Obstetrics and Gynecology 2026/2027 | Beckmann and Ling's Obstetrics and
Gynecology 9th Edition Study Guide, OB/GYN Exam Prep, Practice Questions with
Answers & Rationales, Prenatal Care, Pregnancy, Labor & Delivery, Postpartum Care,
Maternal-Fetal Medicine, Gynecologic Disorders, Reproductive Health, Contraception,
Infertility, Gynecologic Oncology & Women's Health
Question 1: A 28-year-old G1P0 at 39 weeks gestation presents to labor and
delivery with spontaneous rupture of membranes. The nurse notes a large gush
of fluid and observes a pulsating umbilical cord protruding from the vagina.
What is the nurse's immediate priority action?
A. Attempt to replace the cord into the vagina.
B. Administer oxygen at 2 L/min via nasal cannula.
C. Call for assistance and prepare for an emergency cesarean section.
D. Perform a sterile vaginal exam to assess cervical dilation.
CORRECT ANSWER: C. Call for assistance and prepare for an emergency
cesarean section.
Rationale: This is a cord prolapse, an obstetric emergency. The priority is to
relieve pressure on the cord and prepare for an immediate cesarean delivery.
Calling for help and preparing for surgery are the first critical steps. Attempting to
replace the cord is contraindicated.
Question 2: A 32-year-old client at 36 weeks gestation is being assessed. The
nurse notes a blood pressure of 158/102 mmHg and 3+ proteinuria. The client
reports a severe, unrelenting headache. Based on these findings, what is the
most likely diagnosis?
A. Gestational hypertension
B. Chronic hypertension
C. Preeclampsia with severe features
D. Eclampsia
CORRECT ANSWER: C. Preeclampsia with severe features
Rationale: Preeclampsia with severe features is diagnosed with a blood pressure
of 160/110 mmHg or higher, or evidence of organ dysfunction such as proteinuria,
severe headaches, visual disturbances, or elevated liver enzymes. This client's BP
and symptoms meet these criteria.
,Question 3: A postpartum client who delivered 2 hours ago is experiencing a
boggy uterus and heavy vaginal bleeding. After fundal massage, the uterus
remains boggy, and the bleeding continues. What is the priority nursing action?
A. Administer a uterotonic medication as ordered.
B. Prepare the client for a blood transfusion.
C. Insert a urinary catheter to empty the bladder.
D. Perform a bimanual uterine massage.
CORRECT ANSWER: A. Administer a uterotonic medication as ordered.
Rationale: Uterine atony is the most common cause of postpartum hemorrhage.
After fundal massage, the next step is to administer uterotonic medications (e.g.,
oxytocin, methylergonovine, carboprost) to promote uterine contraction.
Emptying the bladder can help but is secondary to medication.
Question 4: A 24-year-old client is being counseled on combined oral
contraceptive pills (COCs). Which of the following statements by the client
indicates a correct understanding of the teaching?
A. "I should take the pill at the same time every day."
B. "I can stop taking the pill if I get a headache."
C. "I need to take a break from the pill every year."
D. "The pill protects me against sexually transmitted infections."
CORRECT ANSWER: A. "I should take the pill at the same time every day."
Rationale: Taking the COC at the same time daily ensures consistent hormone
levels and maximizes effectiveness. COCs do not protect against STIs. There is no
need for a "pill holiday." New or severe headaches should be reported to the
provider, not managed by stopping the pill independently.
Question 5: A nurse is performing a pelvic examination on a 45-year-old client.
The nurse observes a smooth, pale, pear-shaped cervix. Which of the following
is the correct term for this part of the cervix?
A. Ectocervix
B. Endocervix
C. Transformation zone
D. Squamocolumnar junction
,CORRECT ANSWER: A. Ectocervix
Rationale: The ectocervix is the portion of the cervix that protrudes into the
vagina and is covered by smooth, pale squamous epithelium. The endocervix is
the inner canal lined with columnar epithelium. The transformation zone is the
area where the two cell types meet.
Question 6: A client at 12 weeks gestation asks the nurse about the purpose of a
first-trimester screening. The nurse explains that this screening is primarily used
to assess for which of the following?
A. Gestational diabetes
B. Neural tube defects
C. Chromosomal abnormalities
D. Placenta previa
CORRECT ANSWER: C. Chromosomal abnormalities
Rationale: First-trimester screening, which includes nuchal translucency
ultrasound and maternal serum markers (PAPP-A and free beta-hCG), is primarily
used to assess the risk for chromosomal abnormalities like Down syndrome
(trisomy 21) and Edwards syndrome (trisomy 18).
Question 7: A nurse is teaching a pregnant client about the signs of labor. Which
of the following signs indicates the onset of true labor?
A. Irregular contractions that are relieved by walking
B. Regular contractions that increase in frequency and intensity
C. A sudden gush of clear fluid from the vagina
D. Passage of a blood-tinged mucus plug
CORRECT ANSWER: B. Regular contractions that increase in frequency and
intensity
Rationale: True labor is characterized by regular contractions that become
stronger, longer, and closer together over time. They are not typically relieved by
rest or position changes. A bloody show and rupture of membranes can be signs
of impending labor but are not definitive.
, Question 8: A 30-year-old client is diagnosed with endometriosis. Which of the
following symptoms is most commonly associated with this condition?
A. Painful menstruation (dysmenorrhea)
B. Heavy, irregular menstrual bleeding
C. Pain during intercourse (dyspareunia)
D. All of the above
CORRECT ANSWER: D. All of the above
Rationale: Endometriosis can cause a classic triad of symptoms: dysmenorrhea,
dyspareunia, and dyschezia (painful bowel movements). Heavy or irregular
bleeding is also a common complaint. Therefore, all listed symptoms are
commonly associated with endometriosis.
Question 9: A client in the active phase of the first stage of labor is requesting
an epidural for pain management. What is the priority nursing assessment
before the administration of the epidural?
A. Assess fetal heart rate and contraction pattern.
B. Obtain a urine sample for a drug screen.
C. Insert an indwelling urinary catheter.
D. Administer a bolus of intravenous fluids.
CORRECT ANSWER: D. Administer a bolus of intravenous fluids.
Rationale: A fluid bolus (preload) is typically administered prior to epidural
placement to prevent maternal hypotension, which is a common side effect of the
anesthesia. While assessing FHR is important, the fluid bolus is a critical
preparatory intervention. A catheter is often placed after the epidural.
Question 10: A nurse is assessing a newborn 1 minute after birth. The newborn
has a heart rate of 110 bpm, is crying vigorously, has active flexion of the
extremities, grimaces when suctioned, and has a pink body with blue
extremities. What is the Apgar score?
A. 7
B. 8
C. 9
D. 10
Gynecology 9th Edition Study Guide, OB/GYN Exam Prep, Practice Questions with
Answers & Rationales, Prenatal Care, Pregnancy, Labor & Delivery, Postpartum Care,
Maternal-Fetal Medicine, Gynecologic Disorders, Reproductive Health, Contraception,
Infertility, Gynecologic Oncology & Women's Health
Question 1: A 28-year-old G1P0 at 39 weeks gestation presents to labor and
delivery with spontaneous rupture of membranes. The nurse notes a large gush
of fluid and observes a pulsating umbilical cord protruding from the vagina.
What is the nurse's immediate priority action?
A. Attempt to replace the cord into the vagina.
B. Administer oxygen at 2 L/min via nasal cannula.
C. Call for assistance and prepare for an emergency cesarean section.
D. Perform a sterile vaginal exam to assess cervical dilation.
CORRECT ANSWER: C. Call for assistance and prepare for an emergency
cesarean section.
Rationale: This is a cord prolapse, an obstetric emergency. The priority is to
relieve pressure on the cord and prepare for an immediate cesarean delivery.
Calling for help and preparing for surgery are the first critical steps. Attempting to
replace the cord is contraindicated.
Question 2: A 32-year-old client at 36 weeks gestation is being assessed. The
nurse notes a blood pressure of 158/102 mmHg and 3+ proteinuria. The client
reports a severe, unrelenting headache. Based on these findings, what is the
most likely diagnosis?
A. Gestational hypertension
B. Chronic hypertension
C. Preeclampsia with severe features
D. Eclampsia
CORRECT ANSWER: C. Preeclampsia with severe features
Rationale: Preeclampsia with severe features is diagnosed with a blood pressure
of 160/110 mmHg or higher, or evidence of organ dysfunction such as proteinuria,
severe headaches, visual disturbances, or elevated liver enzymes. This client's BP
and symptoms meet these criteria.
,Question 3: A postpartum client who delivered 2 hours ago is experiencing a
boggy uterus and heavy vaginal bleeding. After fundal massage, the uterus
remains boggy, and the bleeding continues. What is the priority nursing action?
A. Administer a uterotonic medication as ordered.
B. Prepare the client for a blood transfusion.
C. Insert a urinary catheter to empty the bladder.
D. Perform a bimanual uterine massage.
CORRECT ANSWER: A. Administer a uterotonic medication as ordered.
Rationale: Uterine atony is the most common cause of postpartum hemorrhage.
After fundal massage, the next step is to administer uterotonic medications (e.g.,
oxytocin, methylergonovine, carboprost) to promote uterine contraction.
Emptying the bladder can help but is secondary to medication.
Question 4: A 24-year-old client is being counseled on combined oral
contraceptive pills (COCs). Which of the following statements by the client
indicates a correct understanding of the teaching?
A. "I should take the pill at the same time every day."
B. "I can stop taking the pill if I get a headache."
C. "I need to take a break from the pill every year."
D. "The pill protects me against sexually transmitted infections."
CORRECT ANSWER: A. "I should take the pill at the same time every day."
Rationale: Taking the COC at the same time daily ensures consistent hormone
levels and maximizes effectiveness. COCs do not protect against STIs. There is no
need for a "pill holiday." New or severe headaches should be reported to the
provider, not managed by stopping the pill independently.
Question 5: A nurse is performing a pelvic examination on a 45-year-old client.
The nurse observes a smooth, pale, pear-shaped cervix. Which of the following
is the correct term for this part of the cervix?
A. Ectocervix
B. Endocervix
C. Transformation zone
D. Squamocolumnar junction
,CORRECT ANSWER: A. Ectocervix
Rationale: The ectocervix is the portion of the cervix that protrudes into the
vagina and is covered by smooth, pale squamous epithelium. The endocervix is
the inner canal lined with columnar epithelium. The transformation zone is the
area where the two cell types meet.
Question 6: A client at 12 weeks gestation asks the nurse about the purpose of a
first-trimester screening. The nurse explains that this screening is primarily used
to assess for which of the following?
A. Gestational diabetes
B. Neural tube defects
C. Chromosomal abnormalities
D. Placenta previa
CORRECT ANSWER: C. Chromosomal abnormalities
Rationale: First-trimester screening, which includes nuchal translucency
ultrasound and maternal serum markers (PAPP-A and free beta-hCG), is primarily
used to assess the risk for chromosomal abnormalities like Down syndrome
(trisomy 21) and Edwards syndrome (trisomy 18).
Question 7: A nurse is teaching a pregnant client about the signs of labor. Which
of the following signs indicates the onset of true labor?
A. Irregular contractions that are relieved by walking
B. Regular contractions that increase in frequency and intensity
C. A sudden gush of clear fluid from the vagina
D. Passage of a blood-tinged mucus plug
CORRECT ANSWER: B. Regular contractions that increase in frequency and
intensity
Rationale: True labor is characterized by regular contractions that become
stronger, longer, and closer together over time. They are not typically relieved by
rest or position changes. A bloody show and rupture of membranes can be signs
of impending labor but are not definitive.
, Question 8: A 30-year-old client is diagnosed with endometriosis. Which of the
following symptoms is most commonly associated with this condition?
A. Painful menstruation (dysmenorrhea)
B. Heavy, irregular menstrual bleeding
C. Pain during intercourse (dyspareunia)
D. All of the above
CORRECT ANSWER: D. All of the above
Rationale: Endometriosis can cause a classic triad of symptoms: dysmenorrhea,
dyspareunia, and dyschezia (painful bowel movements). Heavy or irregular
bleeding is also a common complaint. Therefore, all listed symptoms are
commonly associated with endometriosis.
Question 9: A client in the active phase of the first stage of labor is requesting
an epidural for pain management. What is the priority nursing assessment
before the administration of the epidural?
A. Assess fetal heart rate and contraction pattern.
B. Obtain a urine sample for a drug screen.
C. Insert an indwelling urinary catheter.
D. Administer a bolus of intravenous fluids.
CORRECT ANSWER: D. Administer a bolus of intravenous fluids.
Rationale: A fluid bolus (preload) is typically administered prior to epidural
placement to prevent maternal hypotension, which is a common side effect of the
anesthesia. While assessing FHR is important, the fluid bolus is a critical
preparatory intervention. A catheter is often placed after the epidural.
Question 10: A nurse is assessing a newborn 1 minute after birth. The newborn
has a heart rate of 110 bpm, is crying vigorously, has active flexion of the
extremities, grimaces when suctioned, and has a pink body with blue
extremities. What is the Apgar score?
A. 7
B. 8
C. 9
D. 10
