Obstetric Nursing Practice Test Part 1 4.

During one of the sessions a pregnant mother is expressing concern on her

baby. She is voicing apprehensions on the outcome of her delivery that might be
1. Childbirth education is vital for a successful and comfortable childbirth method.
stressful to her baby. Birth without violence is under which theory?
The first method that includes the father as a support person while embracing the
belief that childbirth is a natural event and with the right preparation most women
can have spontaneous and unmedicated vaginal births is:
a. Lamaze method

a. Lamaze method b. Leboyer method

b. Leboyer method c. Bradley method

c. Bradley method
d. Grantly Dick-Read method

d. Grantly Dick-Read method 5. A sensitive and unobtrusive technique of care while respecting the natural
2. The easiest method for determining if a woman’s caloric intake is adequate is process and promoting a peaceful atmosphere at birth will help the baby to be
assessing: born with a minimum stress. This is least likely achieved by:

a. Food intake
a. Keeping the room noise to a minimum

b. Bowel pattern
b. Not delaying the cutting of the cord

c. Weight she is gaining

c. Giving the newborn a warm bath after delivery
d. A “typical day” history or a 24 hour nutrition recall
3. The total weight gain in pregnancy for women who have multiple fetuses is:
d. Not assisting or pulling the baby’s head in expulsion

6. A pregnant woman came in to the clinic expressing concern about her

a. 20-25 lbs genitalia that has been observed for a change in color. The nurse explained the
physiology adaptations to pregnancy and stated that this discoloration of the
vagina is called:
b. 25-35 lbs

c. 35-40 lbs a. Hegar’s sign

d. 40-45 lbs
 b. Chadwick’s sign
a. Dr. Grantly Dick-Read

c. Goodell’s sign
b. Dr. Robert Bradley

d. Vaginal sign
c. Dr. Ferdinand Lamaze
7. The entitled Childbirth without Fear is authored by:

d. Dr. Frederick Leboyer

a. Dr. Grantly Dick-Read 10. A patient on labor is offered ice chips. What is the purpose of giving ice chips
to a woman on labor?
b. Dr. Robert Bradley

a. To reduce a woman’s anxiety

c. Dr. Ferdinand Lamaze

b. To prevent impulses reach the distracted brain

d. Dr. Frederick Leboyer

8. Physical assessment is very important during prenatal visits to evaluate the c. To promote cutaneous stimulation
overall health status of a pregnant woman. Weight is one indicator of the health
status. A pregnant woman on her second trimester of pregnancy should gain how
many kilograms per month? d. To allow more blood to pool in the uterus, thus alleviating pain

11. The following concepts are emphasized in a Bradley class apart from:

a. 0.45 kg

a. Avoidance of drugs throughout the pregnancy

b. 1.82 kg

c. 1.36 kg b. Natural breathing methods (without patterns)

d. 2 kg c. Coaching techniques
9. The obstetrician who pointed out that a baby born in a less stressful
environment is more content is:
d. Woman should change position during labor

12. The priority management for Hyperemesis Gravidarum is:

 decreases gastric motility thus causing reverse peristaltic waves.”

a. Easting dry toast or crackers 30 minutes before arising in the morning d. “Some cases of morning sickness can also be due to emotional factors.”

15. The structure which contains high amount of estrogen is called:

b. Complete bed rest (CBR)

c. D5NSS 3L in 24 hours a. Corpus albicans

d. Administer Milk of Magnesia b. Corpus luteum

13. A pregnant woman is diagnosed with toxemia. The following are signs of c. Primordial follicles
toxemia apart from:
d. Graafian follicles

a. Edema of the lower extremities

16. Change in the consistency of the lower uterine segment causing extreme
softening is referred as:
b. Sudden Weight gain

c. Blurry vision a. Hegar’s sign

d. Protein in urine b. Chadwick’s sign

14. A pregnant woman is asking about the possible causes of morning sickness.
c. Goodell’s sign
The nurse least likely identifies the cause by stating which of the following?

a. “It is due to the increased human chorionic gonadotrophin levels during
pregnancy.”
b. “It may be due to increased acidity of the GI tract.”
c. “It may be the result of increased progesterone level which in return
d. Vaginal sign
17. The nurse is conducting a health teaching on expectant mothers. She is
stressing the importance of childbirth education classes in one of her
discussions. Most pregnant women are expressing concern about their fear on
the upcoming labor. The nurse is discussing about the ways of alleviating labor
pains using the mind which is based on which childbirth principle?

a. Lamaze method
 b. Leboyer method
a. Moniliasis

c. Bradley method
b. Candidiasis

d. Grantly Dick-Read method

c. Syphilis
18. A diagnosis of Moniliasis is made. The nurse is aware that symptoms of
Moniliasis typically has a symptom of:
d. Vaginitis

21. The obstetrician who associated childbirth method with Pavlov’s conditioning
a. White patchy and cheese like particles that adheres to the vaginal wall studies is:

b. Chancres on the vulva

a. Dr. Grantly Dick-Read

c. Frothy, cream-colored vaginal discharge

b. Dr. Robert Bradley

d. A non-itchy rash covering the whole body or appearing in patches.

c. Dr. Ferdinand Lamaze
19. The hallmark techniques of Leboyer method are the following except:

d. Dr. Frederick Leboyer

a. Newborn warm bath 22. Mrs. White, a pregnant woman, is 5’4” tall and weighs 130 lbs. Calculate her
body mass index.
b. Husband as a coach throughout labor and delivery

a. 22 BMI
c. Infant massage

b. 30 BMI
d. Immediate maternal-newborn bonding

20. During a prenatal visit the pregnant woman is complaining of itchy, foul- c. 24 BMI
smelling vaginal discharges that are frothy and cream-colored. This is a hallmark
sign of:
d. 28 BMI
 a. Lamaze method

23. What is the best interpretation of Mrs. White’s calculated BMI?

b. Leboyer method

a. Underweight c. Bradley method

b. Normal weight d. Grantly Dick-Read method

c. Overweight

d. Obese

24. The nurse is calculating a pregnant woman’s BMI. Her calculated result is 26
BMI. This BMI belongs to the category of:

a. Underweight

b. Normal weight

c. Overweight

d. Obese

25. Myra, a 25-year old woman, on labor firmly told her doctor not to give her
pain medications during labor and delivery. She believes that it is best for her
baby if she would not receive pain medications and no physiological events such
as birth can give rise to pain under the condition that she is free from underlying
diseases. Myra insisted that knowing what are expected and being tension-free
during the delivery process would need no pain medications. Her principle is
based on the philosophy of which method?

ANSWERS
1. Childbirth education is vital for a successful and comfortable childbirth method.
The first method that includes the father as a support person while embracing the
belief that childbirth is a natural event and with the right preparation most women
can have spontaneous and unmedicated vaginal births is:
 a. Lamaze method
 b. Leboyer method
 c. Bradley method
 d. Grantly Dick-Read method
Bradley childbirth method was the first technique to include the father as a
support person during delivery. This method embraces the belief that childbirth is
a natural event and with the right preparation most women can have
spontaneous and unmedicated vaginal births. Lamaze method is a prepared
labor and delivery technique. It is often called psychoprophylactic method as it
uses the mind (psyche) to prevent labor pains (prophylaxis). Leboyer childbirth
method sometimes termed as “birth without violence,” views birth as a stressful
experience for the newborn. The focus of this method is to primarily improve the
quality of the birth experience for the baby. Grantly Dick-read Method is a
psychophysiological preparation for childbirth. This technique alleviates pain
during childbirth by blocking feelings of fear and tension.
2. The easiest method for determining if a woman’s caloric intake is adequate is
assessing:
 a. Food intake
 b. Bowel pattern
 c. Weight she is gaining
 d. A “typical day” history or a 24 hour nutrition recall
The easiest method for determining if a woman’s caloric intake is adequate is
assessing the weight she is gaining. (Pillitteri, 5th Ed). A typical day history or a
24 hour nutrition recall is the best method for assessing overall nutritional intake.
3. The total weight gain in pregnancy for women who have multiple fetuses is:
 a. 20-25 lbs
 b. 25-35 lbs
 c. 35-40 lbs
 d. 40-45 lbs
For women who have twins or multiple fetuses the weight gain should be 1
lb/week for a total of 40-45 lbs. (Adelle Pillitteri, 5th Ed p.302). 25-35 lbs is the
average and recommended weight gain for pregnant woman with one fetus only.
4. During one of the sessions a pregnant mother is expressing concern on her
baby. She is voicing apprehensions on the outcome of her delivery that might be
stressful to her baby. Birth without violence is under which theory?
 a. Lamaze method
 b. Leboyer method
 c. Bradley method
 d. Grantly Dick-Read method
Leboyer childbirth method sometimes termed as “birth without violence,” views
birth as a stressful experience for the newborn. The focus of this method is to
primarily improve the quality of the birth experience for the baby.
5. A sensitive and unobtrusive technique of care while respecting the natural
process and promoting a peaceful atmosphere at birth will help the baby to be
born with a minimum stress. This is least likely achieved by:
 a. Keeping the room noise to a minimum
 b. Not delaying the cutting of the cord
 c. Giving the newborn a warm bath after delivery
 d. Not assisting or pulling the baby’s head in expulsion
Because of the word “least likely” the correct option is B. The method employed
in promoting a sensitive and unobtrusive technique of care while respecting the
natural process and promoting a peaceful atmosphere at birth to help the baby
be born with a minimum stress is LeBoyer Childbirth Method. To decrease the
trauma at birth this technique is an advocate of the following: • The birthing room
is darkened or dimmed. Doing so prevents sudden contrast of light that might
distress the newborn. Leboyer thought that this is less shocking for the neonate’s
eyes that have been in semi-darkness for several months. • A soft music is
played or at least harsh noises are kept to a minimum. All the talking inside the
delivery room is done by whispering. • The room is kept pleasantly warm, not
chilled, to help the newborn be comfortable with the new environment and adapt
to extrauterine life more easily. • Newborns are handled gently and carefully.
Leboyer recommends not pulling the baby’s head to completely allow a natural
childbirth. • The umbilical cord is cut late (It is cut after it has stopped pulsating).
According to Leboyer, this allows the newborn to continue receiving the maternal
hormones and oxygen carrying red blood cells. This is also done to allow the
baby to breathe when he is ready and not have to be rushed. • The infant
receives a warm bath immediately after birth for relaxation. • Before maternal and
newborn bonding is done, the infant is massage to ease crying. Nowadays,
mothers do this massaging to encourage immediate bonding. • Placing the infant
in the mother’s abdomen is done for maternal-neonate bonding.
6. A pregnant woman came in to the clinic expressing concern about her
genitalia that has been observed for a change in color. The nurse explained the
physiology adaptations to pregnancy and stated that this discoloration of the
vagina is called:
 a. Hegar’s sign
 b. Chadwick’s sign
 c. Goodell’s sign
 d. Vaginal sign
Chadwick’s sign is the increased vascularity of the vagina changing its color from
light pink to deep purple or violet. Hegar’s sign is the softening of the uterus.
Goodell’s sign is the change in cervix consistency resembling to that of an
earlobe. There is no known vaginal sign in pregnancy.
7. The entitled Childbirth without Fear is authored by:
 a. Dr. Grantly Dick-Read
 b. Dr. Robert Bradley
 c. Dr. Ferdinand Lamaze
 d. Dr. Frederick Leboyer
Dr. Grantly Dick-Read is an English obstetrician who was practicing medicine in
1900’s. On 1933 his book, “Childbirth without Fear,” was published. He explained
in this publication that no physiological function in a person’s body can give rise
to pain under the condition that it is of normal course of health. Unless a disease
process is taking place, pain or agony would associate delivery Bradley Method
was named after an American obstetrician Dr. Robert Bradley. “Husband
Coached Childbirth,” was written by Dr. Bradley and his principles and theories
paved the way for fathers to be present in the delivery room. This changed the
face of childbirth around the globe. Lamaze childbirth method is an alternative to
the use of medical intervention during childbirth. The method was originally
developed in Russia (based on Pavlov’s conditioning studies) but was
popularized by a French obstetrician Dr. Ferdinand Lamaze. After watching a
woman gave birth in Russia Dr. Lamaze developed his own system of painless
childbirth. Leboyer childbirth method was introduced by Frederick Leboyer. He is
a French obstetrician who believed that the traditional hospital births of the time
(1975) were traumatic for the infant. In 1975, he published a book entitled “Birth
without Violence,” where depth of a newborn’s sensitivity and the importance of
how the baby is handled by the people around him were emphasized. He pointed
out that babies born in a less stressful environment were more content.
8. Physical assessment is very important during prenatal visits to evaluate the
overall health status of a pregnant woman. Weight is one indicator of the health
status. A pregnant woman on her second trimester of pregnancy should gain how
many kilograms per month?
 a. 0.45 kg
 b. 1.82 kg
 c. 1.36 kg
 d. 2 kg
Normal weight gain pattern in pregnancy is 1 lb (0.45 kg) per month in the first
trimester and 1 lb per week in the second and third trimesters. Meaning to say, in
the second and third trimester the pregnant woman should be gaining 4 lbs (1.82
kg) per month. To easily remember the pattern of weight gain in pregnancy is 3-
12-12. 3 lbs in the first trimester and 12 lbs each in the second and third
trimester.
9. The obstetrician who pointed out that a baby born in a less stressful
environment is more content is:
 a. Dr. Grantly Dick-Read
 b. Dr. Robert Bradley
 c. Dr. Ferdinand Lamaze
 d. Dr. Frederick Leboyer
Leboyer childbirth method was introduced by Frederick Leboyer. He is a French
obstetrician who believed that the traditional hospital births of the time (1975)
were traumatic for the infant. In 1975, he published a book entitled “Birth without
Violence,” where depth of a newborn’s sensitivity and the importance of how the
baby is handled by the people around him were emphasized. He pointed out that
babies born in a less stressful environment were more content.
10. A patient on labor is offered ice chips. What is the purpose of giving ice chips
to a woman on labor?
 a. To reduce a woman’s anxiety
 b. To prevent impulses reach the distracted brain
 c. To promote cutaneous stimulation
 d. To allow more blood to pool in the uterus, thus alleviating pain
In Lamaze method one technique of alleviating pain is by cutaneous stimulation.
It is done by effleurage, sacral pressure, thermal stimulation (offering ice chips)
and positioning. Preventing impulses to reach the brain is employing the
distraction or imagery technique. Reducing a woman’s anxiety is done by a
continuous support system. Allowing more blood to pool in the uterus to alleviate
pain is a principle in Dick-Read method.
11. The following concepts are emphasized in a Bradley class apart from:
 a. Avoidance of drugs throughout the pregnancy
 b. Natural breathing methods (without patterns)
 c. Coaching techniques
 d. Woman should change position during labor
Encouraging a woman on labor to change position during labor is a concept of
Lamaze method to stimulate cutaneous stimulation. The following concepts are
taught in Bradley Classes: • Natural birth process • Active involvement of the
husband as a coach • Proper nutrition during pregnancy • Avoidance of drugs
throughout the pregnancy • Natural breathing methods (without patterns) •
Coaching techniques • Natural pain coping methods • Maternal-newborn bonding
• Breastfeeding • Education on emergent situations throughout pregnancy and
delivery (CS) • Postpartum and newborn care • Responsible parenthood
12. The priority management for Hyperemesis Gravidarum is:
 a. Easting dry toast or crackers 30 minutes before arising in the morning
 b. Complete bed rest (CBR)
 c. D5NSS 3L in 24 hours
 d. Administer Milk of Magnesia
The priority treatment for Hyperemesis gravidarum is giving 3 L of D5NSS for 24
hours. CBR is also important but the main treatment is D5NSS to replace the lost
fluids. Eating dry crackers before arising in the morning is the management for
morning sickness not Hyperemesis gravidarum. Milk of magnesia is an antacid
used to manage heartburn in pregnant woman.
13. A pregnant woman is diagnosed with toxemia. The following are signs of
toxemia apart from:
 a. Edema of the lower extremities
 b. Sudden Weight gain
 c. Blurry vision
 d. Protein in urine
Toxemia or Pregnancy induced hypertension has the following manifestations:
Edema of the face, hands, ankle and feet, proteinuria, visual disturbances,
sudden weight gain, headache, fever. Edema of lower extremity alone is not a
sign of toxemia as it is a normal adaptation to pregnancy that is the result of the
poor circulation in the lower extremities due to the pressure from the gravid
uterus. It is managed by raising the legs above the hip level. Edema of the Lower
Extremities plus the upper extremities is a sign of toxemia.
14. A pregnant woman is asking about the possible causes of morning sickness.
The nurse least likely identifies the cause by stating which of the following?
 a. “It is due to the increased human chorionic gonadotrophin levels during
pregnancy.”
 b. “It may be due to increased acidity of the GI tract.”
 c. “It may be the result of increased progesterone level which in return
decreases gastric motility thus causing reverse peristaltic waves.”
 d. “Some cases of morning sickness can also be due to emotional factors.”
Heartburn not morning sickness is the result of increased progesterone level
which in return decreases gastric motility thus causing reverse peristaltic waves.
15. The structure which contains high amount of estrogen is called:
 a. Corpus albicans
 b. Corpus luteum
 c. Primordial follicles
 d. Graafian follicles
Graafian follicles are structures containing high amounts of estrogen. Graafian
follicle are derived from primordial follicles. Corpus Luteum is the structure
containing high amounts of progesterone and is yellow in color. If no fertilization
occurs corpus luteum turns white and is now called Corpus Albicans.
16. Change in the consistency of the lower uterine segment causing extreme
softening is referred as:
 a. Hegar’s sign
 b. Chadwick’s sign
 c. Goodell’s sign
 d. Vaginal sign
Hegar’s sign is the softening of the uterus. Goodell’s sign is the change in cervix
consistency resembling to that of an earlobe. Chadwick’s sign is the increased
vascularity of the vagina changing its color from light pink to deep purple or
violet. There is no known vaginal sign in pregnancy.
17. The nurse is conducting a health teaching on expectant mothers. She is
stressing the importance of childbirth education classes in one of her
discussions. Most pregnant women are expressing concern about their fear on
the upcoming labor. The nurse is discussing about the ways of alleviating labor
pains using the mind which is based on which childbirth principle?
 a. Lamaze method
 b. Leboyer method
 c. Bradley method
 d. Grantly Dick-Read method
Lamaze method is a prepared labor and delivery technique. It is often called
psychoprophylactic method as it uses the mind (psyche) to prevent labor pains
(prophylaxis). The Lamaze method of prepared childbirth is based on the gating
control theory of pain relief. It involves concentration and conditioning to help the
woman respond to contractions with relaxation from techniques thereby
alleviating pain. This is based on the theory that through stimulus-response
conditioning, women can learn to use controlled breathing to reduce the pain in
the labor. Lamaze method is the most popular approach used to today.
18. A diagnosis of Moniliasis is made. The nurse is aware that symptoms of
Moniliasis typically has a symptom of:
 a. White patchy and cheese like particles that adheres to the vaginal wall
 b. Chancres on the vulva
 c. Frothy, cream-colored vaginal discharge
 d. A non-itchy rash covering the whole body or appearing in patches.
Moniliasis or Candidiasis is caused by a fungus Candida Albicans (Monilia).
Symptoms include: white patchy and cheese like particles that adheres to the
vaginal wall, irritatingly itchy and foul smelling vaginal discharges. Chancres on
vulva and non-itchy rash covering the whole body or appearing in patches are
manifestations of syphilis. Frothy, cream-colored vaginal discharges, vulvar
edema and hyperemia are hallmark signs of Trichomoniasis or vaginitis.
19. The hallmark techniques of Leboyer method are the following except:
 a. Newborn warm bath
 b. Husband as a coach throughout labor and delivery
 c. Infant massage
 d. Immediate maternal-newborn bonding
Infant massage, a warm bath and immediate bonding with the mother are all
hallmarks of the Leboyer method. Bradley childbirth method was the first
technique to include the father as a support person during delivery.
20. During a prenatal visit the pregnant woman is complaining of itchy, foul-
smelling vaginal discharges that are frothy and cream-colored. This is a hallmark
sign of:
 a. Moniliasis
 b. Candidiasis
 c. Syphilis
 d. Vaginitis
Frothy, cream-colored vaginal discharges, vulvar edema and hyperemia are
hallmark signs of Trichomoniasis or vaginitis. Moniliasis or Candidiasis is caused
by a fungus Candida Albicans (Monilia). Symptoms include: white patchy and
cheese like particles that adheres to the vaginal wall, irritatingly itchy and foul
smelling vaginal discharges. Chancres on vulva and non-itchy rash covering the
whole body or appearing in patches are manifestations of syphilis.
21. The obstetrician who associated childbirth method with Pavlov’s conditioning
studies is:
 a. Dr. Grantly Dick-Read
 b. Dr. Robert Bradley
 c. Dr. Ferdinand Lamaze
 d. Dr. Frederick Leboyer
Lamaze childbirth method is an alternative to the use of medical intervention
during childbirth. The method was originally developed in Russia (based on
Pavlov’s conditioning studies) but was popularized by a French obstetrician Dr.
Ferdinand Lamaze. After watching a woman gave birth in Russia Dr. Lamaze
developed his own system of painless childbirth.
22. Mrs. White, a pregnant woman, is 5’4” tall and weighs 130 lbs. Calculate her
body mass index.
 a. 22 BMI
 b. 30 BMI
 c. 24 BMI
 d. 28 BMI
22 BMI To compute for BMI 1. Convert weight into kilograms: 130 lbs / 2.2=
59.09 kg (1 kg=2.2 lbs) 2. Convert height into cm: 5’4” ( 5 feet 4 inches) 1
foot=12 inches; 1 inch = 2.54 cm CONVERT TO INCH FIRST: 5 x 12 = 60 inches
+ 4 inches = 64 inches INCN TO CM: 64 x 2.54 = 162.56 cm 3. Square the height
in meters (1 m = 100 cm) CONVERT CM TO METER: 162.56 / 100 = 1.6256 m
or 1.63 m SQUARE THE HEIGHT IN METER: 1.63 x 1.63 = 2.6569 or 2.66 4. supply to the uterus and alleviating labor pains. He also identified that laboring
Divide weight (kg) by meter squared 59.09 / 2.66 = 22 BMI women needed constant emotional support to help them cope.
23. What is the best interpretation of Mrs. White’s calculated BMI?
 a. Underweight
 b. Normal weight
 c. Overweight
 d. Obese
Normal weight a. Underweight – under 18.5 BMI b. Normal weight – 18.5-24.9
BMI c. Overweight – 25-29.9 BMI d. Obese – above 30.0
24. The nurse is calculating a pregnant woman’s BMI. Her calculated result is 26
BMI. This BMI belongs to the category of:
 a. Underweight
 b. Normal weight
 c. Overweight
 d. Obese
a. Underweight – under 18.5 BMI b. Normal weight – 18.5-24.9 BMI c.
Overweight – 25-29.9 BMI d. Obese – above 30.0
25. Myra, a 25-year old woman, on labor firmly told her doctor not to give her
pain medications during labor and delivery. She believes that it is best for her
baby if she would not receive pain medications and no physiological events such
as birth can give rise to pain under the condition that she is free from underlying
diseases. Myra insisted that knowing what are expected and being tension-free
during the delivery process would need no pain medications. Her principle is
based on the philosophy of which method?
 a. Lamaze method
 b. Leboyer method
 c. Bradley method
 d. Grantly Dick-Read method
Question was not answered
Grantly Dick-read Method is a psychophysiological preparation for childbirth. This
technique alleviates pain during childbirth by blocking feelings of fear and
tension. Dr. Dick-Read postulated that this fear felt by women during delivery
causes the blood to be carried away from the uterus to be used by the muscles
needing it due to perceived pain. This results to an unoxygenated uterus which
would be unable to perform its function well leading to pain, a phenomenon
called “the fear-tension-pain syndrome.” Dick-Read believed that presence of
fear and tension result to labor pains. Thus, eliminating fear would increase blood