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Maternity, Newborn, and Women's Health Nursing Newest
Exam Preparation With Complete Questions And Correct
Answers With Rationales Already Graded A+ Brand New
Version!!
1. A 28-year-old primigravida at 39 weeks gestation presents to the
labor and delivery unit with regular uterine contractions occurring
every 3 to 4 minutes, lasting 60 seconds, and of moderate intensity. Her
cervix is 5 cm dilated, 90% effaced, and the fetal station is 0. The fetal
heart rate tracing shows a baseline of 135 beats per minute with
moderate variability and accelerations present. Which of the following
nursing actions is the priority at this time?
A) Administer prescribed intravenous analgesics
B) Prepare the patient for an immediate cesarean delivery
C) Encourage the patient to use breathing techniques and provide
comfort measures
D) Notify the healthcare provider of the admission assessment findings
Answer: C) Encourage the patient to use breathing techniques and
provide comfort measures
Explanation: The patient is in active labor, as evidenced by cervical
dilation of 5 cm and regular contractions. The priority nursing action is
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to provide supportive care, including comfort measures and breathing
techniques, to promote effective coping and labor progress. Intravenous
analgesics may be considered but are not the immediate priority. There
is no indication for cesarean delivery based on the normal fetal heart
rate tracing and labor progression. While notifying the healthcare
provider is appropriate, it is not the priority over direct patient support
and comfort.
2. A nurse is caring for a postpartum patient who gave birth vaginally 2
hours ago. The patient's fundus is firm at the umbilicus and deviated to
the right. The patient reports a constant trickle of blood from the
vagina and a sensation of pelvic pressure. Which of the following
actions should the nurse take first?
A) Massage the fundus vigorously
B) Assist the patient to the bathroom to void
C) Administer prescribed oxytocin intravenously
D) Perform a sterile vaginal examination
Answer: B) Assist the patient to the bathroom to void
Explanation: A fundus that is firm but deviated to the right suggests a
full bladder displacing the uterus. A full bladder can interfere with
uterine contraction and increase the risk of postpartum hemorrhage.
The priority is to have the patient void to empty the bladder, which will
allow the uterus to contract more effectively. Massaging the fundus is
not indicated because it is already firm. Oxytocin would be appropriate
for uterine atony, not for a displaced firm fundus. A vaginal examination
may be needed but is not the first action.
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3. A 32-year-old woman at 34 weeks gestation is diagnosed with
gestational diabetes mellitus. Which of the following findings would
indicate the need for pharmacologic management with insulin rather
than dietary modification alone?
A) Fasting blood glucose level of 95 mg/dL
B) 1-hour postprandial blood glucose level of 140 mg/dL
C) 2-hour postprandial blood glucose level of 130 mg/dL
D) Fasting blood glucose level of 105 mg/dL
Answer: D) Fasting blood glucose level of 105 mg/dL
Explanation: In gestational diabetes, insulin therapy is typically initiated
when fasting blood glucose levels consistently exceed 95 to 100 mg/dL
or when postprandial levels exceed 120 to 140 mg/dL despite dietary
modifications. A fasting blood glucose of 105 mg/dL indicates
hyperglycemia that is not adequately controlled by diet alone and
warrants pharmacologic intervention. The other values are within
acceptable targets for gestational diabetes management.
4. A nurse is assessing a newborn who is 12 hours old. The newborn's
vital signs are: temperature 36.8°C, heart rate 148 beats per minute,
respiratory rate 44 breaths per minute. The nurse notes acrocyanosis
and a respiratory rate of 60 breaths per minute with mild grunting.
Which of the following should the nurse do first?
A) Place the newborn under a radiant warmer
B) Notify the healthcare provider immediately
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C) Suction the newborn's mouth and nose
D) Continue routine monitoring because these findings are normal
Answer: B) Notify the healthcare provider immediately
Explanation: A respiratory rate of 60 breaths per minute with grunting
in a newborn is abnormal and may indicate respiratory distress. Normal
respiratory rate for a newborn is 30 to 60 breaths per minute, but
grunting is a sign of respiratory compromise. The nurse should notify
the healthcare provider for further evaluation. Acrocyanosis is a normal
finding in the first 24 hours. Placing under a radiant warmer addresses
hypothermia, which is not the primary concern here. Suctioning is not
indicated without visible secretions.
5. A pregnant patient at 28 weeks gestation is Rh-negative and has an
Rh-positive partner. The patient's indirect Coombs test is negative.
Which of the following interventions is appropriate at this time?
A) Administer Rh immune globulin at 28 weeks
B) Administer Rh immune globulin after delivery
C) Administer Rh immune globulin at 36 weeks
D) No intervention is needed because the Coombs test is negative
Answer: A) Administer Rh immune globulin at 28 weeks
Explanation: For Rh-negative pregnant patients, Rh immune globulin is
routinely administered at 28 weeks gestation to prevent
isoimmunization, regardless of the indirect Coombs test result. If the
Maternity, Newborn, and Women's Health Nursing Newest
Exam Preparation With Complete Questions And Correct
Answers With Rationales Already Graded A+ Brand New
Version!!
1. A 28-year-old primigravida at 39 weeks gestation presents to the
labor and delivery unit with regular uterine contractions occurring
every 3 to 4 minutes, lasting 60 seconds, and of moderate intensity. Her
cervix is 5 cm dilated, 90% effaced, and the fetal station is 0. The fetal
heart rate tracing shows a baseline of 135 beats per minute with
moderate variability and accelerations present. Which of the following
nursing actions is the priority at this time?
A) Administer prescribed intravenous analgesics
B) Prepare the patient for an immediate cesarean delivery
C) Encourage the patient to use breathing techniques and provide
comfort measures
D) Notify the healthcare provider of the admission assessment findings
Answer: C) Encourage the patient to use breathing techniques and
provide comfort measures
Explanation: The patient is in active labor, as evidenced by cervical
dilation of 5 cm and regular contractions. The priority nursing action is
,2|Page
to provide supportive care, including comfort measures and breathing
techniques, to promote effective coping and labor progress. Intravenous
analgesics may be considered but are not the immediate priority. There
is no indication for cesarean delivery based on the normal fetal heart
rate tracing and labor progression. While notifying the healthcare
provider is appropriate, it is not the priority over direct patient support
and comfort.
2. A nurse is caring for a postpartum patient who gave birth vaginally 2
hours ago. The patient's fundus is firm at the umbilicus and deviated to
the right. The patient reports a constant trickle of blood from the
vagina and a sensation of pelvic pressure. Which of the following
actions should the nurse take first?
A) Massage the fundus vigorously
B) Assist the patient to the bathroom to void
C) Administer prescribed oxytocin intravenously
D) Perform a sterile vaginal examination
Answer: B) Assist the patient to the bathroom to void
Explanation: A fundus that is firm but deviated to the right suggests a
full bladder displacing the uterus. A full bladder can interfere with
uterine contraction and increase the risk of postpartum hemorrhage.
The priority is to have the patient void to empty the bladder, which will
allow the uterus to contract more effectively. Massaging the fundus is
not indicated because it is already firm. Oxytocin would be appropriate
for uterine atony, not for a displaced firm fundus. A vaginal examination
may be needed but is not the first action.
,3|Page
3. A 32-year-old woman at 34 weeks gestation is diagnosed with
gestational diabetes mellitus. Which of the following findings would
indicate the need for pharmacologic management with insulin rather
than dietary modification alone?
A) Fasting blood glucose level of 95 mg/dL
B) 1-hour postprandial blood glucose level of 140 mg/dL
C) 2-hour postprandial blood glucose level of 130 mg/dL
D) Fasting blood glucose level of 105 mg/dL
Answer: D) Fasting blood glucose level of 105 mg/dL
Explanation: In gestational diabetes, insulin therapy is typically initiated
when fasting blood glucose levels consistently exceed 95 to 100 mg/dL
or when postprandial levels exceed 120 to 140 mg/dL despite dietary
modifications. A fasting blood glucose of 105 mg/dL indicates
hyperglycemia that is not adequately controlled by diet alone and
warrants pharmacologic intervention. The other values are within
acceptable targets for gestational diabetes management.
4. A nurse is assessing a newborn who is 12 hours old. The newborn's
vital signs are: temperature 36.8°C, heart rate 148 beats per minute,
respiratory rate 44 breaths per minute. The nurse notes acrocyanosis
and a respiratory rate of 60 breaths per minute with mild grunting.
Which of the following should the nurse do first?
A) Place the newborn under a radiant warmer
B) Notify the healthcare provider immediately
, 4|Page
C) Suction the newborn's mouth and nose
D) Continue routine monitoring because these findings are normal
Answer: B) Notify the healthcare provider immediately
Explanation: A respiratory rate of 60 breaths per minute with grunting
in a newborn is abnormal and may indicate respiratory distress. Normal
respiratory rate for a newborn is 30 to 60 breaths per minute, but
grunting is a sign of respiratory compromise. The nurse should notify
the healthcare provider for further evaluation. Acrocyanosis is a normal
finding in the first 24 hours. Placing under a radiant warmer addresses
hypothermia, which is not the primary concern here. Suctioning is not
indicated without visible secretions.
5. A pregnant patient at 28 weeks gestation is Rh-negative and has an
Rh-positive partner. The patient's indirect Coombs test is negative.
Which of the following interventions is appropriate at this time?
A) Administer Rh immune globulin at 28 weeks
B) Administer Rh immune globulin after delivery
C) Administer Rh immune globulin at 36 weeks
D) No intervention is needed because the Coombs test is negative
Answer: A) Administer Rh immune globulin at 28 weeks
Explanation: For Rh-negative pregnant patients, Rh immune globulin is
routinely administered at 28 weeks gestation to prevent
isoimmunization, regardless of the indirect Coombs test result. If the
