PN 136-01 Maternal Health Nursing Exam
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Free PN 136-01 Maternal Health Nursing Exam Questions
Which strategy to decrease maternal mortality in health care does the nurse suggest? Select all that apply.
- A. Improve access to skilled attendants at birth
- B. Provide postabortion care
- C. Instruct obese women to delay pregnancy
- D. Provide adolescents with better reproductive health services
- E. Improve family planning services
Explanation
A. Improve access to skilled attendants at birth
Skilled birth attendants (midwives, nurses, physicians) recognize and manage the leading direct causes of maternal death—postpartum hemorrhage, hypertensive emergencies, sepsis, and obstructed labor. They can perform active management of the third stage of labor, administer uterotonics, start magnesium sulfate, initiate antibiotics, and escalate care for timely cesarean delivery when indicated. Their presence also ensures continuous risk assessment, partograph use, sterile technique, neonatal resuscitation readiness, and rapid referral/transfer systems—each step breaking the “three delays” (seeking, reaching, receiving care) that drive maternal mortality.
B. Provide postabortion care
Comprehensive postabortion care (PAC) addresses hemorrhage, infection, retained products, and anemia—the immediate complications that can be fatal if untreated. PAC includes emergency treatment (manual vacuum aspiration or medical management), pain control, antibiotics when indicated, and counseling about return of fertility. Integrating same-day contraception (LARC or short-acting methods) reduces repeat unintended pregnancies. PAC also screens for intimate-partner violence, mental health concerns, and provides follow-up, thereby decreasing both short-term mortality and longer-term morbidity such as infertility and chronic pelvic pain.
D. Provide adolescents with better reproductive health services
Adolescents have higher risks of eclampsia, puerperal infection, obstructed labor, and low-birth-weight infants. Youth-friendly services—confidential counseling, comprehensive sexuality education, contraception access (including LARC), and early, respectful prenatal care—reduce unintended pregnancy and enable early detection of complications. Addressing social barriers (stigma, cost, consent requirements, distance) and keeping girls in school delays first pregnancy, improves nutritional and anemia status, and increases care-seeking behaviors. Antenatal supplements, screening for GBV, and birth preparedness further lower adverse outcomes in this high-risk group.
E. Improve family planning services
Modern contraception prevents unintended and closely spaced pregnancies, reducing exposure to the risks of pregnancy and delivery. Family planning lowers unsafe abortion, decreases grand multiparity and advanced maternal age pregnancies, and allows spacing for recovery from anemia or prior cesarean. High-quality programs ensure method mix (including LARC), same-day initiation, management of side effects, postpartum and postabortion contraception, and community outreach. Integrating FP with HIV/STI services and routine maternal care strengthens continuity, autonomy, and equitable access—key drivers of reduced maternal mortality.
Which will the nurse mention to the patient about the effect of secondary powers during labor?
- A. Contractions are expulsive in nature
- B. Contractions begin at pacemaker points
- C. Contractions move downward in waves
- D. The intraabdominal pressure is decreased
Explanation
Secondary powers refer to the voluntary bearing-down efforts made by the mother during the second stage of labor, which aid in expelling the fetus. These powers work in conjunction with uterine contractions (primary powers) and are expulsive in nature, generated by increased intra-abdominal pressure from the diaphragm and abdominal muscles. The effectiveness of secondary powers largely determines the progress of fetal descent and delivery.
Which is the most likely reason for preeclampsia in a pregnant patient during the second trimester of her pregnancy?
- A. Body mass index (BMI) of 34.2 kg/m²
- B. Severe hypotension
- C. Hypervitaminosis
- D. Lower extremity edema
Explanation
A BMI of 34.2 kg/m² indicates obesity, which is a major risk factor for preeclampsia. Obesity contributes to endothelial dysfunction, insulin resistance, and chronic inflammation, all of which impair placental perfusion and increase blood pressure. Preeclampsia typically develops after 20 weeks of gestation and is characterized by hypertension and proteinuria due to abnormal placental vascular development. Obese women are at higher risk for complications such as gestational hypertension, preeclampsia, and eclampsia.
After reviewing the obstetric reports of a pregnant patient, the nurse finds that the patient’s fundal height has not changed in the last 4 weeks. Which condition does the nurse potentially interpret from this finding?
- A. Multifetal pregnancy
- B. Maternal malnourishment
- C. Polyhydramnios
- D. Intrauterine Growth Retardation (IUGR)
Explanation
A lack of increase in fundal height over several weeks is a key indicator of Intrauterine Growth Retardation (IUGR), meaning the fetus is not growing at the expected rate for gestational age. Normally, fundal height (in centimeters) roughly equals the number of weeks of gestation between 18–32 weeks. A stagnant or decreased measurement suggests impaired fetal growth due to placental insufficiency, maternal hypertension, malnutrition, or fetal abnormalities. Early detection is critical for monitoring and intervention to prevent fetal distress.
Which is the factor that enables the baby to initiate respiration immediately postpartum?
- A. Arterial carbon dioxide pressure is decreased.
- B. Fetal respiratory movements increase during labor.
- C. Fetal lung fluid is cleared from the air passage.
- D. Arterial pH and bicarbonate levels are increased.
Explanation
At birth, clearing of fetal lung fluid from the airways is essential for the newborn to initiate effective respiration. During labor and delivery, thoracic compression and hormonal changes help expel lung fluid, allowing the alveoli to fill with air upon the first breath. This clearance decreases pulmonary vascular resistance, increases oxygen exchange, and establishes functional residual capacity—key steps in the newborn’s adaptation to extrauterine life.
A patient gave birth to a 7-lb, 3-oz boy 2 hours ago. The nurse determines that the patient's bladder is distended because her fundus is now 3 cm above the umbilicus and to the right of the midline. In the immediate postpartum period, what is the most serious consequence likely to occur from bladder distention?
- A. Excessive uterine bleeding
- B. Urinary tract infection
- C. Bladder wall atony
- D. Ruptured bladder
Explanation
Bladder distention displaces the uterus upward and to the side, preventing effective uterine contraction. A relaxed (boggy) uterus cannot compress blood vessels at the placental site, leading to excessive postpartum bleeding or hemorrhage. Prompt bladder emptying—either through spontaneous voiding or catheterization—restores uterine tone and position, reducing the risk of hemorrhage and promoting normal postpartum recovery.
Which medication would the nurse expect the primary health care provider to prescribe to a postpartum patient with uterine atony?
- A. Methylergonovine
- B. Misoprostol
- C. Ergonovine
- D. Oxytocin
Explanation
Oxytocin (Pitocin) is the first-line medication used to treat uterine atony, which is the failure of the uterus to contract effectively after childbirth—a major cause of postpartum hemorrhage. Oxytocin stimulates the smooth muscle of the uterus, promoting strong, rhythmic contractions that compress blood vessels and reduce bleeding. It can be given intravenously (IV) or intramuscularly (IM) and is usually administered immediately after delivery of the placenta as part of active management of the third stage of labor.
Which guidance will the nurse provide to a pregnant patient with iron-deficiency anemia who was recently started on iron supplementation, when the patient reports nausea?
- A. Take the supplement at bedtime
- B. Take the supplement between meals
- C. Take a double dose of iron if a dose is missed
- D. Take the supplement with a glass of whole milk
Explanation
Iron supplements often cause gastrointestinal discomfort, including nausea, constipation, and stomach upset. Taking the supplement at bedtime may help reduce nausea because the patient is lying down and less likely to feel the side effects. This adjustment improves adherence while still allowing for adequate absorption. The nurse should also encourage taking iron with vitamin C (e.g., orange juice) to enhance absorption and avoid taking it with dairy, tea, or coffee.
A pregnant patient is receiving tocolytic therapy with magnesium sulfate. Under which patient circumstance would the nurse suggest discontinuing the therapy?
- A. Urine output is 40 mL/hr.
- B. Respiratory rate is 10 breaths/min.
- C. Blood pressure is 120/80 mm Hg.
- D. Serum magnesium level is 5 mEq/L.
Explanation
Magnesium sulfate can cause respiratory depression when serum magnesium levels become toxic. A respiratory rate below 12 breaths per minute indicates potential magnesium toxicity and requires immediate discontinuation of the drug. The nurse should notify the provider, stop the infusion, and administer calcium gluconate as the antidote if ordered. Continuous monitoring of reflexes, respiratory rate, and urine output is critical during magnesium sulfate therapy to ensure maternal safety.
Which time of day is best to take an at-home pregnancy test to increase accuracy?
- A. Time of day is not a factor in at-home urine pregnancy tests
- B. Mid-day urine
- C. Last urine of the day
- D. First urine of the day
Explanation
The first urine of the day provides the most accurate result for an at-home pregnancy test because it contains the highest concentration of human chorionic gonadotropin (hCG). Since hCG levels rise after implantation, concentrated morning urine improves the test’s sensitivity and helps detect pregnancy earlier. Testing later in the day may produce a false negative result if urine is diluted from fluid intake.
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