OB EXAM 2 PREP 2026-200 Practice Questions & Detailed Answers |
Updated Rated A+ | Verified Solutions
SECTION 1: ANTEPARTUM CARE & ASSESSMENT
Question 1
A client at 34 weeks gestation presents with a blood pressure of 158/102 mmHg and 3+ proteinuria on
dipstick. Which of the following laboratory findings would most strongly suggest severe preeclampsia
with features of HELLP syndrome?
A) Platelet count 150,000/µL, AST 45 U/L, LDH 300 U/L
B) Platelet count 80,000/µL, AST 120 U/L, LDH 700 U/L
C) Platelet count 200,000/µL, AST 30 U/L, LDH 200 U/L
D) Platelet count 50,000/µL, AST 250 U/L, LDH 1,200 U/L
Answer: B) Platelet count 80,000/µL, AST 120 U/L, LDH 700 U/L
Rationale: HELLP syndrome is characterized by microangiopathic hemolytic anemia (elevated LDH >600
U/L), elevated liver enzymes (AST >70 U/L), and low platelets (<100,000/µL). Option B shows moderate
thrombocytopenia and elevated AST/LDH, consistent with HELLP. Option D has more severe values but
is less specific for the classic HELLP triad. Options A and C are normal or nearnormal.
Question 2
A pregnant individual at 28 weeks gestation presents with a blood pressure of 155/100 mmHg and 2+
proteinuria on dipstick. Which of the following findings would most strongly suggest the diagnosis of
preeclampsia with severe features rather than gestational hypertension?
A) Platelet count of 120,000/µL
B) Serum creatinine 0.9 mg/dL
C) AST 45 U/L
D) Urine proteintocreatinine ratio of 0.2
,Answer: A) Platelet count of 120,000/µL
Rationale: Severe preeclampsia is characterized by severerange blood pressure and either
thrombocytopenia (platelets <100,000/µL), impaired liver function (AST >70 U/L), renal insufficiency
(creatinine >1.1 mg/dL), or pulmonary edema. A platelet count of 120,000 is below the normal range
and, in the context of hypertension and proteinuria, suggests severe preeclampsia.
Question 3
A client at 16 weeks gestation with a history of recurrent pregnancy loss is found to have a cervical
length of 22 mm on transvaginal ultrasound. According to current guidelines, what is the most
appropriate next step?
A) Initiate vaginal progesterone 200 mg daily
B) Perform cervical cerclage immediately
C) Repeat cervical length measurement in 2 weeks
D) Administer betamethasone for fetal lung maturity
Answer: A) Initiate vaginal progesterone 200 mg daily
Rationale: In patients with a history of spontaneous preterm birth, a cervical length ≤25 mm before 24
weeks is an indication for vaginal progesterone to reduce preterm birth risk. Cerclage is reserved for
those with a prior preterm birth and cervical length <25 mm, but current guidelines recommend
progesterone first. Betamethasone is not indicated until viability (24 weeks).
Question 4
A client arrives to the clinic for the first prenatal assessment. She tells the nurse that the first day of her
menstrual period was October 19. Using Nagele's rule, which expected date of delivery should the nurse
document?
,A) July 12
B) July 26
C) August 12
D) August 26
Answer: B) July 26
Rationale: Nagele's rule: Subtract 3 months from the first day of the last menstrual period and add 7
days. October 19 minus 3 months = July 19; July 19 plus 7 days = July 26.
Question 5
During a routine antepartum visit at 28 weeks gestation, a client reports intermittent uterine tightening
that is painless and irregular. On examination, the cervix is closed and long. Which of the following is the
most appropriate interpretation and management?
A) These are Braxton Hicks contractions; no intervention is needed unless they become regular or
painful
B) This indicates preterm labor; prescribe bed rest and tocolytic therapy
C) This is a sign of placental abruption; order an ultrasound and fetal monitoring
D) This suggests cervical insufficiency; schedule a cerclage placement
Answer: A) These are Braxton Hicks contractions; no intervention is needed unless they become regular
or painful
Rationale: Painless, irregular contractions with a closed, long cervix at 28 weeks are characteristic of
Braxton Hicks contractions, which are normal and do not indicate preterm labor. Tocolytics, cerclage, or
abruption workup are not indicated without cervical change or other concerning features.
, Question 6
A pregnant person at 32 weeks gestation has a positive 1hour glucose challenge test (50 g) with a value
of 145 mg/dL. A 3hour oral glucose tolerance test (100 g) yields the following: fasting 95 mg/dL, 1hour
190 mg/dL, 2hour 160 mg/dL, 3hour 140 mg/dL. According to CarpenterCoustan criteria, which of the
following is correct?
A) The patient has gestational diabetes because two or more values are elevated
B) The patient does not have gestational diabetes because only one value is elevated
C) The patient has gestational diabetes because the fasting value is elevated
D) The patient requires immediate insulin therapy
Answer: A) The patient has gestational diabetes because two or more values are elevated
Rationale: According to CarpenterCoustan criteria for the 3hour OGTT, gestational diabetes is diagnosed
if two or more values meet or exceed the thresholds: fasting ≥95 mg/dL, 1hour ≥180 mg/dL, 2hour ≥155
mg/dL, 3hour ≥140 mg/dL. This patient has elevated fasting (95), 1hour (190), and 2hour (160) values.
Question 7
The nurse is assessing a pregnant client with type 1 diabetes mellitus about her understanding regarding
changing insulin needs during pregnancy. The nurse determines that FURTHER TEACHING IS NEEDED if
the client makes which statement?
A) "I will need to increase my insulin dosage during the first 3 months of pregnancy."
B) "My insulin dose will likely need to be increased during the second and third trimesters."
C) "Episodes of hypoglycemia are more likely to occur during the first 3 months of pregnancy."
D) "My insulin needs should return to normal within 710 days after birth if I am bottle feeding."
Answer: A) "I will need to increase my insulin dosage during the first 3 months of pregnancy."
Rationale: Insulin needs typically decrease during the first trimester due to increased insulin sensitivity
and the emetic effects of pregnancy. Insulin needs increase during the second and third trimesters due
to insulin resistance from placental hormones. Hypoglycemia is more common in the first trimester.
Updated Rated A+ | Verified Solutions
SECTION 1: ANTEPARTUM CARE & ASSESSMENT
Question 1
A client at 34 weeks gestation presents with a blood pressure of 158/102 mmHg and 3+ proteinuria on
dipstick. Which of the following laboratory findings would most strongly suggest severe preeclampsia
with features of HELLP syndrome?
A) Platelet count 150,000/µL, AST 45 U/L, LDH 300 U/L
B) Platelet count 80,000/µL, AST 120 U/L, LDH 700 U/L
C) Platelet count 200,000/µL, AST 30 U/L, LDH 200 U/L
D) Platelet count 50,000/µL, AST 250 U/L, LDH 1,200 U/L
Answer: B) Platelet count 80,000/µL, AST 120 U/L, LDH 700 U/L
Rationale: HELLP syndrome is characterized by microangiopathic hemolytic anemia (elevated LDH >600
U/L), elevated liver enzymes (AST >70 U/L), and low platelets (<100,000/µL). Option B shows moderate
thrombocytopenia and elevated AST/LDH, consistent with HELLP. Option D has more severe values but
is less specific for the classic HELLP triad. Options A and C are normal or nearnormal.
Question 2
A pregnant individual at 28 weeks gestation presents with a blood pressure of 155/100 mmHg and 2+
proteinuria on dipstick. Which of the following findings would most strongly suggest the diagnosis of
preeclampsia with severe features rather than gestational hypertension?
A) Platelet count of 120,000/µL
B) Serum creatinine 0.9 mg/dL
C) AST 45 U/L
D) Urine proteintocreatinine ratio of 0.2
,Answer: A) Platelet count of 120,000/µL
Rationale: Severe preeclampsia is characterized by severerange blood pressure and either
thrombocytopenia (platelets <100,000/µL), impaired liver function (AST >70 U/L), renal insufficiency
(creatinine >1.1 mg/dL), or pulmonary edema. A platelet count of 120,000 is below the normal range
and, in the context of hypertension and proteinuria, suggests severe preeclampsia.
Question 3
A client at 16 weeks gestation with a history of recurrent pregnancy loss is found to have a cervical
length of 22 mm on transvaginal ultrasound. According to current guidelines, what is the most
appropriate next step?
A) Initiate vaginal progesterone 200 mg daily
B) Perform cervical cerclage immediately
C) Repeat cervical length measurement in 2 weeks
D) Administer betamethasone for fetal lung maturity
Answer: A) Initiate vaginal progesterone 200 mg daily
Rationale: In patients with a history of spontaneous preterm birth, a cervical length ≤25 mm before 24
weeks is an indication for vaginal progesterone to reduce preterm birth risk. Cerclage is reserved for
those with a prior preterm birth and cervical length <25 mm, but current guidelines recommend
progesterone first. Betamethasone is not indicated until viability (24 weeks).
Question 4
A client arrives to the clinic for the first prenatal assessment. She tells the nurse that the first day of her
menstrual period was October 19. Using Nagele's rule, which expected date of delivery should the nurse
document?
,A) July 12
B) July 26
C) August 12
D) August 26
Answer: B) July 26
Rationale: Nagele's rule: Subtract 3 months from the first day of the last menstrual period and add 7
days. October 19 minus 3 months = July 19; July 19 plus 7 days = July 26.
Question 5
During a routine antepartum visit at 28 weeks gestation, a client reports intermittent uterine tightening
that is painless and irregular. On examination, the cervix is closed and long. Which of the following is the
most appropriate interpretation and management?
A) These are Braxton Hicks contractions; no intervention is needed unless they become regular or
painful
B) This indicates preterm labor; prescribe bed rest and tocolytic therapy
C) This is a sign of placental abruption; order an ultrasound and fetal monitoring
D) This suggests cervical insufficiency; schedule a cerclage placement
Answer: A) These are Braxton Hicks contractions; no intervention is needed unless they become regular
or painful
Rationale: Painless, irregular contractions with a closed, long cervix at 28 weeks are characteristic of
Braxton Hicks contractions, which are normal and do not indicate preterm labor. Tocolytics, cerclage, or
abruption workup are not indicated without cervical change or other concerning features.
, Question 6
A pregnant person at 32 weeks gestation has a positive 1hour glucose challenge test (50 g) with a value
of 145 mg/dL. A 3hour oral glucose tolerance test (100 g) yields the following: fasting 95 mg/dL, 1hour
190 mg/dL, 2hour 160 mg/dL, 3hour 140 mg/dL. According to CarpenterCoustan criteria, which of the
following is correct?
A) The patient has gestational diabetes because two or more values are elevated
B) The patient does not have gestational diabetes because only one value is elevated
C) The patient has gestational diabetes because the fasting value is elevated
D) The patient requires immediate insulin therapy
Answer: A) The patient has gestational diabetes because two or more values are elevated
Rationale: According to CarpenterCoustan criteria for the 3hour OGTT, gestational diabetes is diagnosed
if two or more values meet or exceed the thresholds: fasting ≥95 mg/dL, 1hour ≥180 mg/dL, 2hour ≥155
mg/dL, 3hour ≥140 mg/dL. This patient has elevated fasting (95), 1hour (190), and 2hour (160) values.
Question 7
The nurse is assessing a pregnant client with type 1 diabetes mellitus about her understanding regarding
changing insulin needs during pregnancy. The nurse determines that FURTHER TEACHING IS NEEDED if
the client makes which statement?
A) "I will need to increase my insulin dosage during the first 3 months of pregnancy."
B) "My insulin dose will likely need to be increased during the second and third trimesters."
C) "Episodes of hypoglycemia are more likely to occur during the first 3 months of pregnancy."
D) "My insulin needs should return to normal within 710 days after birth if I am bottle feeding."
Answer: A) "I will need to increase my insulin dosage during the first 3 months of pregnancy."
Rationale: Insulin needs typically decrease during the first trimester due to increased insulin sensitivity
and the emetic effects of pregnancy. Insulin needs increase during the second and third trimesters due
to insulin resistance from placental hormones. Hypoglycemia is more common in the first trimester.
