1. A client arrives at a birthing center in active labor.

During assessment, it shows that her membranes

are still intact, and the obstetrician orders to prepare for an amniotomy procedure. The nurse assisting
the obstetrician explain to the client that after this procedure, she will most like have
A. Decreased number of contractions
B. The need for increased maternal blood pressure monitoring
C. Increased efficiency of contractions
D. Less pressure on her cervix
2. A 25-year-old client has been missing her regular mense of 5 days now. She suspects that she is
pregnant and comes to the clinic for laboratory testing. It reveals that the HCG level is 50mIU/mL, how
should the nurse interpret this result?
A. It strongly suggest that the is pregnant as increase level of HCG is a presumptive sign
B. 50mIU/mL of HCG is a negative sign of pregnancy, maybe the client is just having menstrual
irregularities and may seen her attending physician for consultation
C. It strongly suggest that the client is pregnant as increase level of HCG is a positive sign of pregnancy
D. Although the client HCG level is increase as compare to woman's that are non pregnant, the client
still need undergo other exams like ultrasound and hetal heart rate monitoring to confirm the
pregnancy, as increase level of HCG is just a probable sign
3. Jasmine had a normal vaginal delivery 12 hours ago and is to be discharged from the birthing center.
You evaluated that Jasmine understands the teaching related to the episiotomy and perineal area when
she states,
A. The ice pack should be removed for 10 minutes before replacing it.
B. The water for the Sitz bath should be warm at about 102 to 105 degree F.
C. The anesthetic spray and the heat lamp will help a lot.
D. I know the stitches will be removed at my postpartum clinic visit.
4. On a Monday morning at your Family Care Nursing Clinic, a mother of a 2-year-old postoperative child
and who has just been discharged from the hospital came appearing to be overly anxious and tells you,
My child seem so restless. Your first course of action should be
A. Check if the child's sutures are still intact
B. Check and see when the child had his last pain medication
C. Check the child's vital signs
D. Try taking the child for a walk
5. Mary Ann, 32 years old, G2P1, 28 weeks pregnant, visits your clinic and told you that she has been
having various discomforts during this pregnancy and wanted some advices.
Mary Ann complains that she does not get enough rest and sleep because of her frequent trips to the
bathroom to urinate. The best advise you can give is for her to:
A. Drink more fluids at daytime and decrease intake at night
B. Hold urge to urinate to improve muscle tone and bladdercapacity
C. Bring urine specimen for urinalysis to check for possibleinfection
D. Bring a commode to the bedroom to reduce trips to the bathroom
6. A 3 days postpartum client is under the care of Nurse Angelica. When assessing the lochia, it is
considered normal if the following is observed, except,
A. The color is red, with large particles of deciduas and mucus
B. The color is red with the same odor as menstrual blood
C. All of these are normal findings
D. The color is red and increases in amount during exertion
7. In some hospitals, nurses assigned to care for mothers with reproductive health concerns are given a
TRIAGE assignment. They rotate in the obstetrics unit or ward, the labor room, and delivery room. Your
nursing care to clients in these units is vital in maintaining the wellness of these women. You are taking
care of a woman in the labor room whose abdomen remains rigid and hard between contractions. Upon
further assessment, the fetal heart rate registered at 100 or minute. The priority problems in the care of
this client a would be,
A. Fluid and electrolyte imbalance
B. Risk for fetal death
C. Ineffective breathing
D. Alteration in comfort
8. You also have Lailani who is on her 4th Stage of Labor. Where do you palpate the fundus?
A. 3 cm below the umbilicus
B. At the umbilicus
C. To the right of the umbilicus
D. 2 cm above the umbilicus
9. In some hospitals, nurses assigned to care for mothers with reproductive health concerns are given a
TRIAGE assignment. They rotate in the obstetrics unit or ward, the labor room, and delivery room. Your
nursing care to clients in these units is vital in maintaining the wellness of these women. Your client in
labor is diagnosed with pre-eclampsia. Which interventions would be most appropriate for this client?
1. Check current intravenous administration of Magnesium Sulfate.
2. Frequently check client's telemetry monitor.
3. Assess the client's deep tendon reflexes.
4. Inform the nursery for incoming infant.
5. Administer Furosemide Lasix intravenously as ordered.
A. 1,3,4
B. 2,3,5
C. 1,2,5
D. 2,4,5
10. You are conducting a teaching session to a group of primipara clients, whose AOG are on the first
trimester. The topic is about miscarriage. You are discussing about what causes miscarriage. Which of
the following information regarding the cause of miscarriage should be included in the discussion?
A. Systemic infection
B. Implantation abnormalities
C. Abnormal fetal development
D. All of these
11. You recorded a 3+ in the molding, this means that,
A. The bones are separated and sutures can be felt easily
B. The bones are touching each other
C. The bones are severely overlapping each other
D. The bones are overlapping each other
12. In some hospitals, nurses assigned to care for mothers with reproductive health concerns are given a
TRIAGE assignment. They rotate in the obstetrics unit or ward, the labor room, and delivery room. Your
nursing care to clients in these units is vital in maintaining the wellness of these women. Of the
following clients endorsed to you by the outgoing nurse on-duty, who would you assess immediately?
The client who:
A. Cannot decide if she wants anesthesia during delivery
B. Is upset because her obstetrician is on vacation
C. Exhibits early decelerations on the fetal monitor
D. Is 10 cm dilated and 100% effaced
13. Following a spontaneous vaginal delivery of a huge healthy baby boy, the client suffered a fourth
degree laceration. During the physician rounds, the nurse reviews the recent nursing orders. Which of
the following order will the nurse clarify to the obstetrician?
A. Encourage high fiber and high fluid diet
B. Administer enema to soften stool
C. None of these
D. Administer stool softer
14. The action of hormones during pregnancy affects the body by:
A. Preventing the liver from metabolizing glycogen
B. Blocking the release of insulin from the pancreas
C. Enhancing the conversion of food to glucose
D. Raising the resistance to insulin utilization
15. A diabetic mother named Ruffa plans to breastfeed her baby. As health educator, you explained that,
if Ruffa is hyperglycemic,
A. The glucose content of her breast milk may be high.
B. The production of milk may be impaired.
C. Her baby will not grow well.
D. Her baby will receive insulin in the milk.
16. A glycosylated hemoglobin level is ordered for a pregnant diabetic because it:
A. Will predict how well the pancreas can respond to the stressof pregnancy
B. Indicates mean glucose level over a 1 to 3 month period
C. Gives diagnostic information related to the peripheral effects of diabetes
D. Is the most accurate method of determining present insulinlevels
17. You are a newly passed and registered nurse applying for a starting nursing job. While waiting, you
heard your Parish Priest calling for volunteers for a Parish-Based Health Program. You signed up to help
and practice your profession. Among the health conditions you would normally encounter are
obstetrical cases.
QUESTION: A 22-year-old mother missed 2 of her regular menstrual periods. The Parish Medical
Volunteer confirms an early, intrauterine pregnancy. This is her first pregnancy. To determine her
expected due date, which of the following assessments is most important?
A. Date of her 1st menstrual period
B. Age of menarche
C. Date of last normal menstrual period
D. Date of last intercourse
18. A 20-year-old primipara attends a class for women who plan to breastfeed. To prepare for
breastfeeding, the nurse should encourage the woman to
A. Expose their breast to air every day for 20 minutes
B. Wash their breasts with water and rub with a towel every day
C. Apply moisturizer to their breasts every day after bathing
D. Massage their breasts to increase circulation twice a day
19. You admit Stella, 34 years old, nulliparous, 38 weeks AOG. She says she had bloody show an hour
ago and was having very frequent but moderate contractions every 45 minutes, felt achy and short of
breath. Contractions slowed down and were less intense as she reached the hospital. To assess the
characteristics and pattern of uterine contractions, you will,
A. Place your hand on the abdomen below the umbilicus andpalpate uterus with fingertips
B. Assess the characteristics and pattern of uterinecontractions
C. Increase in intensity, duration, then every 10 minutes thereafter
D. Time duration of contractions from the end of one to theend of the next contraction noting interval
between contraction
20. By 12noon on the same Monday, another client, named Mrs. Nicole Angeles, attended to by Nurse
Lucy in the RHU got admitted in active labor. Nurse Nina locates the fetal heart sounds in the upper right
quadrant of the mother's abdomen. Nurse Nina would recognize which of the following?
A. Nicole will probably deliver very quickly and withoutproblems.
B. Nicole will probably have a breech delivery.
C. This position is referred to as left anteropelvic.
D. The fetus is in the most common anterior fetal position.
21. You admit Stella, 34 years old, nulliparous, 38 weeks AOG. She says she had bloody show an hour
ago and was having very frequent but moderate contractions every 45 minutes, felt achy and short of
breath.Contractions slowed down and were less intense as she reached the hospital.
Stella returns to the hospital with intense and painful contractions that come every 3-4 minutes. The
nurse does Leopold's maneuver to check fetal presentation and position in the following sequence,
1. Determine whether presenting part moves easily engaged
2. Facing the foot part of the bed, assess fetal attitude of relationship of body parts to one another
3. Palpate fetal part at the fundus and identify the presentingpart
4. Place the palms of each hand on either the side of the abdomen to locate for the fetal back
A. 3,4,1,2
B. 3,2,1,4
C. 4,3,2,1
D. 1,2,3,4
22. Mary Ann, 32 years old, G2P1, 28 weeks pregnant, visits your clinic and told you that she has been
having various discomforts during this pregnancy and wanted some advices.
Mary Ann had leg cramps that come and go and are extremely painful. The most effective measure that
you can suggest to relieve cramps is to,
A. Stand with feet flat on floor and tiptoe alternately untilcramping stops.
B. Lie down and elevate affected leg with a pillow until the cramps stop.
C. Extend affected leg with knee straight then bend foot towards the body.
D. Increase intake of high phosphorus foods.
23. Nurse Sulin Usap implements a teaching plan for a pregnant client who is newly diagnosed with
gestational diabetes mellitus. When evaluating the teaching, which comment, if made by the client
indicates a need for further teaching?
A. I should be aware of any infection and report signs of infection immediately to my health care
provider
B. I should avoid exercise because of negative effects on insulin production
C. I should perform glucose monitoring at home
D. I should stay of the diabetic diet
24. By 3pm, Nurse Nina was done with her endorsement when another mother, Mrs. Kristine De Castro,
came in active labor. She trembles intensely with contractions and quite irritable. She frequently says,
Hindi ko na kaya ito! (I can no longer bear this! ). This behavior may be indicative of the client:
A. Developing some abnormality in terms of uterine contractions
B. As having been poorly prepared for labor in the parents' classes
C. Already entering the transition phase of labor
D. Needs immediate administration of an analgesic or anesthetic
25. The nurse assesses a prolonged deceleration of the fetal heart while the client is receiving oxytocin
IV to stimulate labor. The priority nursing intervention would be to,
A. Change the fluid to LR
 B. Discontinue the infusion
C. Increase the IV flow rate
D. Turn the client to the left side
26. Mrs. Gomez is a 22-year-old woman, primigravida at 8 weeks AOG develops a deep vein thrombosis
while in the hospital on bed rest and is prescribed low-molecular-weight heparin subcutaneous. What
education will she need in relation to this?
A. Heparin does not cross the placenta and so does not affect a fetus
B. Her infant will be born with scattered petechiae on his trunk
C. Heparin can cause darkened or nonflexible skin in newborn
D. Some infants will be born with allergic symptoms to heparin
27. A 28-year-old mother has had diabetes mellitus since she was adolescent. Now, she is 8-week
pregnant. Hyperglycemia during the first trimester will have which effect on the fetus?
A. Abnormal positioning of the fetus
B. Potential malformation of the fetal organs
C. Excessive fetal size
D. Hyperinsulinemia
28. You are caring for Reyna, a multipara client who just delivered a female infant one hour ago. You
observed that Reyna's breasts are soft; the uterus boggy, to the right of the midline, and 2 cm below the
umbilicus; moderate lochia rubra. Which action is called for you to undertake with these findings?
A. Put her baby to her breast
B. Massage the uterine fundus
C. Perform a straight catheterization
D. Offer bedpan immediately
29. Jane's prenatal antibody titer shows that she is not immune to rubella and will receive the
immunization after delivery. You would include which of the following instructions in your teaching
plan?
A. An injection will be needed after each succeedingpregnancy.
B. Breastfeeding should be postponed for 5 days after the injection.
C. Another immunization should be administered in the nextpregnancy.
D. Pregnancy must be avoided for the next 3 months.
30. In some hospitals, nurses assigned to care for mothers with reproductive health concerns are given a
TRIAGE assignment. They rotate in the obstetrics unit or ward, the labor room, and delivery room. Your
nursing care to clients in these units is vital in maintaining the wellness of these women. You are
assigned to the postpartum unit or ward and you are to take care of several clients. When prioritizing
care for these clients, you will first assess the client who,
A. Has saturated several sanitary napkin during the night
B. Complains of pain and burning sensation upon urination
C. Is upset because the baby does not nurse when breast fed
D. Refuses to have the newborn roomed-in with her
31. During labor, a client's cervix fails to dilate progressively despite her uncomfortable uterine
contractions. To augment labor, the physician orders oxytocin Pitocin . When preparing the client for
oxytocin administration, the nurse describes the contraction the client is likely to feel when she starts to
receive the drug. Which description is accurate?
A. Contractions will be stronger, shorter, and less uncomfortable
B. Contractions will be stronger and shorter and will peak more slowly
C. Contractions will be weaker, longer, and more effective
D. Contractions will be stronger and more uncomfortable and will peak more abruptly
32. During routine assessment of a postpartum client, the nurse assesses the lochial discharge of the
client and notes presence of clots that are larger than 1 cm. Which nursing action is the most
appropriate?
A. Document the findings
B. Notify the physician
C. Reassess the client after 2hours
D. Encourage increased oral intake of fluid to dissolve clots
33. The nurse is monitoring a 20-year-old woman in active labor who is receiving oxytocin, Pitocin, 1
mU/min IV. The nurse should stop the infusion if,
A. The contractions occur at 2.5 minute intervals and last more than 90 seconds
B. The contractions occur at 3-minute intervals and last more than 60 seconds
C. The contractions occur at 2-minute intervals and last more than 90 seconds
D. The contractions occur at 2-minute intervals and last more than 60 seconds
34. Leah is developing constipation from being on bed rest. Which measures would you suggest she take
to help prevent this?
A. Eat more frequent, small meals instead of 3 large ones daily
B. Drink more milk, increased calcium intake prevents constipation.
C. Drink 8 full glasses of fluid such as water daily.
D. Walk for at least half an hour daily to stimulate peristalsis.
35. You are back on your usual nursing clinic duties, it is a Tuesday and a woman at 38-weeks gestation
comes to you with problems of vaginal bleeding. Which of the following remarks, if made by the client,
would suggest placental previa as potential cause of bleeding?
A. The bleeding started after I carried 4 bags of groceries.
B. I feel fine, but the bleeding scares me.
C. I feel nauseated more during the past few weeks.
D. I have been experiencing severe abdominal cramps.
36. You opt that all Fridays are Family Care Nursing clinic HOLIDAYS. On Fridays, you prefer to do
personal visits. You follow-up patients in their homes, do volunteer health work in schools, or visit
industries within the vicinity. In a student health clinic, a client confides to you that her boyfriend
informed her that he tested positive for Hepatitis B. Which of the following is your best response?
A. You should also be tested for Hepatitis B.
B. You will receive the Hepatitis B immune globulin
C. Have you had sex with your boyfriend?
D. That must be real shocking to you.
37. The triage nurse in the emergency room receives a phone call from each of the following women.
Which woman should be directed to the hospital immediately because of ectopic pregnancy?
A. A primigravida client at five weeks gestation and is having spotting and some cramping
B. A multigravida client with AOG of sex weeks and reporting frank, red vaginal bleeding with moderate
cramps
C. A primipara client who is seven weeks pregnant and reporting an increase in whitish vaginal secretion
D. A multipara woman who is four weeks pregnant and reporting unilateral, dull abdominal pain
38. The lab reports a Lung Surfactant ratio of 3:1 for a client who has been on bedrest 48 hours in an
unsuccessful attempt to arrest preature labor at 33-weeks gestation. Based on this result, the nurse
would anticipate,
A. Initiation of an oxytocin (Pitocin) drip
B. Continuation of bedrest until otherwise indicated
C. Delivery of the infant by cesarean section
D. Administration of ritodrine hydrochloride (Yutopar)
39. The nurse takes a history from a woman in the prenatal clinic. The nurse identifies that which of the
following pregnant women is MOST likely to have an Rh-incompatibility problem?
A. An Rh-negative woman who conceived with an Rh-positive man who has Rh antibodies
B. An Rh-negative woman who never received RhoGAM and now conceived with an Rh-negative man
C. An Rh-positive woman who previously aborted a fetus at 12 weeks gestation and did not receive
RhoGAM and now conceived with an Rh-positive man
D. An Rh-positive woman pregnant for the third time who conceived with an Rh-negative man and never
has received RhoGAM.
40. Nurse Minette is an independent Nurse Practitioner following up referred clients in their respective
homes. Here, she handles a case of POSTPARTAL MOTHER AND FAMILY focusing on HOME CARE. Nurse
Minette needs to schedule a first home visit to OB client Leah. When is the first home-care visit typically
made?
A. Within 24 hrs after discharge
B. Within 1 hour after discharge
C. Within 1 week of discharge
D. Within 4 days after discharge
41. The nurse plans care for a 25-year-old woman immediately after a cesarean section. Which of the
following nursing goals is most important?
A. Prevent infection
B. Prevent fluid and electrolyte imbalances
C. Prevent hazards of immobility
D. Provide for pain management
42. One Monday morning, during the community nursing assignment, Nurse Nina was transferred to
their RHU-attached district hospital. She attends to Mrs. Lalaine Mariano who is on her second vaginal
examination and labor. Nurse Nina finds the fetus in the right occiput anterior position and at -1 station.
Nurse Nina based her findings from,
A. Presentation in no relationship with the ischial spine condition
B. Presentation directly in line with that of the ischial spines
C. 1 cm below the ischial spines presentation
D. 1 cm above the ischial spines presentation
43. A 34 weeks pregnant client presents to the emergency department following a painless vaginal
bleeding. After assessing the client, the nurse reviews the admission chart. Which orders by the
obstetrician will require clarification by the nurse?
A. Monitor blood pressure every 5 minutes to 15 minutes
B. Avoid internal examination
C. Start IV therapy, 0.9% NaCl using large gauge needle
D. Monitor the fetal heart rate using internal monitoring device
44. Unlike, placenta previa, in premature separation of placenta, the placenta appears to have been
implanted correctly. Sudden, however, it can begin to separate and bleeding results. The development
of this condition is linked to certain predisposing factors including: Select all that apply,
1.Advance maternal age
2. High parity
3. Short umbilical cord
4.Cocaine use
5.Cigarette use
6.Chronic hypertensive disease
A. Except 1, 3 and 6
B. 1, 4, 5, and 6
 C. 1, 2, 4, and 5
D. 1, 2, 3, 4, 5, and 6
45. You also attend to another young diabetic parishioner mother who is in her 1st trimester of
pregnancy. As her pregnancy continues, which changes in her medication needs should you also
anticipate?
A. A steady increase in insulin requirements
B. Oral hypoglycemic drugs will be given several times daily.
C. The variable pattern of insulin absorption throughout the pregnancy requires constant close
adjustments
D. A decrease in the need for short-acting insulin
46. A 12-year-old girl comes to the clinic with her mother for an annual physical exam. The mother
claims that her daughter has been menstruating since last year and asks the nurse, Which activities
should be avoided during her periods? The nurse is considered knowledgeable if she respond by stating
that:
A. During mense period, restrict her from eating sour food, pickles or cold drinks as this may cause
severe dysmenorrheal
B. Washing of hair or bathing is harmful as this may cause severe menstrual pain
C. none of the choices are correct
D. There are no activities contraindicated when menstruating, although some discomfort may be
present like pain, taking ibuprofen and applying local heat may help the case
47. On May 12, 2012, a primigravida mother named Mrs. Carla Del Pilar came to Nurse Nina for check-
up. Her EDC happens to be May 21. Which of the following can you expect to find during assessment?
A. Cervix open, FH-2 fingers below xyphoid process, floating.
B. Cervix closed, unaffected, fundic height -midway between the umbilicus and symphysis pubis.
C. FH at least at the level of the xyphoid process, engaged.
D. FH-2 fingers below xyphoid process, engaged.
48. This postpartal mother wants to lose the weight she gained in pregnancy, so she is reluctant to
increase her caloric intake for breast-feeding. By how much should a lactating mother increase her
caloric intake during the first 6 months after birth?
A. 1,000 kcal per day
B. 350 kcal per day
C. 200 kcal per day
D. 500 kcal per day
49. Prior to a cesarean section delivery, a 24-year-old woman is treated for abruption placentae. The
nurse is caring for the woman during the postpartum period. Which of the following symptoms would
be suggestive of disseminated intravascular coagulation?
A. The client is nauseated, lethargic, and has vomited three times
B. The client's vital sign are: BP 90/58, temperature 101 F, pulse 112, respirations 18
C. The client's laboratory results are: Hgb 13g/dL, Hct 40%, WBC 7,000/mm3
D. There is oozing blood from the venipuncture site and abdominal incision
50. Kimberly just delivered her first baby and whom she is expected to breastfeed. In the development
of your teaching plan, which of the following instruction must you include?
A. Avoid nursing bras with plastic lining.
B. Try to schedule feedings at least every 3 to 4 hours.
C. Supplement with water feedings when necessary.
D. Wash nipples with soap and water before each feeding.