PART 2 TEST 2

After an amniotomy, which finding indicates possible infection?

• A. Clear, odorless fluid

• B. Maternal temperature of 100.6°F

• C. Fetal heart rate of 140 bpm

• D. Contractions every 5 minutes

Answer explanation

Answer: B
Rationale: A maternal temperature ≥100.4°F after amniotomy is a sign of infection.

What is an amniotomy?

• A. Surgical removal of the amniotic sac

• B. Artificial rupture of membranes using a sterile instrument

• C. Natural rupture of membranes during active labor

• D. Drainage of amniotic fluid with ultrasound guidance

Answer explanation

Answer: B
Rationale: Amniotomy is the artificial rupture of membranes to induce or augment labor.

Which finding is consistent with hypertonic labor?

• A. Weak contractions during the active phase

• B. Frequent, cramp-like, poorly coordinated contractions in latent phase

• C. Overdistended uterus with decreased tone

• D. Soft uterus between contractions

Answer explanation

Answer: B
Rationale: Hypertonic labor presents with increased uterine tone, frequent, uncoordinated contractions, and a tense uterus.

How is the Apgar score assessed?

• A. By evaluating heart rate, respirations, muscle tone, reflexes, and color

• B. By measuring weight, length, and head circumference

• C. By assessing blood glucose, temperature, and heart rate

• D. By checking cord blood gases and bilirubin

Answer explanation

Answer: A
Rationale: The Apgar measures five signs; scores <7 at 5 minutes require reassessment in 20 minutes.

Which is a common early cause of postpartum hemorrhage?

• A. Retained placental fragments

• B. Subinvolution

• C. Uterine atony

• D. Infection

Answer explanation

Answer: C
Rationale: Uterine atony is the most common cause of early postpartum hemorrhage.

What is the first nursing intervention for postpartum hemorrhage?

• A. Notify the provider

• B. Administer antibiotics

• C. Massage the fundus

• D. Prepare for surgery

Answer explanation

Answer: C
Rationale: Fundal massage stimulates contraction and is the priority action.

Which is a sign of hypoglycemia in a term newborn?

• A. Hyperactive reflexes

• B. High-pitched cry

• C. Flushed skin

• D. Bradycardia

Answer explanation

Answer: B
Rationale: High-pitched cry, jitteriness, and poor muscle tone are classic signs.

Where should the uterus be immediately after delivery?

• A. Two fingerbreadths above the umbilicus, boggy

• B. Midline at the umbilicus, firm

• C. To the right of the umbilicus, firm

• D. Midline below the umbilicus, soft

Answer explanation

Answer: B
Rationale: The uterus should be midline, firm, and at the umbilicus postpartum.

Which medication is used to ripen the cervix?

• A. Oxytocin

• B. Magnesium sulfate

• C. Prostaglandin

• D. Betamethasone

Answer explanation

Answer: C
Rationale: Prostaglandins soften and dilate the cervix before induction.

What medication increases fetal lung maturity?

• A. Oxytocin

• B. Betamethasone

• C. Magnesium sulfate

• D. Erythromycin

Answer explanation

Answer: B
Rationale: Betamethasone stimulates surfactant production; surfactant is given via ET tube to newborns.