Inpatient Obstetric Nursing Practice Test

Sample Questions and Answers

Question 1. A laboring patient is receiving continuous electronic fetal monitoring. The nurse observes recurrent late decelerations on the fetal heart rate tracing. What is the priority nursing action?

A. Encourage the patient to begin pushing.

B. Reposition the patient to improve uteroplacental blood flow and notify the healthcare provider.

C. Increase the oxytocin infusion rate.

D. Prepare the patient for discharge.

Correct Answer: B. Reposition the patient to improve uteroplacental blood flow and notify the healthcare provider.

Explanation:
Recurrent late decelerations may indicate uteroplacental insufficiency and decreased oxygen delivery to the fetus during contractions. The nurse should immediately implement intrauterine resuscitation measures, including repositioning the patient, assessing maternal vital signs, evaluating uterine activity, administering oxygen if prescribed, discontinuing oxytocin when appropriate, and notifying the healthcare provider. Prompt intervention helps improve fetal oxygenation and may reduce the risk of fetal compromise. Accurate interpretation of fetal heart rate patterns and timely nursing interventions are essential responsibilities in inpatient obstetric nursing and are commonly assessed on certification examinations.

Question 2. A postpartum nurse assesses a patient’s uterus one hour after delivery and finds it boggy and displaced above the umbilicus. What is the nurse’s priority intervention?

A. Encourage the patient to eat a full meal.

B. Massage the uterine fundus and assess for bladder distention.

C. Place the patient in a Trendelenburg position.

D. Begin newborn discharge teaching immediately.

Correct Answer: B. Massage the uterine fundus and assess for bladder distention.

Explanation:
A boggy uterus after delivery is commonly associated with uterine atony, one of the leading causes of postpartum hemorrhage. The nurse should gently massage the uterine fundus to stimulate contraction while also assessing whether a full bladder is preventing the uterus from contracting effectively. Continued monitoring of vaginal bleeding, maternal vital signs, and uterine tone is essential. Early recognition and prompt intervention help reduce blood loss, promote uterine contraction, and improve maternal outcomes. Postpartum assessment and hemorrhage prevention are fundamental components of inpatient obstetric nursing practice.

Question 3. During labor, a patient’s membranes rupture spontaneously. The nurse immediately notes a sudden decrease in the fetal heart rate. What should the nurse assess first?

A. Maternal blood glucose level

B. Presence of an umbilical cord prolapse

C. Newborn feeding readiness

D. Maternal hemoglobin level

Correct Answer: B. Presence of an umbilical cord prolapse.

Explanation:
A sudden fetal heart rate decrease immediately following rupture of membranes may indicate umbilical cord prolapse, a true obstetric emergency. The nurse should quickly assess for the presence of the cord, notify the healthcare provider, relieve pressure on the cord if prolapse is confirmed, and prepare for emergency interventions as directed. Rapid recognition is essential because prolonged cord compression can significantly reduce fetal oxygenation. Early assessment, prompt communication, and coordinated emergency management help improve fetal outcomes and are important competencies in obstetric nursing.

Question 4. A nurse is caring for a patient with preeclampsia who suddenly reports a severe headache and blurred vision. What is the nurse’s priority action?

A. Document the symptoms and reassess later.

B. Notify the healthcare provider immediately and continue close maternal and fetal monitoring.

C. Encourage the patient to walk around the unit.

D. Offer the patient a caffeinated beverage.

Correct Answer: B. Notify the healthcare provider immediately and continue close maternal and fetal monitoring.

Explanation:
A severe headache and visual disturbances are warning signs that preeclampsia may be worsening and can indicate an increased risk of progression to eclampsia. The nurse should promptly notify the healthcare provider, continue monitoring maternal blood pressure, assess fetal status, and prepare for additional interventions as ordered. Close observation allows rapid identification of changes that may require urgent treatment. Early recognition and timely management of hypertensive disorders during pregnancy are essential for protecting both maternal and fetal health and are frequently evaluated on obstetric nursing certification exams.

Question 5. Shortly after birth, the newborn is breathing regularly with a heart rate of 140 beats per minute but has blue hands and feet. How should the nurse interpret this finding?

A. It is a normal finding known as acrocyanosis during the newborn transition period.

B. It indicates severe respiratory failure requiring immediate intubation.

C. It is evidence of congenital heart disease.

D. It requires immediate chest compressions.

Correct Answer: A. It is a normal finding known as acrocyanosis during the newborn transition period.

Explanation:
Acrocyanosis, characterized by bluish discoloration of the hands and feet while the trunk remains pink, is a common and expected finding during the first hours after birth. It occurs as the newborn’s circulatory system adapts to life outside the uterus and usually resolves without treatment. The nurse should continue routine newborn assessment while monitoring respiratory effort, heart rate, skin color, muscle tone, and overall adaptation. Distinguishing normal transitional findings from signs of neonatal distress is an important skill in inpatient obstetric and newborn nursing care.