Perinatal Nursing
Chapter Exam Questions
Course Introduction
Perinatal Nursing focuses on the care of women and their families during the antepartum, intrapartum, and postpartum periods, as well as the care of newborns. This course covers comprehensive assessment, planning, and implementation of evidence-based nursing interventions to promote maternal and neonatal health. Students will explore topics such as prenatal care, labor and delivery management, newborn adaptation and assessment, risk identification, and the management of complications. Emphasis is also placed on family-centered care, cultural sensitivity, interprofessional collaboration, patient education, and strategies for supporting families through the physical and emotional transitions associated with childbirth.
Recommended Textbook
Foundations of Maternal Newborn and Womens Health Nursing 7th Edition Murray
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Chapter 1: Maternity and Womens Health Care Today
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Sample Questions
Q1) The RN is delegating tasks to the unlicensed assistive personnel (UAP). Which tasks can the nurse delegate? (Select all that apply.)
A) Teaching the patient about breast care
B) Assessment of a patient's lochia and perineal area
C) Assisting a patient to the bathroom for the first time after birth
D) Vital signs on a postpartum patient who delivered the night before
E) Assisting a postpartum patient to take a shower on the second postpartum day
Answer: D, E
Q2) The nurse is assessing a patient's use of complementary and alternative therapies. Which should the nurse document as an alternative or complementary therapy practice? (Select all that apply.)
A) Practicing yoga daily
B) Drinking green tea in the morning
C) Taking omeprazole (Prilosec) once a day
D) Using aromatherapy during a relaxing bath
E) Wearing a lower back brace when lifting heavy objects
Answer: A, B, D
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Chapter 2: Social, Ethical, and Legal Issues
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Sample Questions
Q1) A nurse working in a labor and birth unit is asked to take care of two high-risk patients in the labor and birth suite: a 34 weeks' gestation 28-year-old gravida 3, para 2 in preterm labor and a 40-year-old gravida 1, para 0 who is severely preeclamptic. The nurse refuses this assignment telling the charge nurse that based on individual patient acuity, each patient should have one-on-one care. Which ethical principle is the nurse advocating?
A) Accountability
B) Beneficence
C) Justice
D) Fidelity
Answer: B
Q2) Which step of the nursing process is being used when the nurse decides whether an ethical dilemma exists?
A) Analysis
B) Planning
C) Evaluation
D) Assessment
Answer: A
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Page 4
Chapter 3: Reproductive Anatomy and Physiology
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Sample Questions
Q1) A newly pregnant patient asks the nurse, "What is a false pelvis?" Which statement by the nurse will best explain this anatomy to the patient?
A) It is the total anterior portion of the pelvis.
B) It is considered to be the lower portion of the pelvis.
C) It provides support for the internal organs and the upper part of the body.
D) It is the narrowest part of the pelvis through which a fetus will pass during birth.
Answer: C
Q2) The nurse is explaining the function of the male's cremaster muscle to a group of nursing students. Which statement accurately describes the function of the cremaster muscle?
A) Assists with transporting sperm
B) Aids in temperature control of the testicles
C) Aids in voluntary control of excretion of urine
D) Entraps blood in the penis to produce an erection
Answer: B
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Chapter 4: Hereditary and Environmental Influences on Childbearing
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Sample Questions
Q1) The nurse is working with a patient to obtain information necessary for genetic counseling. Which tool will be used to obtain this information?
A) Braden scale
B) Genogram
C) Chorionic villus sampling (CVS)
D) Serum protein electrophoresis
Q2) Which statement regarding multifactorial disorders is correct?
A) They may not be evident until later in life.
B) They are usually present and detectable at birth.
C) The disorders are characterized by multiple defects.
D) Secondary defects are rarely associated with them.
Q3) The nurse is explaining genetics to a group of nursing students. Which are autosomal recessive disorders that the nurse should discuss during the teaching session? (Select all that apply.)
A) Hemophilia
B) Cystic fibrosis
C) Sickle cell disease
D) Turner's syndrome
E) Phenylketonuria (PKU) disease
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Chapter 5: Conception and Prenatal Development
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Sample Questions
Q1) An expectant father asks the nurse, "Which part of the mature sperm contains the male chromosome?" What is the correct response by the nurse?
A) X-bearing sperm
B) The tail of the sperm
C) The head of the sperm
D) The middle portion of the sperm
Q2) Which physical characteristics decrease as the fetus nears term? (Select all that apply.)
A) Vernix caseosa
B) Lanugo
C) Port wine stain
D) Brown fat
E) Eyebrows or head hair
Q3) One of the assessments performed in the birth room is checking the umbilical cord for blood vessels. Which finding is considered to be within normal limits?
A) One artery and one vein
B) Two veins and one artery
C) Two arteries and one vein
D) Two arteries and two veins
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Chapter 6: Maternal Adaptations to Pregnancy
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Sample Questions
Q1) A patient reports to the clinic nurse that she has not had a period in over 12 weeks, she is tired, and her breasts are sore all of the time. The patient's urine test is positive for hCG. What is the correct nursing action related to this information?
A) Ask the patient if she has had any nausea or vomiting in the morning.
B) Schedule the patient to be seen by a health care provider within the next 4 weeks.
C) Send the patient to the maternity screening area of the clinic for a routine ultrasound.
D) Determine if there are any factors that might prohibit her from seeking medical care.
Q2) A 36-year-old divorcee with a successful modeling career finds out that her 18-year-old daughter is expecting her first child. Which is a major factor in determining how this woman will respond to becoming a grandmother?
A) Her age
B) Her career
C) Being divorced
D) Age of the daughter
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Chapter 7: Antepartum Assessment, Care, and Education
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Sample Questions
Q1) When documenting a patient encounter, which term will the nurse use to describe the woman who is in the 28th week of her first pregnancy?
A) Multigravida
B) Multipara
C) Nullipara
D) Primigravida
Q2) A patient with an IUD in place has a positive pregnancy test. When planning care, the nurse will base decisions on which anticipated action?
A) A therapeutic abortion will need to be scheduled since fetal damage is inevitable.
B) Hormonal analyses will be done to determine the underlying cause of the false-positive test result.
C) The IUD will need to be removed to avoid complications such as miscarriage or infection.
D) The IUD will need to remain in place to avoid injuring the fetus.
Q3) Calculate the estimated date of birth (EDD) in October using Nägele's rule for a patient whose last normal menstrual period (LNMP) began on January 1. Record your answer as a whole number. _______
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Chapter 8: Nutrition for Childbearing
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Sample Questions
Q1) A pregnant patient has lactose intolerance. Which recommendation will the nurse provide to best help the patient meet dietary needs for calcium?
A) Add foods such as nuts, dried fruit, and broccoli to the diet.
B) Consume dairy products but take an over-the-counter anti-gas product.
C) Increase the intake of dark leafy vegetables, such as spinach and chard.
D) Use powdered milk instead of liquid forms of milk.
Q2) Which patient is most at risk for a low-birth-weight infant?
A) 22-year-old, 60 inches tall, normal prepregnant weight
B) 18-year-old, 64 inches tall, body mass index is <18.5
C) 30-year-old, 78 inches tall, prepregnant weight is 15 lb above the norm
D) 35-year-old, 75 inches tall, total weight gain in previous pregnancies was 33 lb
Q3) A pregnant woman of normal weight enters her 13th week of pregnancy. If the patient eats and exercises as directed, what will the nurse anticipate as the ongoing weight gain for the remaining trimesters?
A) 0.3 lb every week
B) 1 lb every week
C) 1.8 lb every week
D) 2 lb every week
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10
Chapter 9: Assessing the Fetus
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Sample Questions
Q1) Which analysis of maternal serum is the best predictor of chromosomal abnormalities in the fetus?
A) Biophysical profile
B) Multiple-marker screening
C) Lecithin-to-sphingomyelin ratio
D) Blood type and crossmatch of maternal and fetal serum
Q2) What is the purpose of initiating contractions in a contraction stress test (CST)?
A) Increase placental blood flow.
B) Identify fetal acceleration patterns.
C) Determine the degree of fetal activity.
D) Apply a stressful stimulus to the fetus.
Q3) What is the purpose of amniocentesis for a patient hospitalized at 34 weeks of gestation with pregnancy-induced hypertension?
A) Determine if a metabolic disorder exists.
B) Identify the sex of the fetus.
C) Identify abnormal fetal cells.
D) Determine fetal lung maturity.
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11
Chapter 10: Complications of Pregnancy
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Sample Questions
Q1) A nurse is explaining to the nursing students working on the antepartum unit how to assess for edema. Which edema assessment score indicates edema of the lower extremities, face, hands, and sacral area?
A) +1
B) +2
C) +3
D) +4
Q2) The labor and birth nurse is reviewing the risk factors for placenta previa with a group of nursing students. The nurse determines that the students understood the discussion when they identify which patient being at the highest risk for developing a placenta previa?
A) Female fetus, Mexican-American, primigravida
B) Male fetus, Asian-American, previous preterm birth
C) Male fetus, African-American, previous cesarean birth
D) Female fetus, European-American, previous spontaneous abortion
Q3) Which maternal condition always necessitates delivery by cesarean birth?
A) Partial abruptio placentae
B) Total placenta previa
C) Ectopic pregnancy
D) Eclampsia
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Chapter 11: The Childbearing Family with Special Needs
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Sample Questions
Q1) A patient has delivered twins. The first twin was stillborn, and the second is in the intensive care nursery, recovering quickly from respiratory distress. The patient is crying softly and says, "I wish my baby could have lived." What is the most therapeutic response?
A) "How soon do you plan to have another baby?"
B) "Don't be sad. At least you have one healthy baby."
C) "I have a friend who lost a twin and she's doing just fine now."
D) "I am so sorry about your loss. Would you like to talk about it?"
Q2) A patient at 24 weeks of gestation reports that she has a glass of wine with dinner every evening. Which rationale should the nurse provide this patient regarding the necessity to eliminate alcohol intake?
A) The fetus is placed at risk for altered brain growth.
B) The fetus is at risk for severe nervous system injury.
C) The patient will be at risk for abusing other substances as well.
D) A daily consumption of alcohol indicates a risk for alcoholism.
Q3) Which complication of adolescent pregnancy should the nurse plan to monitor?
A) Anemia
B) Placenta previa
C) Abruptio placenta
D) Incompetent cervix
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Chapter 12: Processes of Birth
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Sample Questions
Q1) The clinical nurse educator is providing instruction to a group of new nurses during labor orientation. Which information regarding the factors that have a role in the initiation of labor should the educator include in this teaching session? (Select all that apply.)
A) Progesterone levels become higher than estrogen levels.
B) Natural oxytocin in conjunction with other substances plays a role.
C) Stretching, pressure, and irritation of the uterus and cervix increase.
D) The secretion of prostaglandins from the fetal membranes decreases.
Q2) A laboring patient asks the nurse how she will know that the contraction is at its peak. The nurse explains that the contraction peaks during which stage of measurement?
A) The acme
B) The interval
C) The increment
D) The decrement
Q3) Which maternal factor may inhibit fetal descent during labor?
A) A full bladder
B) Decreased peristalsis
C) Rupture of membranes
D) Reduction in internal uterine size
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Chapter 13: Pain Management During Childbirth
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Sample Questions
Q1) The nurse is administering fentanyl (Sublimaze) to a patient in labor. The health care provider's prescription reads fentanyl (Sublimaze), 100 mcg IV stat. The medication vial reads fentanyl (Sublimaze), 50 mcg/mL. The nurse should prepare how many milliliters to administer the correct dose? Record your answer as a whole number. _____ mL
Q2) A patient in labor reports a feeling of burning pain during the second stage of labor. This type of pain is associated with
A) visceral pain.
B) tissue ischemia.
C) somatic pain.
D) cervical dilation.
Q3) The health care provider's prescription reads diphenhydramine (Benadryl), 25 mg IV stat. The medication vial reads diphenhydramine (Benadryl), 50 mg/mL. The nurse should prepare how many milliliters to administer the correct dose? Record your answer to one decimal point. _____ mL
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Chapter 14: Intrapartum Fetal Surveillance
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Sample Questions
Q1) A nurse documents that the fetal heart rate variability is marked. This indicates that the range is greater than how many beats per minute? Record your answer as a whole number. _____ bpm
Q2) The nurse is reviewing an electronic fetal monitor tracing from a patient in active labor and notes the fetal heart rate gradually drops to 20 beats per minute (bpm) below the baseline and returns to the baseline well after the completion of the patient's contractions. How will the nurse document these findings?
A) Late decelerations
B) Early decelerations
C) Variable decelerations
D) Proximal decelerations
Q3) When a Category II pattern of the fetal heart rate is noted and the patient is lying on her left side, which nursing action is indicated?
A) Lower the head of the bed.
B) Place a wedge under the left hip.
C) Change her position to the right side.
D) Place the mother in Trendelenburg position.
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Chapter 15: Nursing Care During Labor and Birth
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Sample Questions
Q1) Which assessment would be important for a 6-hour-old infant who has bruising over the cheeks from a forceps birth?
A) Presence of newborn reflexes
B) Symmetry of facial movements
C) Caput and molding of the head
D) Anterior and posterior fontanels
Q2) The nurse is monitoring a patient in the active stage of labor. Which conditions associated with fetal compromise should the nurse monitor? (Select all that apply.)
A) Maternal hypotension
B) Fetal heart rate of 140 to 150 bpm
C) Meconium-stained amniotic fluid
D) Maternal fever-38°C (100.4°F) or higher
E) Complete uterine relaxation of more than 30 seconds between contractions
Q3) Which aspect of newborn assessment may be limited by the application of a vacuum extractor at birth?
A) Anterior fontanel
B) Coronal suture lines
C) Posterior fontanel
D) Biparietal diameter
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Page 17
Chapter 16: Intrapartum Complications
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Sample Questions
Q1) A dose of dexamethasone 12 mg was administered to a patient in preterm labor at 0830 hours on March 12. The nurse knows that the next dose must be scheduled for
A) 1430 hours on March 12th.
B) 2030 hours on March 12th.
C) 0830 hours on March 13th.
D) 1430 hours on March 13th.
Q2) Which presentation is most likely to occur with a hypertonic labor pattern? (Select all that apply.)
A) Increased risk for placenta previa
B) Painful uterine contractions
C) Increased resting tone
D) Uterine vasodilation
E) Increased uterine pressure
F) Effective uterine contraction
Q3) Which pelvic shape is most conducive to vaginal labor and birth?
A) Android
B) Gynecoid
C) Platypelloid
D) Anthropoid
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Chapter 17: Postpartum Adaptations and Nursing Care
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Sample Questions
Q1) The nurse is caring for a postpartum patient who delivered by the vaginal route 12 hours ago. Which assessment finding should the nurse report to the health care provider?
A) Pulse rate of 50
B) Temperature of 38°C (100.4°F)
C) Firm fundus, but excessive lochia
D) Lightheaded when moving from a lying to standing position
Q2) The nurse is conducting discharge teaching for a patient going home after a cesarean birth. Which signs and symptoms should the patient be taught to report?
(Select all that apply.)
A) Mild incisional pain
B) Feeling of pelvic fullness
C) Lochia changing from red to pink in color
D) Frequency, urgency, or burning on urination
E) Redness or edema of the abdominal incision
Q3) Which maternal event is abnormal in the early postpartal period?
A) Diuresis and diaphoresis
B) Flatulence and constipation
C) Extreme hunger and thirst
D) Lochial color changes from rubra to alba
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Chapter 18: Postpartum Maternal Complications
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Sample Questions
Q1) Which information should the nurse recognize as contributing to mastitis in the breastfeeding mother? (Select all that apply.)
A) Insufficient emptying
B) Feeding every 2 hours
C) Supplementing feedings
D) Blisters on both nipples
E) Alternating breastfeeding positions
Q2) If the nurse suspects a complication of a low forceps birth labor, she should immediately
A) administer a strong oral analgesic.
B) assess the perineal and vaginal areas.
C) assess the position of the uterine fundus.
D) review the labor record for duration of second stage.
Q3) To evaluate the desired response of methylergonovine (Methergine), the nurse would assess the patient's
A) uterine tone.
B) pain level.
C) blood pressure.
D) last voiding.
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Page 20
Chapter 19: Normal Newborn: Processes of Adaptation
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Sample Questions
Q1) Which of the following organs are nonfunctional during fetal life?
A) Eyes and ears
B) Lungs and liver
C) Kidneys and adrenals
D) Gastrointestinal system
Q2) A multiparous patient arrives to the labor unit and urgently states, "The baby is coming RIGHT NOW!" The nurse assists the patient into a comfortable position and delivers the infant. To prevent infant heat loss from conduction, what is the priority nursing action?
A) Dry the baby off.
B) Turn up the temperature in the patient's room.
C) Pour warmed water over the baby immediately after birth.
D) Place the baby on the patient's abdomen after the cord is cut.
Q3) Which action by the nurse can result in hyperthermia in the newborn?
A) Placing a cap on the newborn
B) Wrapping the newborn in a warm blanket
C) Placing the newborn in a skin to skin position with the mother
D) Placing the newborn in the radiant warmer without attaching the skin probe
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Chapter 20: Assessment of the Normal Newborn
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Q1) A newborn that is a large-for-gestational-age (LGA) infant is in which percentile(s) for weight?
A) Below the 90th
B) Less than the 10th
C) Greater than the 90th
D) Between the 10th and 90th
Q2) Which newborn reflex is elicited by stroking the lateral sole of the infant's foot from the heel to the ball of the foot?
A) Babinski
B) Stepping
C) Tonic neck
D) Plantar grasp
Q3) The nurse is performing a gestational age assessment on a newborn. Which characteristic indicates the greatest gestational maturity?
A) The infant's arms and legs are extended.
B) There is some peeling and cracking of the skin.
C) There are few rugae on the scrotum and the testes are high in the scrotum.
D) The arm can be positioned with the elbow beyond the midline of the chest.
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Chapter 21: Care of the Normal Newborn
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Q1) During a prenatal education class regarding infant home care, the nurse is reviewing the simulated setting created by new mothers for putting the baby to bed. Which observation indicates to the nurse that the new mothers understood the nurse's teaching about infant safety?
A) The crib is lined with a bumper pad.
B) Stuffed animals are placed in the crib.
C) The baby mannequin is in the supine position.
D) The baby mannequin is covered with a handmade quilt.
Q2) Which of the following guidelines should the nurse implement to prevent the abduction of a newborn from the hospital?
A) Restricting the amount of time infants are out of the nursery
B) Questioning anyone who is seen walking in the hallways carrying an infant
C) Allowing no visitors in the maternity area except those who have identification bracelets
D) Instructing the parents not to give the baby to anyone except the nurse assigned that day
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Chapter 22: Infant Feeding
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Q1) To prevent breast engorgement, what should the new breastfeeding mother be instructed to do?
A) Feed her infant no more than every 4 hours.
B) Limit her intake of fluids for the first few days.
C) Apply cold packs to the breast prior to feeding.
D) Breast-feed frequently and for adequate lengths of time.
Q2) Which is an important consideration regarding the storage of breast milk?
A) Can be thawed and refrozen
B) Can be frozen for up to 6 months
C) Should be stored only in glass bottles
D) Can be kept refrigerated for 72 hours
Q3) A new mother asks the nurse, "How will I know early signs of hunger in my baby?" The nurse's best response is which of the following? (Select all that apply.)
A) Crying
B) Rooting
C) Lip smacking
D) Decrease in activity
E) Sucking on the hands
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Chapter 23: High-Risk Newborn: Complications Associated with Gestational
Age and Development
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Q1) Which nursing action is especially important for an SGA newborn?
A) Promote bonding.
B) Observe for and prevent dehydration.
C) Observe for respiratory distress syndrome.
D) Prevent hypoglycemia with early and frequent feedings.
Q2) An infant delivered prematurely at 28 weeks' gestation weighs 1200 g. Based on this information the infant is classified as
A) SGA.
B) VLBW.
C) ELBW.
D) low birth weight at term.
Q3) In caring for the preterm infant, which complication is thought to be a result of high arterial blood oxygen level?
A) Necrotizing enterocolitis (NEC)
B) Retinopathy of prematurity (ROP)
C) Intraventricular hemorrhage (IVH)
D) Bronchopulmonary dysplasia (BPD)
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Page 25
Chapter 24: High-Risk Newborn: Acquired and Congenital Conditions
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Q1) Newborns whose mothers are substance abusers frequently exhibit which of the following behaviors?
A) Hypothermia, decreased muscle tone, and weak sucking reflex
B) Excessive sleep, weak cry, and diminished grasp reflex
C) Circumoral cyanosis, hyperactive Babinski reflex, and constipation
D) Decreased amounts of sleep, hyperactive Moro reflex, and difficulty feeding
Q2) Four hours after the birth of a healthy neonate of an insulin-dependent (type 1) diabetic mother, the baby appears jittery and irritable and has a high-pitched cry. Which nursing action has top priority?
A) Notify the clinician stat.
B) Test for the blood glucose level.
C) Start an intravenous line with D10W.
D) Document the event in the nurses' notes.
Q3) The nurse should be alert to a blood group incompatibility if
A) both mother and infant are O-positive.
B) mother is A-positive and infant is A-negative.
C) mother is O-positive and infant is B-negative.
D) mother is B-positive and infant is O-negative.
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Chapter 25: Family Planning
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Q1) The role of the nurse in family planning is to
A) refer the couple to a reliable physician.
B) decide on the best method for the couple.
C) advise couples on which contraceptive to use.
D) educate couples on the various methods of contraception.
Q2) A nurse is leading a discussion regarding options for birth control. Which of the following methods is considered the most reliable?
A) Coitus interruptus
B) Breastfeeding
C) Natural family planning
D) Intrauterine device
Q3) When instructing a patient in the use of spermicidal foam or gel, it is important to include the information that
A) effectiveness is about 85%.
B) douching should be avoided for at least 6 hours.
C) it should be inserted 1 to 2 hours before intercourse.
D) one application is effective for several hours.
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Chapter 26: Infertility
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Q1) The procedure in which ova are removed by laparoscopy, mixed with sperm, and the embryo(s) returned to the woman's uterus is
A) in vitro fertilization (IVF).
B) tubal embryo transfer (TET).
C) therapeutic insemination (IUI).
D) gamete intrafallopian transfer (GIFT).
Q2) Chromosome analysis is a diagnostic test that should be offered to which couple?
A) Never conceived
B) Has long-standing infertility
C) Has had repeated pregnancy losses
D) Has a normal child but has not conceived again
Q3) A couple who has not achieved a successful pregnancy is scheduled to meet with a fertility specialist. Which simple evaluation is usually the first test to be performed?
A) Semen analysis
B) Testicular biopsy
C) Endometrial biopsy
D) Hysterosalpingography
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28
Chapter 27: Womens Health
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Q1) Healthy People 2020 goals directed at women's health issues focus on which areas? (Select all that apply.)
A) Increased screening for cervical and colorectal cancers
B) Reduction of cancer survivor rate based on clinical management treatment
C) Decreased morbidity and mortality related to breast cancer
D) Reduction in hospitalization for hip fractures in the older female population
E) Reduction in deaths associated with cardiovascular causes such as stroke and coronary artery disease (CAD)
Q2) A benign breast condition that includes dilation and inflammation of the collecting ducts is known as
A) fibroadenoma.
B) ductal ectasia.
C) intraductal papilloma.
D) chronic cystic disease.
Q3) Which sexually transmitted disease can be treated and eradicated?
A) Herpes
B) AIDS
C) Chlamydia
D) Venereal warts
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