REFRESHER PHASE

POST TEST
OBSTETRIC NURSING
Prepared By: PROF. KENNETH ARZADON
NOV 2023 Philippine Nurse Licensure Examination Review
7. During the physical assessment on a pregnant woman on
1. A pregnant woman the nurse she doesn’t know whether her late 20’s, the nurse notes the uterus is firm under the
she’s ready to have another baby, even though this was a abdominal wall just in line with the umbilicus. Approximately
planned pregnancy. Which response should the nurse offer? what week of gestation is the client in:
A. “You may want to discuss these concerns with a social A. 20th week
worker.” B. 22nd week
B. “You’re feeling ambivalent, which is normal during the C. 36th week
first trimester.” D. 12th week
C. “You need to share these feelings with your partner.” 8. A woman 19 weeks pregnant, has been admitted to the
D. “You may want to consider having an abortion.” emergency department following. Contractions are noted
2. A 9-week primigravida client asks you, “Is it possible for me which lasted 35 seconds, and cervix dilated at 7cm. She has
to listen to my baby’s fetal heart beat?” Which of the following passed tissue fragments and no fetal heart was heard upon
responses by the nurse would be appropriate? auscultation. Obstetrical history tells that he had a previous
A. “We can listen to your baby’s heart beat with a cesarean section 3 years ago due to placenta previa @ 38th
Doppler but we still have to wait for additional 4 week AOG giving birth to a small-for-gestational age infant.
weeks.” Her first pregnancy successfully ended via normal spontaneous
B. “Fetoscope is best used during the 16th week of your vaginal delivery @ 37 weeks giving birth to twins. What is her
pregnancy to listen to the baby’s heart beat.” obstetrical score?
C. “The heart beats 8 weeks before delivery so I don’t A. G-3, T-2, P-1, A-0, L-2
think you can listen to it now.” B. G-3, T-2, P-0, A-1, L-2
D. “Your obstetrician would probably use the Doppler to C. G-2, T-2, P-1, A-0, L-2
check for fetal heart tones, she may let you listen to D. G-3, T-3, P-0, A-1, L-3
it.” 9. Emergency nursing interventions for a 16-week pregnancy
3. A primigravida client, 24 y/o, 18 weeks AOG verbalized her woman who is suspected to have a miscarriage would include
concern, “Why is my baby not yet moving, my neighbor who is all but one of the following :
also pregnant for the second time says she felt her baby move A. Withhold oral fluids
yesterday. We have the same AOG, I’m afraid there is B. Save perineal pads and any tissue passed
something wrong with my baby!” what would be your best C. Ensure adequate hydration by letting mother drink
response: plenty of fluids to prevent dehydration
A. “Quickening is usually felt by first-time mothers a D. Monitor uterine contractions and fetal heart rate
week before delivery.” 10. Early detection of an ectopic pregnancy is paramount in
B. “Don’t worry everything is alright.” preventing a life-threatening rupture. Which symptoms should
C. “Normally for a primigravida client like you will feel alert the nurse to the possibility of an ectopic pregnancy?
the first movement on the 20th week” A. Unilateral lower abdominal tenderness and a positive
D. “You’re overreacting ma’am, that might harm the pregnancy test
baby.” B. Hyperemesis and weight loss
4. During their rotation in the OB ward, a student nurse was C. Amenorrhea and a negative pregnancy test
asked by her clinical instructor about the changes in a woman’s D. Copious discharge of clear mucous and prolonged
body during pregnancy. The student nurse is aware that a epigastric pain
common adaptation during pregnancy would be: 11. The characteristic manifestation of gestation trophoblastic
A. Hypoventilation disease is:
B. Increased pH of the vagina A. Uterus tends to expand faster than a normal
C. Decreased gastrointestinal motility pregnancy
D. Decreased glomerular filtration rate B. Lower abdominal quadrant pain
5. All but one are principles in identifying parity: C. Emesis Gravidarum
A. Stillbirth is counted D. An HCG level of 400,000 IU
B. Count the number of fetus delivered before 20 weeks 12. Which of the following discharge instructions must be
C. Count the number of pregnancy that reached 20 given to a woman who has just undergone suction and
weeks AOG and subsequently delivered dead or alive curettage for gestational trophoblstic disease?
D. Multiple pregnancy is considered as one parity A. “Visit your physician after one year for a follow-up
6. Suppose the primigravida woman had her last menstrual examination to find out if there is still a possibility
period for 4 days and the menstrual flow ended May 5, 2021. that get pregnant.”
What would be her expected date of confinement? B. “Women who has had molar pregnancy must avoid
A. February 5, 2022 sexual intercourse for a year or two.”
B. February 9, 2022 C. “HCG levels usually return to normal 48 hours after
C. January 29, 2022 evacuation.”
D. January 5, 2022 D. “Use a reliable contraceptive method for 12 months.”

13. A 34 y/o client is 34 weeks pregnant and is experiencing

bleeding caused by placenta previa. The fetal heart sounds are

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normal and the client isn’t in labor. Which of the following C. Help the client into the lithotomy position for delivery.
interventions should the nurse perform? D. Notify the physician and surgical team of an
A. Allow the client to ambulate with assistance emergency.
B. Perform an internal examination to check for cervical 23. EINC practices during intrapartum period consists of
dilatation measures that, based on scientific evidence, are necessary for
C. Do perineal pad count safe and quality care of woman during childbirth. Which is NOT
D. Notify the physician of FHT of 130 bpm recommended?
14. A nurse is assigned to care for a client with hypotonic A. Freedom of movement during labor
uterine dysfunction and signs of a slowing labor. The midwife is B. Monitoring progress of labor using the partograph
reviewing the physician’s order and would expect to note which C. Routine episiotomy
of the following prescribed treatments for this condition? D. Non-routine episiotomy
A. Increase hydration 24. Essential newborn care within the first 30 seconds after
B. Oxytocin (Pitocin) infusion birth includes:
C. Medication that will provide sedation A. Cord clamping and cutting
D. Administration of a tocolytic medication B. Immediate breastfeeding
15. The nurse is developing a plan of care for a client in her C. Drying and providing warmth to the newborn
34th week of gestation who's experiencing premature labor. D. Administration of Vitamin K prophylaxis
What non-pharmacologic intervention should the plan include 25. Essential non-immediate newborn care from 90 minutes to
to halt premature labor? 6 hours includes all the following EXCEPT:
A. Encouraging ambulation A. Administration of Hep B Vaccine
B. Serving a nutritious diet B. Administration of Tetanus Toxoid
C. Promoting adequate hydration C. Administration of BCG Vaccine
D. Performing nipple stimulation D. Administration of Vit K prophylaxis
16. A client at 28 weeks’ gestation is complaining of
contractions. Following admission and hydration, physician
writes an order for the nurse to give 12 mg of betamethasone
I.M. The nurse should explain that this medication is given to:
A. Slow contraction
B. Enhance fetal growth
C. Prevent infection
D. Promote fetal lung maturity
17. The nurse would best position a pregnant woman with
prolapsed umbillical cord to:
A. Supine position with hips elevated on a pillow
B. Exaggerated Sim’s Lateral Position
C. Right Side lying position
D. Prone position turned to the side
18. During a contraction stress test, a decrease in the fetal
heart rate occurs with the onset of contractions. The best
nursing action would be to:
A. Reposition the client
B. Continue monitoring the client
C. Stop oxytocin administration
D. Notify the physician
19. A nurse is monitoring a client labor. The nurse suspects
umbilical cord compression if which of the following is noted on
the external monitor tracing during a contraction?
A. Late decelerations
B. Early decelerations
C. Short-term variability
D. Variable decelerations
20. A nurse in the labor room is caring for a client in the active
phases of labor. The nurse is assessing the fetal patterns and
notes a late deceleration on the monitor strip. The most
appropriate nursing action is to:
A. Place the mother in the supine position and
administer magnesium sulfate
B. Document the findings and continue to monitor the
fetal patterns
C. Stop oxytocin administration, reposition the woman,
administer oxygen via face mask and notify the
physician
D. Increase the rate of Pitocin IV infusion
21. A nurse is assessing the fundus in a postpartum woman
and notes that the uterus is soft and spongy and not firmly
contracted. The midwife prepares to implement which of the
following interventions EXCEPT:
A. Massaging the uterus
B. Assisting the woman to urinate
C. Checking for distended bladder
D. Administration of ritodrine hydrochloride
22. A primigravid client is admitted to the labor and delivery
area. Assessment reveals fetal malpresentation, yellow
amniotic fluid, and a fetal heart rate (FHR) of 80 beats/minute.
What should the nurse do?
A. Increase the I.V. oxytocin flow rate, as ordered, to
hasten labor and delivery.
B. Reassess the client for continued normal findings in
15 minutes.

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