ADN Exam Questions With Answers and detailed Rationales
Question 1.
A nurse is monitoring a client in labor and notices late decelerations on the fetal heart rate
monitor. What is the priority nursing action?
A. Increase the rate of the oxytocin infusion
B. Place the client in a lateral position
C. Administer oxygen via nasal cannula at 2L/min
D. Perform a vaginal exam to check for cord prolapse
Correct Answer: B. Place the client in a lateral position
Explanation: Late decelerations are caused by uteroplacental insufficiency. The priority is
to improve oxygenation by turning the client to the side, increasing IV fluids, and applying
oxygen via non-rebreather mask.
Question 2.
Which clinical finding is characteristic of abruptio placentae rather than placenta previa?
A. Painless, bright red vaginal bleeding
B. Board-like, tender abdomen
C. Soft, non-tender abdomen
D. Normal fetal heart rate patterns
Correct Answer: B. Board-like, tender abdomen
Explanation: Abruptio placentae involves the premature separation of the placenta,
causing painful, dark red bleeding and a rigid, board-like abdomen. Placenta previa is
usually painless and bright red.
Question 3.
A nurse is caring for a client receiving magnesium sulfate for preeclampsia. Which finding
should the nurse report immediately?
A. Respiratory rate of 10 breaths per minute
B. Blood pressure of 150/95 mmHg
C. Deep tendon reflexes of 2+
D. Urinary output of 40 mL per hour
Correct Answer: A. Respiratory rate of 10 breaths per minute
Explanation: A respiratory rate below 12/min is a sign of magnesium sulfate toxicity.
Other signs include absent deep tendon reflexes and decreased urinary output (<30
mL/hr).
,Question 4.
What is the primary purpose of administering Vitamin K to a newborn within the first hours
of life?
A. To stimulate the production of red blood cells
B. To prevent hemorrhagic disease of the newborn
C. To promote lung maturity
D. To prevent ophthalmia neonatorum
Correct Answer: B. To prevent hemorrhagic disease of the newborn
Explanation: Newborns have a sterile gut and lack Vitamin K-producing bacteria, which is
necessary for the synthesis of clotting factors. Vitamin K prevents early bleeding disorders.
Question 5.
During the fourth stage of labor, the nurse finds the client’s fundus is boggy and displaced
to the right. What is the first action the nurse should take?
A. Administer oxytocin as ordered
B. Massage the fundus until firm
C. Assist the client to void or catheterize if necessary
D. Call the healthcare provider immediately
Correct Answer: C. Assist the client to void or catheterize if necessary
Explanation: A fundus displaced to the right usually indicates a full bladder, which
prevents the uterus from contracting. Emptying the bladder is the priority to allow for
effective fundal massage/contraction.
Question 6.
Which medication is specifically contraindicated for a client with a history of asthma who is
experiencing postpartum hemorrhage?
A. Oxytocin (Pitocin)
B. Methylergonovine (Methergine)
C. Carboprost tromethamine (Hemabate)
D. Misoprostol (Cytotec)
Correct Answer: C. Carboprost tromethamine (Hemabate)
Explanation: Hemabate can cause severe bronchoconstriction and is contraindicated in
clients with asthma. Methergine is contraindicated in clients with hypertension.
, Question 7.
A newborn has an Apgar score of 8 at 1 minute and 9 at 5 minutes. What does this score
indicate?
A. Severe distress requiring resuscitation
B. Minimal to no difficulty adjusting to extrauterine life
C. Moderate difficulty adjusting to extrauterine life
D. The need for immediate oxygen administration
Correct Answer: B. Minimal to no difficulty adjusting to extrauterine life
Explanation: Apgar scores of 7 to 10 are considered normal and indicate that the
newborn is in good condition and making an effective transition.
Question 8.
Variable decelerations on the fetal monitor are typically caused by which of the following?
A. Head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Maternal fever
Correct Answer: B. Umbilical cord compression
Explanation: Variable decelerations (V-shaped) are caused by cord compression. Early
decelerations are head compression, and late decelerations are placental insufficiency.
Question 9.
A nurse is assessing a newborn and notes a diamond-shaped soft spot on the top of the
head. This is identified as the:
A. Posterior fontanelle
B. Anterior fontanelle
C. Sagittal suture
D. Occiput
Correct Answer: B. Anterior fontanelle
Explanation: The anterior fontanelle is diamond-shaped and closes by 12-18 months. The
posterior fontanelle is triangular and closes by 2-3 months.
Question 10.
A client is in the ‘transition’ phase of the first stage of labor. Which behavior is the nurse
most likely to observe?
A. The client is talkative and excited
B. The client is irritable, nauseated, and feels a loss of control
C. The client is serious and focused
D. The client is pushing with each contraction
Correct Answer: B. The client is irritable, nauseated, and feels a loss of control
Question 1.
A nurse is monitoring a client in labor and notices late decelerations on the fetal heart rate
monitor. What is the priority nursing action?
A. Increase the rate of the oxytocin infusion
B. Place the client in a lateral position
C. Administer oxygen via nasal cannula at 2L/min
D. Perform a vaginal exam to check for cord prolapse
Correct Answer: B. Place the client in a lateral position
Explanation: Late decelerations are caused by uteroplacental insufficiency. The priority is
to improve oxygenation by turning the client to the side, increasing IV fluids, and applying
oxygen via non-rebreather mask.
Question 2.
Which clinical finding is characteristic of abruptio placentae rather than placenta previa?
A. Painless, bright red vaginal bleeding
B. Board-like, tender abdomen
C. Soft, non-tender abdomen
D. Normal fetal heart rate patterns
Correct Answer: B. Board-like, tender abdomen
Explanation: Abruptio placentae involves the premature separation of the placenta,
causing painful, dark red bleeding and a rigid, board-like abdomen. Placenta previa is
usually painless and bright red.
Question 3.
A nurse is caring for a client receiving magnesium sulfate for preeclampsia. Which finding
should the nurse report immediately?
A. Respiratory rate of 10 breaths per minute
B. Blood pressure of 150/95 mmHg
C. Deep tendon reflexes of 2+
D. Urinary output of 40 mL per hour
Correct Answer: A. Respiratory rate of 10 breaths per minute
Explanation: A respiratory rate below 12/min is a sign of magnesium sulfate toxicity.
Other signs include absent deep tendon reflexes and decreased urinary output (<30
mL/hr).
,Question 4.
What is the primary purpose of administering Vitamin K to a newborn within the first hours
of life?
A. To stimulate the production of red blood cells
B. To prevent hemorrhagic disease of the newborn
C. To promote lung maturity
D. To prevent ophthalmia neonatorum
Correct Answer: B. To prevent hemorrhagic disease of the newborn
Explanation: Newborns have a sterile gut and lack Vitamin K-producing bacteria, which is
necessary for the synthesis of clotting factors. Vitamin K prevents early bleeding disorders.
Question 5.
During the fourth stage of labor, the nurse finds the client’s fundus is boggy and displaced
to the right. What is the first action the nurse should take?
A. Administer oxytocin as ordered
B. Massage the fundus until firm
C. Assist the client to void or catheterize if necessary
D. Call the healthcare provider immediately
Correct Answer: C. Assist the client to void or catheterize if necessary
Explanation: A fundus displaced to the right usually indicates a full bladder, which
prevents the uterus from contracting. Emptying the bladder is the priority to allow for
effective fundal massage/contraction.
Question 6.
Which medication is specifically contraindicated for a client with a history of asthma who is
experiencing postpartum hemorrhage?
A. Oxytocin (Pitocin)
B. Methylergonovine (Methergine)
C. Carboprost tromethamine (Hemabate)
D. Misoprostol (Cytotec)
Correct Answer: C. Carboprost tromethamine (Hemabate)
Explanation: Hemabate can cause severe bronchoconstriction and is contraindicated in
clients with asthma. Methergine is contraindicated in clients with hypertension.
, Question 7.
A newborn has an Apgar score of 8 at 1 minute and 9 at 5 minutes. What does this score
indicate?
A. Severe distress requiring resuscitation
B. Minimal to no difficulty adjusting to extrauterine life
C. Moderate difficulty adjusting to extrauterine life
D. The need for immediate oxygen administration
Correct Answer: B. Minimal to no difficulty adjusting to extrauterine life
Explanation: Apgar scores of 7 to 10 are considered normal and indicate that the
newborn is in good condition and making an effective transition.
Question 8.
Variable decelerations on the fetal monitor are typically caused by which of the following?
A. Head compression
B. Umbilical cord compression
C. Uteroplacental insufficiency
D. Maternal fever
Correct Answer: B. Umbilical cord compression
Explanation: Variable decelerations (V-shaped) are caused by cord compression. Early
decelerations are head compression, and late decelerations are placental insufficiency.
Question 9.
A nurse is assessing a newborn and notes a diamond-shaped soft spot on the top of the
head. This is identified as the:
A. Posterior fontanelle
B. Anterior fontanelle
C. Sagittal suture
D. Occiput
Correct Answer: B. Anterior fontanelle
Explanation: The anterior fontanelle is diamond-shaped and closes by 12-18 months. The
posterior fontanelle is triangular and closes by 2-3 months.
Question 10.
A client is in the ‘transition’ phase of the first stage of labor. Which behavior is the nurse
most likely to observe?
A. The client is talkative and excited
B. The client is irritable, nauseated, and feels a loss of control
C. The client is serious and focused
D. The client is pushing with each contraction
Correct Answer: B. The client is irritable, nauseated, and feels a loss of control
