositioning is the most rapid and effective primary
intervention to restore uteroplacental perfusion.
QUESTION 4
A nurse is evaluating a newborn infant who was delivered one
minute ago. The infant has a heart rate of 130 beats per minute,
cries vigorously when stimulated, exhibits well-flexed
, extremities, actively withdraws to a stimulus, and has a
completely pink body and extremities. What is the Apgar score
for this newborn?
A. 7
B. 8
C. 9
D. 10
Correct Answer: D
Rationale: The Apgar score evaluates five newborn parameters
at one and five minutes of life, each scored from 0 to 2: heart
rate, respiratory effort, muscle tone, reflex irritability, and color.
A heart rate above 100 beats per minute scores 2. A vigorous cry
indicates a good respiratory effort, scoring 2. Well-flexed
extremities demonstrate good muscle tone, scoring 2. Active
withdrawal to stimulation shows strong reflex irritability,
scoring 2. A completely pink body and extremities indicate
normal oxygenation without acrocyanosis, scoring 2. The total
score is 2 plus 2 plus 2 plus 2 plus 2, equaling 10.
QUESTION 5
A nurse is caring for a client diagnosed with mild preeclampsia
at 36 weeks of gestation. Which of the following assessment
findings should the nurse identify as a sign of disease
progression to severe preeclampsia?
A. Blood pressure of 142/90 mmHg
