NUR 230 OB/Peds Exam 2 Practice Questions
With Verified And Correct Answers With
Detailed Rationale
Question 1.
A client at 18 weeks gestation asks the nurse when the fetus's sex can be visually
identified via ultrasound. The nurse correctly responds that external genitalia
differentiation is typically visible by:
A. 8–10 weeks gestation.
B. 12–14 weeks gestation.
C. 16–20 weeks gestation.
D. 24–28 weeks gestation.
Correct Answer: C
Rationale: External genitalia differentiation is usually visible on ultrasound between 16
and 20 weeks gestation, with most accurate visualization occurring around 18–20 weeks
during the anatomy scan. Before 16 weeks, the genital tubercle may be too small for reliable
identification. After 20 weeks, visualization becomes easier as the fetus grows larger.
Question 2.
A pregnant client at 14 weeks gestation reports severe nausea and vomiting that has
persisted for 3 days, preventing her from keeping any food or fluids down. She has
lost 3 lbs in one week. The nurse suspects hyperemesis gravidarum. The priority
nursing intervention is to:
A. Recommend ginger supplements and small, frequent meals.
B. Encourage the client to increase oral fluid intake at home.
C. Initiate IV fluid replacement and electrolyte monitoring.
D. Prescribe ondansetron and discharge the client.
Correct Answer: C
Rationale: Hyperemesis gravidarum is characterized by severe, persistent nausea and
vomiting leading to dehydration, weight loss (>5% of pre-pregnancy weight), and
electrolyte imbalances. The priority intervention is IV fluid resuscitation with dextrose-
,containing fluids and electrolyte replacement. Ginger and small meals are appropriate for
mild morning sickness but insufficient for hyperemesis gravidarum. Oral intake is often
impossible. Antiemetics are adjunctive therapy after hydration is established.
Question 3.
A client at 30 weeks gestation is diagnosed with placenta previa after an ultrasound
reveals the placenta completely covers the internal os. The client asks when she can
expect to deliver. The nurse correctly responds that delivery will most likely be:
A. Vaginal delivery at 38–40 weeks if no further bleeding occurs.
B. Scheduled cesarean section at 36–37 weeks gestation.
C. Induced vaginal delivery at 34 weeks to prevent hemorrhage.
D. Emergency cesarean section immediately regardless of gestational age.
Correct Answer: B
Rationale: Complete placenta previa (where the placenta completely covers the internal
cervical os) is an absolute indication for cesarean delivery. Delivery is typically scheduled at
36–37 weeks gestation after confirming fetal lung maturity with amniocentesis, or at any
time if severe bleeding occurs. Vaginal delivery is contraindicated due to the high risk of
catastrophic hemorrhage when the cervix dilates and the placenta separates.
Question 4.
The nurse is caring for a client in labor whose cervix is 5 cm dilated, 90% effaced,
with the fetal head at 0 station. Contractions occur every 3 minutes, lasting 60
seconds, and are moderate to strong by palpation. The nurse documents this client as
being in which phase of labor?
A. Latent phase of the first stage.
B. Active phase of the first stage.
C. Transition phase of the first stage.
D. Second stage of labor.
Correct Answer: B
Rationale: The active phase of the first stage of labor is defined as cervical dilation from 6
cm to 10 cm (or traditionally 4–6 cm to 10 cm according to newer ACOG guidelines).
, Characteristics include contractions every 3–5 minutes, lasting 45–60 seconds, moderate to
strong intensity, and rapid cervical change. The latent phase involves 0–3/4 cm dilation
with mild, irregular contractions. Transition is 8–10 cm with very strong, frequent
contractions. The second stage begins at complete dilation (10 cm) with pushing.
Question 5.
A postpartum client on day 1 reports burning and pain with urination. The nurse
notes the client's temperature is 100.8°F (38.2°C). The nurse suspects a urinary tract
infection (UTI). Which factor most likely contributed to this client's UTI?
A. Increased progesterone causing urethral dilation.
B. Urinary stasis and trauma to the perineum during delivery.
C. Decreased fluid intake during labor.
D. Use of prophylactic antibiotics during labor.
Correct Answer: B
Rationale: Postpartum UTIs are commonly caused by urinary stasis (from decreased
bladder tone after delivery, perineal pain inhibiting voiding, and residual urine) combined
with trauma to the perineum and urethra during vaginal delivery. These factors create an
environment conducive to bacterial growth. While decreased fluid intake may contribute, it
is not the primary factor. Progylactic antibiotics would actually reduce infection risk, not
increase it.
Question 6.
The nurse is monitoring a client in labor and notes late decelerations on the fetal
heart rate tracing. The decelerations begin at the onset of the contraction, reach their
lowest point after the peak of the contraction, and return to baseline after the
contraction ends. The nurse's priority action is to:
A. Continue monitoring as this is a normal reassuring pattern.
B. Turn the client to her left side and administer oxygen by face mask at 10 L/min.
C. Increase the oxytocin infusion to strengthen contractions.
D. Prepare for immediate forceps-assisted delivery.
Correct Answer: B
With Verified And Correct Answers With
Detailed Rationale
Question 1.
A client at 18 weeks gestation asks the nurse when the fetus's sex can be visually
identified via ultrasound. The nurse correctly responds that external genitalia
differentiation is typically visible by:
A. 8–10 weeks gestation.
B. 12–14 weeks gestation.
C. 16–20 weeks gestation.
D. 24–28 weeks gestation.
Correct Answer: C
Rationale: External genitalia differentiation is usually visible on ultrasound between 16
and 20 weeks gestation, with most accurate visualization occurring around 18–20 weeks
during the anatomy scan. Before 16 weeks, the genital tubercle may be too small for reliable
identification. After 20 weeks, visualization becomes easier as the fetus grows larger.
Question 2.
A pregnant client at 14 weeks gestation reports severe nausea and vomiting that has
persisted for 3 days, preventing her from keeping any food or fluids down. She has
lost 3 lbs in one week. The nurse suspects hyperemesis gravidarum. The priority
nursing intervention is to:
A. Recommend ginger supplements and small, frequent meals.
B. Encourage the client to increase oral fluid intake at home.
C. Initiate IV fluid replacement and electrolyte monitoring.
D. Prescribe ondansetron and discharge the client.
Correct Answer: C
Rationale: Hyperemesis gravidarum is characterized by severe, persistent nausea and
vomiting leading to dehydration, weight loss (>5% of pre-pregnancy weight), and
electrolyte imbalances. The priority intervention is IV fluid resuscitation with dextrose-
,containing fluids and electrolyte replacement. Ginger and small meals are appropriate for
mild morning sickness but insufficient for hyperemesis gravidarum. Oral intake is often
impossible. Antiemetics are adjunctive therapy after hydration is established.
Question 3.
A client at 30 weeks gestation is diagnosed with placenta previa after an ultrasound
reveals the placenta completely covers the internal os. The client asks when she can
expect to deliver. The nurse correctly responds that delivery will most likely be:
A. Vaginal delivery at 38–40 weeks if no further bleeding occurs.
B. Scheduled cesarean section at 36–37 weeks gestation.
C. Induced vaginal delivery at 34 weeks to prevent hemorrhage.
D. Emergency cesarean section immediately regardless of gestational age.
Correct Answer: B
Rationale: Complete placenta previa (where the placenta completely covers the internal
cervical os) is an absolute indication for cesarean delivery. Delivery is typically scheduled at
36–37 weeks gestation after confirming fetal lung maturity with amniocentesis, or at any
time if severe bleeding occurs. Vaginal delivery is contraindicated due to the high risk of
catastrophic hemorrhage when the cervix dilates and the placenta separates.
Question 4.
The nurse is caring for a client in labor whose cervix is 5 cm dilated, 90% effaced,
with the fetal head at 0 station. Contractions occur every 3 minutes, lasting 60
seconds, and are moderate to strong by palpation. The nurse documents this client as
being in which phase of labor?
A. Latent phase of the first stage.
B. Active phase of the first stage.
C. Transition phase of the first stage.
D. Second stage of labor.
Correct Answer: B
Rationale: The active phase of the first stage of labor is defined as cervical dilation from 6
cm to 10 cm (or traditionally 4–6 cm to 10 cm according to newer ACOG guidelines).
, Characteristics include contractions every 3–5 minutes, lasting 45–60 seconds, moderate to
strong intensity, and rapid cervical change. The latent phase involves 0–3/4 cm dilation
with mild, irregular contractions. Transition is 8–10 cm with very strong, frequent
contractions. The second stage begins at complete dilation (10 cm) with pushing.
Question 5.
A postpartum client on day 1 reports burning and pain with urination. The nurse
notes the client's temperature is 100.8°F (38.2°C). The nurse suspects a urinary tract
infection (UTI). Which factor most likely contributed to this client's UTI?
A. Increased progesterone causing urethral dilation.
B. Urinary stasis and trauma to the perineum during delivery.
C. Decreased fluid intake during labor.
D. Use of prophylactic antibiotics during labor.
Correct Answer: B
Rationale: Postpartum UTIs are commonly caused by urinary stasis (from decreased
bladder tone after delivery, perineal pain inhibiting voiding, and residual urine) combined
with trauma to the perineum and urethra during vaginal delivery. These factors create an
environment conducive to bacterial growth. While decreased fluid intake may contribute, it
is not the primary factor. Progylactic antibiotics would actually reduce infection risk, not
increase it.
Question 6.
The nurse is monitoring a client in labor and notes late decelerations on the fetal
heart rate tracing. The decelerations begin at the onset of the contraction, reach their
lowest point after the peak of the contraction, and return to baseline after the
contraction ends. The nurse's priority action is to:
A. Continue monitoring as this is a normal reassuring pattern.
B. Turn the client to her left side and administer oxygen by face mask at 10 L/min.
C. Increase the oxytocin infusion to strengthen contractions.
D. Prepare for immediate forceps-assisted delivery.
Correct Answer: B
