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Diagnostic Exam Level 4
TopRank | Comprehensive
Review Test, Practice
Questions & Answer Guide
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DIAGNOSTIC EXAM (LEVEL 4)
1. Nurse would suspect an ectopic pregnancy if the client complained of:
A. An adherent painful ovarian mass
B. lower abdominal cramping for a long period of time.
C. Leukorrhea and dysuria a few days after the first missed period
D. Sharp lower right or left abdominal pain radiating to the shoulder.
2. A client who has missed two menstrual cycle period comes to the prenatal clinic complaining of
vaginal bleeding and one-sided lower-quadrant pain. The nurse suspects that this client has.
A. Abruptio placentae
B. An ectopic pregnancy
C. An incomplete abortion
D. A rupture of a graafian follicle.
3. Variable decelerations indicates:
A. cord compression
B. placental insufficiency
C. fetal head compression
D. hypoxia
4. Late deceleration indicates:
A. cord compression
B. placental insufficiency
C. fetal head compression
D. hypoxia
5. Early deceleration indicates:
A. cord compression
B. placental insufficiency
C. fetal head compression
D. hypoxia
6. Blood therapeutic level of magnesium So4?
A. 1.3 – 2.1 mEq/L
B. 0.5 – 1 meq/L
C. 1.3 – 5meq/L
D. 0.5 – 2 meq/L
7. A client is on Magnesium So4 therapy for severe preeclampsia. The nurse must be alert for the
first sign of an excessive blood magnesium level which is:
A. Disturbance in sensorium
B. Increased in respiratory rate
6/15/2026, 2:12:04 PM TOPRANK_DIAGNOSTIC_EXAM.docx.pdf TOPRANK_DIAGNOSTIC_EXAM.docx.pdf
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C. Development of cardiac dysrythmia
D. Disappearance of the knee-jerk reflex
Situation: Diane is arrived to the labor and delivery area in labor. She complains of regular
uterine contractions with 8 to 10 minutes interval and states that her bag of water has been
ruptured. The fetus is in a left occiput anterior position (LOA).
8. The nurse’s first action should be to:
A. check the FHR
B. start IV fluid as ordered
C. call the physician
D. place to lying position
9. Which procedure would best determine if Diane’s BOW has ruptured
A. A complete blood count
B. Nitrazine Paper test
C. Urinalysis
D. Vaginal examination
10. Initial assessment done and revealed the following FH = 30cm, FHT 145bpm, BP =110/70
mmHg. IE done by Dr. Mar and revealed 4 cm cervical dilatation. Diane asked for Demerol. The
nurse’s best response is:
A. “Try to wait until you really need it.”
B. “It is too early in your labor; medication will retard progress of uterine contraction.”
C. “I know you are in pain. I’ll just prepare the medication.”
D. “Perhaps a change in position will make you more comfortable.”
11. The pregnant woman ask “When does the heart and the brain of the baby form”. The best
response made by the nurse is:
A. First month
B. Second month
C. Third month
D. Fourth month
12. When the client is only 15 years old, the nurse caring for such client during labor process
should assess the client for signs of:
A. uterine atony
B. cephalo-pelvic disproportion
C. rapid second stage of labor
D. early deceleration pattern
13. Due to hyperventilation ,the nurse should assess the client for signs and symptom of:
A. metabolic alkalosis
B. metabolic acidosis
C. respiratory acidosis
6/15/2026, 2:12:04 PM TOPRANK_DIAGNOSTIC_EXAM.docx.pdf TOPRANK_DIAGNOSTIC_EXAM.docx.pdf
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D. respiratory alkalosis
14. The client experiences severe back pain the nurse should instruct that her severe back pain is
cause by what fetal position?
A. oblique
B. transverse
C. posterior
D. anterior
15. The client calls out the nurse, ”the baby is coming” the nurse first action is:
A. inspect the perineum
B. open the emergency delivery box
C. auscultate the heart sound
D. contact the birth attendant
16. To help the client remain calm and cooperative during imminent delivery, the nurse should tell
the client:
A. ”you are right the baby is coming”
B. ”do you want to help me get you through this”
C. “your doctor will see you soon”
D. ”ill explain what’s happening”
17. The nurse is caring to woman in active labor. Which information is most important to assess in
order to prevent the complication during labor and delivery.
A. family history of lung illness
B. food allergies
C. number of cigarette smoked per month
D. last food intake
18. When the bag of water rupture’s, the nurse should expect to see?
A. a large amount of bloody fluid
B. a moderate amount of clear to straw-colored
C. a small segment of umbilical cord
D. greenish fliud
19. When bag of water rupture, the nurse first action is?
A. notify the physician
B. measure the amount of fluid
C. monitor fetal heart tone
D. perform vaginal examination
6/15/2026, 2:12:04 PM TOPRANK_DIAGNOSTIC_EXAM.docx.pdf TOPRANK_DIAGNOSTIC_EXAM.docx.pdf
a.com/user/assistant
Diagnostic Exam Level 4
TopRank | Comprehensive
Review Test, Practice
Questions & Answer Guide
https://www.stuvia.com/user/assistanthttps://www.stuvia.com/user/assistanthttps://www.stuvi
a.com/user/assistanthttps://www.stuvia.com/user/assistant
,TOPRANK_DIAGNOSTIC_EXAM.docx.pdf TOPRANK_DIAGNOSTIC_EXAM.docx.pdf 6/15/2026, 2:12:01 PM
DIAGNOSTIC EXAM (LEVEL 4)
1. Nurse would suspect an ectopic pregnancy if the client complained of:
A. An adherent painful ovarian mass
B. lower abdominal cramping for a long period of time.
C. Leukorrhea and dysuria a few days after the first missed period
D. Sharp lower right or left abdominal pain radiating to the shoulder.
2. A client who has missed two menstrual cycle period comes to the prenatal clinic complaining of
vaginal bleeding and one-sided lower-quadrant pain. The nurse suspects that this client has.
A. Abruptio placentae
B. An ectopic pregnancy
C. An incomplete abortion
D. A rupture of a graafian follicle.
3. Variable decelerations indicates:
A. cord compression
B. placental insufficiency
C. fetal head compression
D. hypoxia
4. Late deceleration indicates:
A. cord compression
B. placental insufficiency
C. fetal head compression
D. hypoxia
5. Early deceleration indicates:
A. cord compression
B. placental insufficiency
C. fetal head compression
D. hypoxia
6. Blood therapeutic level of magnesium So4?
A. 1.3 – 2.1 mEq/L
B. 0.5 – 1 meq/L
C. 1.3 – 5meq/L
D. 0.5 – 2 meq/L
7. A client is on Magnesium So4 therapy for severe preeclampsia. The nurse must be alert for the
first sign of an excessive blood magnesium level which is:
A. Disturbance in sensorium
B. Increased in respiratory rate
6/15/2026, 2:12:04 PM TOPRANK_DIAGNOSTIC_EXAM.docx.pdf TOPRANK_DIAGNOSTIC_EXAM.docx.pdf
,TOPRANK_DIAGNOSTIC_EXAM.docx.pdf TOPRANK_DIAGNOSTIC_EXAM.docx.pdf 6/15/2026, 2:12:01 PM
C. Development of cardiac dysrythmia
D. Disappearance of the knee-jerk reflex
Situation: Diane is arrived to the labor and delivery area in labor. She complains of regular
uterine contractions with 8 to 10 minutes interval and states that her bag of water has been
ruptured. The fetus is in a left occiput anterior position (LOA).
8. The nurse’s first action should be to:
A. check the FHR
B. start IV fluid as ordered
C. call the physician
D. place to lying position
9. Which procedure would best determine if Diane’s BOW has ruptured
A. A complete blood count
B. Nitrazine Paper test
C. Urinalysis
D. Vaginal examination
10. Initial assessment done and revealed the following FH = 30cm, FHT 145bpm, BP =110/70
mmHg. IE done by Dr. Mar and revealed 4 cm cervical dilatation. Diane asked for Demerol. The
nurse’s best response is:
A. “Try to wait until you really need it.”
B. “It is too early in your labor; medication will retard progress of uterine contraction.”
C. “I know you are in pain. I’ll just prepare the medication.”
D. “Perhaps a change in position will make you more comfortable.”
11. The pregnant woman ask “When does the heart and the brain of the baby form”. The best
response made by the nurse is:
A. First month
B. Second month
C. Third month
D. Fourth month
12. When the client is only 15 years old, the nurse caring for such client during labor process
should assess the client for signs of:
A. uterine atony
B. cephalo-pelvic disproportion
C. rapid second stage of labor
D. early deceleration pattern
13. Due to hyperventilation ,the nurse should assess the client for signs and symptom of:
A. metabolic alkalosis
B. metabolic acidosis
C. respiratory acidosis
6/15/2026, 2:12:04 PM TOPRANK_DIAGNOSTIC_EXAM.docx.pdf TOPRANK_DIAGNOSTIC_EXAM.docx.pdf
, TOPRANK_DIAGNOSTIC_EXAM.docx.pdf TOPRANK_DIAGNOSTIC_EXAM.docx.pdf 6/15/2026, 2:12:01 PM
D. respiratory alkalosis
14. The client experiences severe back pain the nurse should instruct that her severe back pain is
cause by what fetal position?
A. oblique
B. transverse
C. posterior
D. anterior
15. The client calls out the nurse, ”the baby is coming” the nurse first action is:
A. inspect the perineum
B. open the emergency delivery box
C. auscultate the heart sound
D. contact the birth attendant
16. To help the client remain calm and cooperative during imminent delivery, the nurse should tell
the client:
A. ”you are right the baby is coming”
B. ”do you want to help me get you through this”
C. “your doctor will see you soon”
D. ”ill explain what’s happening”
17. The nurse is caring to woman in active labor. Which information is most important to assess in
order to prevent the complication during labor and delivery.
A. family history of lung illness
B. food allergies
C. number of cigarette smoked per month
D. last food intake
18. When the bag of water rupture’s, the nurse should expect to see?
A. a large amount of bloody fluid
B. a moderate amount of clear to straw-colored
C. a small segment of umbilical cord
D. greenish fliud
19. When bag of water rupture, the nurse first action is?
A. notify the physician
B. measure the amount of fluid
C. monitor fetal heart tone
D. perform vaginal examination
6/15/2026, 2:12:04 PM TOPRANK_DIAGNOSTIC_EXAM.docx.pdf TOPRANK_DIAGNOSTIC_EXAM.docx.pdf
