Free Inpatient Obstetric Nursing Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Inpatient Obstetric Nursing practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1A nurse is assessing a patient with gestational hypertension at 32 weeks. What is the minimum systolic blood pressure that meets the severe-hypertension threshold, even if the diastolic pressure remains below 110 mm Hg?

   1. A. 120 mm Hg
   2. B. 130 mm Hg
   3. C. 140 mm Hg
   4. D. 160 mm Hg

   Answer: D

   Explanation: ACOG lists "systolic pressure of 160 mm Hg or higher" as a severe feature. The minimum severe systolic threshold is therefore 160 mm Hg, independently of whether the diastolic threshold is reached.

   Reference: Preeclampsia and High Blood Pressure During Pregnancy — Preeclampsia — What are the symptoms of preeclampsia? Severe features

2. 2At 30 weeks, ultrasound estimates fetal weight at the 8th percentile. What percentile threshold does SMFM use to define fetal growth restriction by estimated weight or abdominal circumference?

   1. A. Below the 3rd percentile
   2. B. Below the 10th percentile
   3. C. Below the 25th percentile
   4. D. Below the 50th percentile

   Answer: B

   Explanation: SMFM specifies "below the 10th percentile". The 8th-percentile measurement meets that definition; the 3rd percentile identifies a more severe subgroup.

   Reference: SMFM Consult Series #52: Diagnosis and management of fetal growth restriction — Recommendation 1, sonographic definition of FGR

3. 3During labor education, a nurse describes the cervix becoming shorter and thinner. What is the name of this physiologic process?

   1. A. Dilation
   2. B. Effacement
   3. C. Descent
   4. D. Internal rotation

   Answer: B

   Explanation: The VA/DoD guide calls "softening and shortening of your cervix" effacement. Dilation is opening, while descent and rotation concern fetal movement.

   Reference: Pregnancy & Childbirth: A Goal Oriented Guide to Prenatal Care — p. 119, Labor & Delivery Basics, cervical changes

4. 4Soon after placental delivery, a patient has heavy vaginal bleeding and the uterus fails to become firmly contracted. Which mechanism most directly explains this bleeding?

   1. A. Uterine atony
   2. B. Uterine inversion
   3. C. Cervical laceration
   4. D. Vaginal hematoma

   Answer: A

   Explanation: ACOG explains uterine atony as a state in which uterine muscles "do not contract normally." Without effective contraction, vessels at the placental site are not adequately compressed.

   Reference: 3 Conditions to Watch for After Childbirth — Postpartum Hemorrhage: causes

5. 5A pregnant adult with decision-making capacity understands the risks and alternatives but declines recommended treatment. Which ethical principle is central to respecting her informed refusal?

   1. A. Beneficence
   2. B. Autonomy
   3. C. Justice
   4. D. Nonmaleficence

   Answer: B

   Explanation: ACOG emphasizes "the centrality of the pregnant woman’s decisional authority." Respect for the capable patient’s informed choice reflects autonomy, even when clinicians believe a recommended treatment would benefit her or the fetus.

   Reference: Refusal of Medically Recommended Treatment During Pregnancy — Abstract: ethical approach to refusal

6. 6A patient hospitalized at 28 weeks has syphilis requiring treatment and a confirmed penicillin allergy. Which treatment plan should the nurse anticipate to treat maternal infection and protect the fetus?

   1. A. Desensitize, then administer penicillin G.
   2. B. Substitute a ceftriaxone treatment course.
   3. C. Substitute an azithromycin treatment course.
   4. D. Substitute a doxycycline treatment course.

   Answer: A

   Explanation: CDC states, "Pregnant women who have a history of penicillin allergy should be desensitized and treated with penicillin G." No proven alternative treats syphilis in pregnancy adequately; ceftriaxone has insufficient evidence, azithromycin is unreliable, and doxycycline is avoided in this trimester.

   Reference: Syphilis During Pregnancy — STI Treatment Guidelines — Special Considerations — Penicillin Allergy

7. 7A fetus has newly diagnosed growth restriction at 30 weeks. Which vessel should be assessed with Doppler for routine surveillance of deterioration?

   1. A. Middle cerebral artery
   2. B. Uterine artery
   3. C. Ductus venosus
   4. D. Umbilical artery

   Answer: D

   Explanation: SMFM recommends "umbilical artery" Doppler assessment after FGR diagnosis. It recommends against routine management Dopplers of the three competing vessels.

   Reference: SMFM Consult Series #52: Diagnosis and management of fetal growth restriction — Recommendations 9 and 13, Doppler assessment in FGR

8. 8At 38 weeks, a patient reports easier breathing but more frequent urination after her fetus moves lower into the pelvis. Which physiologic event explains this change?

   1. A. Cervical ripening
   2. B. Membrane rupture
   3. C. Placental separation
   4. D. Lightening

   Answer: D

   Explanation: The VA/DoD guide describes lightening when the baby drops into the pelvis: "breathing is a lot easier but you will need to urinate even more frequently." The other events do not describe this descent-related symptom combination.

   Reference: Pregnancy & Childbirth: A Goal Oriented Guide to Prenatal Care — p. 119, Before Labor Begins — Lightening

9. 9A postpartum patient's heavy bleeding is attributed to a poorly contracted uterus. While emergency assistance and prescribed uterotonics are arranged, which bedside intervention directly stimulates uterine contraction?

   1. A. Massage the uterine fundus.
   2. B. Pack the vaginal canal.
   3. C. Repair the cervical tissue.
   4. D. Inflate a uterine tamponade balloon.

   Answer: A

   Explanation: ACOG describes "abdominal massage" to help the uterus contract. Fundal massage directly targets atony, whereas packing, repair, and tamponade act through different mechanisms or require separate indications.

   Reference: 3 Conditions to Watch for After Childbirth — Postpartum Hemorrhage: Treatment

10. 10In a HIPAA-covered hospital, an alert postpartum patient asks the nurse to explain her care instructions to the friend who will help her at home. Which statement is correct about sharing information relevant to that care?

    1. A. The patient's agreement can permit this care-related discussion.
    2. B. A court order must precede this care-related discussion.
    3. C. A health care power of attorney must precede this care-related discussion.
    4. D. A separate written HIPAA authorization must precede every such discussion.

    Answer: A

    Explanation: HHS permits sharing with involved family or friends when "You tell the provider or plan that it can do so." The alert patient has asked for this care-related sharing; a court order, power of attorney, or separate written authorization is not required for this circumstance.

    Reference: Family Members and Friends: HIPAA Privacy Rule — Family Members and Friends: permitted care-related sharing