1. A nurse is providing care for a pregnant client who is 12 weeks gestation.
Which of the following findings would the nurse report to the healthcare
provider immediately?
a) Mild, intermittent cramping b) A small amount of vaginal discharge c) Light bleeding with
mild discomfort d) Heavy vaginal bleeding with severe cramping
Answer: d) Heavy vaginal bleeding with severe cramping
Rationale: Heavy vaginal bleeding with severe cramping may indicate a miscarriage or ectopic
pregnancy and requires immediate medical intervention.
2. A client in labor is experiencing intense contractions every 2 minutes. The
nurse assesses the fetal heart rate and notes variable decelerations. What is the
nurse’s first priority?
a) Administer oxygen to the mother b) Increase the rate of intravenous fluids c) Prepare for
emergency cesarean delivery d) Position the mother on her left side
Answer: d) Position the mother on her left side
Rationale: Positioning the mother on her left side can relieve pressure on the umbilical cord,
which may help resolve variable decelerations and improve fetal heart rate patterns.
3. A nurse is assessing a postpartum client. The nurse notes that the client’s
uterus is boggy and displaced to the right. What action should the nurse take
first?
a) Massage the uterus b) Administer an oxytocic medication c) Increase the rate of intravenous
fluids d) Assist the client to the bathroom to void
Answer: d) Assist the client to the bathroom to void
Rationale: A boggy uterus that is displaced to the right can indicate bladder distention. Assisting
the client to void should be the first step before massaging the uterus.
4. A client has just delivered a healthy newborn. The nurse notes that the
newborn’s respiratory rate is 50 breaths per minute and the heart rate is 90
beats per minute. What should the nurse do next?
, a) Administer oxygen to the newborn b) Suction the newborn’s airways c) Stimulate the newborn
to cry d) Start resuscitation efforts
Answer: c) Stimulate the newborn to cry
Rationale: A newborn with a heart rate of 90 beats per minute and a respiratory rate of 50 is not
in immediate distress. Gentle stimulation (e.g., rubbing the back) can help stimulate breathing.
5. A nurse is teaching a pregnant client about managing morning sickness.
Which statement by the client indicates an understanding of the teaching?
a) “I should avoid eating until my nausea completely goes away.” b) “It helps to eat small meals
throughout the day instead of three large meals.” c) “I can lie down after eating to prevent
nausea.” d) “I should drink lots of caffeinated beverages to reduce nausea.”
Answer: b) “It helps to eat small meals throughout the day instead of three large meals.”
Rationale: Eating small, frequent meals can help manage nausea and vomiting during
pregnancy. Lying down after eating or drinking caffeinated beverages is not recommended.
6. A nurse is caring for a postpartum client who is breastfeeding. Which of the
following should the nurse recommend to help prevent nipple pain and cracking?
a) Apply a topical ointment before each feeding b) Ensure the baby is latched properly c) Feed
the baby less frequently to allow the nipples to heal d) Use a breast shield to protect the nipples
Answer: b) Ensure the baby is latched properly
Rationale: Proper latch is key to preventing nipple pain and cracking. It ensures efficient milk
transfer and minimizes trauma to the nipples.
7. A nurse is assessing a newborn immediately after delivery. Which of the
following findings should the nurse report to the healthcare provider?
a) Respiratory rate of 40 breaths per minute b) Heart rate of 110 beats per minute c)
Acrocyanosis of the hands and feet d) Grunting with every exhalation
Answer: d) Grunting with every exhalation
Which of the following findings would the nurse report to the healthcare
provider immediately?
a) Mild, intermittent cramping b) A small amount of vaginal discharge c) Light bleeding with
mild discomfort d) Heavy vaginal bleeding with severe cramping
Answer: d) Heavy vaginal bleeding with severe cramping
Rationale: Heavy vaginal bleeding with severe cramping may indicate a miscarriage or ectopic
pregnancy and requires immediate medical intervention.
2. A client in labor is experiencing intense contractions every 2 minutes. The
nurse assesses the fetal heart rate and notes variable decelerations. What is the
nurse’s first priority?
a) Administer oxygen to the mother b) Increase the rate of intravenous fluids c) Prepare for
emergency cesarean delivery d) Position the mother on her left side
Answer: d) Position the mother on her left side
Rationale: Positioning the mother on her left side can relieve pressure on the umbilical cord,
which may help resolve variable decelerations and improve fetal heart rate patterns.
3. A nurse is assessing a postpartum client. The nurse notes that the client’s
uterus is boggy and displaced to the right. What action should the nurse take
first?
a) Massage the uterus b) Administer an oxytocic medication c) Increase the rate of intravenous
fluids d) Assist the client to the bathroom to void
Answer: d) Assist the client to the bathroom to void
Rationale: A boggy uterus that is displaced to the right can indicate bladder distention. Assisting
the client to void should be the first step before massaging the uterus.
4. A client has just delivered a healthy newborn. The nurse notes that the
newborn’s respiratory rate is 50 breaths per minute and the heart rate is 90
beats per minute. What should the nurse do next?
, a) Administer oxygen to the newborn b) Suction the newborn’s airways c) Stimulate the newborn
to cry d) Start resuscitation efforts
Answer: c) Stimulate the newborn to cry
Rationale: A newborn with a heart rate of 90 beats per minute and a respiratory rate of 50 is not
in immediate distress. Gentle stimulation (e.g., rubbing the back) can help stimulate breathing.
5. A nurse is teaching a pregnant client about managing morning sickness.
Which statement by the client indicates an understanding of the teaching?
a) “I should avoid eating until my nausea completely goes away.” b) “It helps to eat small meals
throughout the day instead of three large meals.” c) “I can lie down after eating to prevent
nausea.” d) “I should drink lots of caffeinated beverages to reduce nausea.”
Answer: b) “It helps to eat small meals throughout the day instead of three large meals.”
Rationale: Eating small, frequent meals can help manage nausea and vomiting during
pregnancy. Lying down after eating or drinking caffeinated beverages is not recommended.
6. A nurse is caring for a postpartum client who is breastfeeding. Which of the
following should the nurse recommend to help prevent nipple pain and cracking?
a) Apply a topical ointment before each feeding b) Ensure the baby is latched properly c) Feed
the baby less frequently to allow the nipples to heal d) Use a breast shield to protect the nipples
Answer: b) Ensure the baby is latched properly
Rationale: Proper latch is key to preventing nipple pain and cracking. It ensures efficient milk
transfer and minimizes trauma to the nipples.
7. A nurse is assessing a newborn immediately after delivery. Which of the
following findings should the nurse report to the healthcare provider?
a) Respiratory rate of 40 breaths per minute b) Heart rate of 110 beats per minute c)
Acrocyanosis of the hands and feet d) Grunting with every exhalation
Answer: d) Grunting with every exhalation