Maternity / OB

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Sample questions from Maternity / OB

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 24-year-old G1P0 at 34 weeks is seen in the prenatal clinic. Her blood pressure is 164/110 mm Hg on repeat measurement, urine protein-to-creatinine ratio is 0.5, and she reports a persistent headache. Which action should the nurse take first?

   • A.Arrange immediate evaluation in labor and delivery
   • B.Schedule a routine blood pressure check in 1 week
   • C.Encourage oral fluids and rest at home
   • D.Teach her to reduce dietary sodium

   Rationale: Severe-range blood pressure with proteinuria and a persistent headache suggests preeclampsia with severe features and requires urgent maternal-fetal evaluation. A routine follow-up or home rest delays assessment and treatment, while sodium restriction does not manage an acute hypertensive emergency. The exam priority is prompt escalation for severe maternal symptoms.

2. 2.A 29-year-old G2P1 at 35 weeks is admitted with severe preeclampsia and is receiving magnesium sulfate. Her respiratory rate is 10/min, patellar reflexes are absent, and urine output is 20 mL/hr. What should the nurse do first?

   • A.Stop the magnesium sulfate infusion
   • B.Increase the infusion rate to prevent seizures
   • C.Place the client supine and reassess in 30 minutes
   • D.Administer the next scheduled antihypertensive medication

   Rationale: Respiratory depression, absent reflexes, and oliguria indicate possible magnesium toxicity, so the infusion should be stopped immediately. Increasing magnesium worsens toxicity, and delaying intervention for reassessment or another medication is unsafe. The nurse should then notify the provider and anticipate calcium gluconate per protocol.

3. 3.A 26-year-old client at 30 weeks arrives at the emergency department with painless bright-red vaginal bleeding. Blood pressure is 118/72 mm Hg, pulse is 92/min, and fetal heart rate is 145/min. What action is appropriate?

   • A.Perform a digital vaginal examination to assess dilation
   • B.Place the client on fetal monitoring and avoid vaginal examination
   • C.Encourage ambulation to determine whether bleeding increases
   • D.Begin oxytocin to stimulate labor

   Rationale: Painless bright-red bleeding raises concern for placenta previa, and fetal monitoring is appropriate while the condition is evaluated. A digital vaginal examination can disrupt the placenta and cause severe hemorrhage. Ambulation and oxytocin are not appropriate before the source of bleeding is established.

4. 4.A 32-year-old G3P2 at 37 weeks reports sudden severe abdominal pain and vaginal bleeding. Her uterus is firm and tender, blood pressure is 88/54 mm Hg, pulse is 124/min, and fetal heart rate is 90/min. Which action is the priority?

   • A.Prepare for emergency birth while initiating maternal resuscitation
   • B.Perform a vaginal examination to determine cervical dilation
   • C.Apply warm packs to the abdomen and reassess in 1 hour
   • D.Administer an oral analgesic and encourage side-lying rest

   Answer and rationale are in the full material.

5. 5.A 22-year-old client at 10 weeks' gestation reports persistent vomiting and inability to keep fluids down. She has dry mucous membranes, a pulse of 112/min, and urine ketones. Which prescription should the nurse anticipate first?

   • A.IV isotonic fluid replacement
   • B.A high-fiber diet and increased walking
   • C.Oral iron supplementation with meals
   • D.Fluid restriction until vomiting stops

   Answer and rationale are in the full material.