West Coast University NURS 306 Exam 3 | OB Nursing (2026)
Q&A
1. A nurse is reviewing the process of milk production in a breastfeeding client. Which hormone
is primarily responsible for milk synthesis?
A) Oxytocin
B) Prolactin
C) Estrogen
D) Progesterone
Correct Answer: Prolactin
Rationale: Prolactin is the anterior pituitary hormone primarily responsible for lactogenesis, the
synthesis of milk. Oxytocin is responsible for milk ejection (the let-down reflex), while estrogen
and progesterone support the pregnancy and decline after birth to allow lactation to begin.
2. A nurse is assessing a client who is 2 hours postpartum. The client's fundus is firm, at the
umbilicus, and midline. Which action should the nurse take?
A) Massage the fundus vigorously.
B) Document the finding and continue monitoring.
C) Notify the provider immediately.
D) Administer a uterotonic medication.
Correct Answer: Document the finding and continue monitoring.
,Rationale: A firm, midline fundus at the umbilicus is a normal finding 2 hours postpartum. No
intervention is required. Massaging a firm fundus is unnecessary and can cause discomfort,
while notifying the provider or administering medication is not indicated for a normal
assessment.
3. A nurse is preparing to assess a newborn's Apgar score at 1 minute of life. Which parameters
are included in this assessment?
A) Heart rate, respiratory effort, muscle tone, reflex irritability, and color
B) Heart rate, blood pressure, temperature, oxygen saturation, and color
C) Respiratory rate, blood pressure, muscle tone, reflex irritability, and color
D) Heart rate, respiratory effort, temperature, reflex irritability, and color
Correct Answer: Heart rate, respiratory effort, muscle tone, reflex irritability, and color
Rationale: The Apgar score assesses five parameters: heart rate, respiratory effort, muscle tone,
reflex irritability, and color. Each parameter is scored 0, 1, or 2, with a maximum total score of
10. Blood pressure and temperature are not part of the Apgar assessment.
4. A client who is 38 weeks pregnant presents with painless, bright red vaginal bleeding. Which
condition should the nurse suspect first?
A) Placental abruption
B) Placenta previa
C) Uterine rupture
D) Cervical insufficiency
Correct Answer: Placenta previa
,Rationale: Painless, bright red vaginal bleeding in the third trimester is a classic presentation of
placenta previa. Placental abruption typically presents with painful bleeding and a rigid, tender
abdomen. Uterine rupture is associated with severe pain and fetal distress, and cervical
insufficiency typically presents earlier in pregnancy.
5. A nurse is caring for a client receiving magnesium sulfate for preeclampsia. Which assessment
finding indicates magnesium toxicity?
A) Respiratory rate of 16 breaths/min
B) Blood pressure of 130/80 mm Hg
C) Absent deep tendon reflexes
D) Urine output of 50 mL/hr
Correct Answer: Absent deep tendon reflexes
Rationale: Absent deep tendon reflexes are a sign of magnesium sulfate toxicity, along with
respiratory depression and decreased urine output. The nurse should stop the infusion and
notify the provider immediately. A respiratory rate of 16, blood pressure of 130/80, and urine
output of 50 mL/hr are within normal limits.
6. A nurse is teaching a client about the expected changes in lochia during the postpartum
period. Which description is correct for lochia serosa?
A) Bright red discharge lasting 1 to 3 days
B) Pinkish-brown discharge lasting 4 to 10 days
C) Yellowish-white discharge lasting 10 to 14 days
D) Dark red discharge lasting 2 to 4 weeks
, Correct Answer: Pinkish-brown discharge lasting 4 to 10 days
Rationale: Lochia serosa is the second stage of lochia, occurring approximately 4 to 10 days
postpartum. It is pinkish-brown in color and consists of serous exudate, leukocytes, and debris.
Lochia rubra is bright red and occurs in the first 1 to 3 days, while lochia alba is yellowish-white
and occurs after 10 days.
7. A nurse is assessing a newborn who was born at 42 weeks of gestation. Which finding is most
consistent with postmaturity?
A) Abundant vernix caseosa
B) Lanugo covering the body
C) Dry, cracked, peeling skin
D) Excessive subcutaneous fat
Correct Answer: Dry, cracked, peeling skin
Rationale: Postmature newborns (born after 42 weeks) often have dry, cracked, peeling skin due
to decreased vernix and lanugo. They may also have long nails, meconium staining, and a thin
appearance. Abundant vernix and lanugo are seen in preterm newborns.
8. A nurse is caring for a client in the active phase of the first stage of labor. Which finding
indicates that the client is progressing normally?
A) Cervical dilation from 4 to 7 cm
B) Cervical dilation from 8 to 10 cm
C) Complete cervical dilation with urge to push
D) Delivery of the placenta
Q&A
1. A nurse is reviewing the process of milk production in a breastfeeding client. Which hormone
is primarily responsible for milk synthesis?
A) Oxytocin
B) Prolactin
C) Estrogen
D) Progesterone
Correct Answer: Prolactin
Rationale: Prolactin is the anterior pituitary hormone primarily responsible for lactogenesis, the
synthesis of milk. Oxytocin is responsible for milk ejection (the let-down reflex), while estrogen
and progesterone support the pregnancy and decline after birth to allow lactation to begin.
2. A nurse is assessing a client who is 2 hours postpartum. The client's fundus is firm, at the
umbilicus, and midline. Which action should the nurse take?
A) Massage the fundus vigorously.
B) Document the finding and continue monitoring.
C) Notify the provider immediately.
D) Administer a uterotonic medication.
Correct Answer: Document the finding and continue monitoring.
,Rationale: A firm, midline fundus at the umbilicus is a normal finding 2 hours postpartum. No
intervention is required. Massaging a firm fundus is unnecessary and can cause discomfort,
while notifying the provider or administering medication is not indicated for a normal
assessment.
3. A nurse is preparing to assess a newborn's Apgar score at 1 minute of life. Which parameters
are included in this assessment?
A) Heart rate, respiratory effort, muscle tone, reflex irritability, and color
B) Heart rate, blood pressure, temperature, oxygen saturation, and color
C) Respiratory rate, blood pressure, muscle tone, reflex irritability, and color
D) Heart rate, respiratory effort, temperature, reflex irritability, and color
Correct Answer: Heart rate, respiratory effort, muscle tone, reflex irritability, and color
Rationale: The Apgar score assesses five parameters: heart rate, respiratory effort, muscle tone,
reflex irritability, and color. Each parameter is scored 0, 1, or 2, with a maximum total score of
10. Blood pressure and temperature are not part of the Apgar assessment.
4. A client who is 38 weeks pregnant presents with painless, bright red vaginal bleeding. Which
condition should the nurse suspect first?
A) Placental abruption
B) Placenta previa
C) Uterine rupture
D) Cervical insufficiency
Correct Answer: Placenta previa
,Rationale: Painless, bright red vaginal bleeding in the third trimester is a classic presentation of
placenta previa. Placental abruption typically presents with painful bleeding and a rigid, tender
abdomen. Uterine rupture is associated with severe pain and fetal distress, and cervical
insufficiency typically presents earlier in pregnancy.
5. A nurse is caring for a client receiving magnesium sulfate for preeclampsia. Which assessment
finding indicates magnesium toxicity?
A) Respiratory rate of 16 breaths/min
B) Blood pressure of 130/80 mm Hg
C) Absent deep tendon reflexes
D) Urine output of 50 mL/hr
Correct Answer: Absent deep tendon reflexes
Rationale: Absent deep tendon reflexes are a sign of magnesium sulfate toxicity, along with
respiratory depression and decreased urine output. The nurse should stop the infusion and
notify the provider immediately. A respiratory rate of 16, blood pressure of 130/80, and urine
output of 50 mL/hr are within normal limits.
6. A nurse is teaching a client about the expected changes in lochia during the postpartum
period. Which description is correct for lochia serosa?
A) Bright red discharge lasting 1 to 3 days
B) Pinkish-brown discharge lasting 4 to 10 days
C) Yellowish-white discharge lasting 10 to 14 days
D) Dark red discharge lasting 2 to 4 weeks
, Correct Answer: Pinkish-brown discharge lasting 4 to 10 days
Rationale: Lochia serosa is the second stage of lochia, occurring approximately 4 to 10 days
postpartum. It is pinkish-brown in color and consists of serous exudate, leukocytes, and debris.
Lochia rubra is bright red and occurs in the first 1 to 3 days, while lochia alba is yellowish-white
and occurs after 10 days.
7. A nurse is assessing a newborn who was born at 42 weeks of gestation. Which finding is most
consistent with postmaturity?
A) Abundant vernix caseosa
B) Lanugo covering the body
C) Dry, cracked, peeling skin
D) Excessive subcutaneous fat
Correct Answer: Dry, cracked, peeling skin
Rationale: Postmature newborns (born after 42 weeks) often have dry, cracked, peeling skin due
to decreased vernix and lanugo. They may also have long nails, meconium staining, and a thin
appearance. Abundant vernix and lanugo are seen in preterm newborns.
8. A nurse is caring for a client in the active phase of the first stage of labor. Which finding
indicates that the client is progressing normally?
A) Cervical dilation from 4 to 7 cm
B) Cervical dilation from 8 to 10 cm
C) Complete cervical dilation with urge to push
D) Delivery of the placenta
