A woman at 7 weeks by dates has sudden lower abdominal pain, pain in her right shoulder tip and dizziness. The shoulder-tip pain most likely comes from:

Blood in the peritoneum irritating the diaphragm

Muscle strain from repeated heavy vomiting

Referred pain from a urinary tract infection

Gas pains from early pregnancy constipation

A woman at 26 weeks has a 75 g OGTT: fasting 5.3 mmol/L, 1 hour 9.4 mmol/L, 2 hours 7.6 mmol/L. Using IADPSG cut-offs (fasting 5.1, 1 hour 10.0, 2 hours 8.5 mmol/L), how should the nurse read this result?

Gestational diabetes, as one value meets its cut-off

Normal, as two of the three values are below cut-off

Overt diabetes, because the fasting value is raised

Borderline, so the test is repeated in 4 weeks

Which instruction helps a pregnant woman absorb the most iron from her ferrous sulfate tablet?

Take it with a glass of orange juice

Take it together with a glass of milk

Take it with a cup of tea after meals

Take it with her calcium supplement

An Rh-negative mother with a negative antibody screen gives birth. Cord blood shows the baby is O Rh-negative. Regarding anti-D, the nurse should:

Not give postnatal anti-D, as the baby is Rh-negative

Give the mother a double dose of anti-D

Give anti-D within 72 hours, as for every Rh-negative mother

Give anti-D to the baby within 72 hours of birth

Antenatal care and high-risk pregnancy

50 Gulf Prometric RN (DHA, DOH, MOH, SCFHS) practice questions on Antenatal care and high-risk pregnancy, part of Maternal and Newborn Nursing. The first 25 are below; the first 5 with answers and explanations (tap Show answer after you have chosen), the rest in Learn with a free account.

Question 1 · Medium
A woman at 7 weeks by dates has sudden lower abdominal pain, pain in her right shoulder tip and dizziness. The shoulder-tip pain most likely comes from:
1. ABlood in the peritoneum irritating the diaphragm
2. BMuscle strain from repeated heavy vomiting
3. CReferred pain from a urinary tract infection
4. DGas pains from early pregnancy constipation
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Answer: A · Blood in the peritoneum irritating the diaphragm
Shoulder-tip pain in early pregnancy with abdominal pain and dizziness suggests a ruptured ectopic pregnancy. Blood in the peritoneal cavity irritates the diaphragm, and the pain is referred along the phrenic nerve (C3-C5) to the shoulder. This is an emergency because bleeding can be heavy. The nurse checks vital signs, inserts IV access and alerts the team.
- B: Vomiting may strain abdominal muscles but does not explain dizziness and shoulder pain.
- C: A urinary infection causes loin or suprapubic pain, not shoulder-tip pain.
- D: Constipation does not cause shoulder-tip pain or dizziness.
Question 2 · Medium
A woman at 26 weeks has a 75 g OGTT: fasting 5.3 mmol/L, 1 hour 9.4 mmol/L, 2 hours 7.6 mmol/L. Using IADPSG cut-offs (fasting 5.1, 1 hour 10.0, 2 hours 8.5 mmol/L), how should the nurse read this result?
1. AGestational diabetes, as one value meets its cut-off
2. BNormal, as two of the three values are below cut-off
3. COvert diabetes, because the fasting value is raised
4. DBorderline, so the test is repeated in 4 weeks
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Answer: A · Gestational diabetes, as one value meets its cut-off
In the one-step IADPSG method a single value at or above its cut-off is enough to diagnose GDM. Her fasting value of 5.3 mmol/L is above 5.1, so she has GDM even though the 1- and 2-hour values are normal. Two abnormal values are needed only in the older two-step (100 g) method. She is referred for diet, glucose monitoring and education.
- B: The one-step method does not need two abnormal values; one is enough.
- C: Overt diabetes needs a fasting value of 7.0 mmol/L or more.
- D: There is no borderline category, and repeating the test delays treatment.
Question 3 · Hard
At booking, a woman is 1.60 m tall and weighed 70 kg before pregnancy. Using the US Institute of Medicine (IOM) guidance for a singleton pregnancy, what total weight gain should the nurse advise?
1. A11.5-16 kg
2. B5-9 kg
3. C12.5-18 kg
4. D7-11.5 kg
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Answer: D · 7-11.5 kg
BMI = weight / height squared = 70 / (1.60 x 1.60) = 70 / 2.56 = 27.3 kg/m2, which is overweight (25-29.9). The IOM range for overweight women is 7-11.5 kg in total. The ranges are 12.5-18 kg if underweight, 11.5-16 kg if normal weight and 5-9 kg if obese. Too much gain raises the risk of GDM, pre-eclampsia, macrosomia and caesarean birth.
- A: 11.5-16 kg is the range for a normal BMI of 18.5-24.9.
- B: 5-9 kg is the range for obesity, BMI 30 or more.
- C: 12.5-18 kg is the range for an underweight woman.
Question 4 · Easy
Which instruction helps a pregnant woman absorb the most iron from her ferrous sulfate tablet?
1. ATake it together with a glass of milk
2. BTake it with a cup of tea after meals
3. CTake it with a glass of orange juice
4. DTake it with her calcium supplement
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Answer: C · Take it with a glass of orange juice
Vitamin C keeps iron in the ferrous form and improves its absorption, so a citrus drink helps. Absorption is best on an empty stomach, although taking it with food can be allowed if it upsets her stomach. Tea and coffee contain tannins, and milk, calcium and antacids bind iron, so they should be taken at least 1-2 hours apart from the tablet. Good absorption speeds the rise in haemoglobin.
- A: Calcium in milk competes with iron and lowers its absorption.
- B: Tannins in tea bind iron and reduce how much is absorbed.
- D: Calcium supplements block iron uptake and should be taken at a different time.
Question 5 · Medium
An Rh-negative mother with a negative antibody screen gives birth. Cord blood shows the baby is O Rh-negative. Regarding anti-D, the nurse should:
1. AGive the mother a double dose of anti-D
2. BNot give postnatal anti-D, as the baby is Rh-negative
3. CGive anti-D within 72 hours, as for every Rh-negative mother
4. DGive anti-D to the baby within 72 hours of birth
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Answer: B · Not give postnatal anti-D, as the baby is Rh-negative
Postnatal anti-D is needed only when the baby is Rh-positive, because only Rh-positive fetal cells can sensitise her. An Rh-negative baby's cells carry no D antigen, so there is nothing to sensitise her against. Cord blood grouping is therefore done for every Rh-negative mother at birth. Anti-D is always given to the mother, never to the baby.
- A: A higher dose is used only for a large fetomaternal bleed with an Rh-positive baby.
- C: Anti-D after birth is given only when the baby is Rh-positive.
- D: Anti-D is given to the mother; giving it to the baby is wrong.
Question 6 · Easy
In a woman with severe pre-eclampsia, the main purpose of giving magnesium sulfate is to:
1. ALower the blood pressure rapidly
2. BPrevent eclamptic seizures
3. CReduce the amount of proteinuria
4. DMature the fetal lungs before birth
Answer and explanation in LearnFree account
Question 7 · Medium
After methotrexate for an unruptured ectopic pregnancy, which statement shows the woman has understood the teaching?
1. AI do not need any more blood tests after today
2. BI can try for another baby after my next period
3. CI can take ibuprofen for any abdominal pain I have
4. DI will stop my folic acid vitamins until my doctor says
Answer and explanation in LearnFree account
Question 8 · Medium
A woman had gestational diabetes controlled with diet. After birth her glucose readings are normal. What follow-up should the nurse explain to her?
1. AA fasting glucose only if she plans another baby
2. BA 75 g glucose tolerance test 4-12 weeks after birth
3. CNone, because gestational diabetes always resolves
4. DAn HbA1c test on the day she is discharged
Answer and explanation in LearnFree account
Question 9 · Easy
For a healthy woman planning a pregnancy who has no history of a baby with a neural tube defect, the recommended daily dose of folic acid is:
1. A5 milligrams
2. B60 milligrams
3. C100 micrograms
4. D400 micrograms
Answer and explanation in LearnFree account
Question 10 · Medium
After suction evacuation of a complete hydatidiform mole, what is the main purpose of the follow-up she will have?
1. AWeekly blood pressure checks for pre-eclampsia
2. BA repeat chorionic villus sample to confirm the diagnosis
3. CMonthly ultrasound scans to check the size of the uterus
4. DSerial hCG levels to detect persistent trophoblastic disease
Answer and explanation in LearnFree account
Question 11 · Medium
Two weeks after starting ferrous sulfate, a pregnant woman says her stools have become black but formed. She has no pain or dizziness and her vital signs are normal. The nurse should:
1. AAdvise her to take each tablet with milk instead
2. BSend a stool sample urgently for occult blood
3. CReassure her that this is an expected effect of iron
4. DTell her to stop the iron and go to the emergency room
Answer and explanation in LearnFree account
Question 12 · Medium
A woman with severe pre-eclampsia gave birth 2 hours ago and is still on magnesium sulfate. She asks when it will stop. The nurse explains that it is usually continued for about:
1. AUntil the placenta is out
2. B1 hour after birth
3. CUntil she goes home
4. D24 hours after birth
Answer and explanation in LearnFree account
Question 13 · Hard
After handover, the nurse reviews the antenatal ward list. Whose new problem carries the greatest immediate risk to mother and fetus?
1. APre-eclampsia at 34 weeks with new epigastric pain
2. BPlacenta praevia at 32 weeks, no bleeding for 3 days
3. CGDM at 30 weeks, 1-hour glucose of 8.1 mmol/L
4. DRh-negative at 28 weeks, due for routine anti-D
Answer and explanation in LearnFree account
Question 14 · Hard
A woman at 30 weeks with sickle cell disease is admitted with a painful crisis. On day 2 she develops chest pain, fever 38.4 °C, respiratory rate 28/min and SpO2 90% on room air, and the chest X-ray shows a new infiltrate. What is the most likely complication?
1. AOpioid-induced respiratory depression
2. BPulmonary oedema from fluids
3. CSimple viral upper respiratory infection
4. DAcute chest syndrome
Answer and explanation in LearnFree account
Question 15 · Easy
A woman at 9 weeks has light vaginal bleeding and mild cramps. The cervical os is closed and the ultrasound shows a live fetus with a heartbeat. This is classified as:
1. AIncomplete miscarriage
2. BMissed miscarriage
3. CInevitable miscarriage
4. DThreatened miscarriage
Answer and explanation in LearnFree account
Question 16 · Hard
A woman at 32 weeks with pre-eclampsia has BP 150/98 mmHg and no headache, visual change or pain. Results: protein:creatinine ratio 280 mg/mmol, platelets 160 x10^9/L, ALT 30 U/L, creatinine 102 µmol/L (1.15 mg/dL). Which finding is a severe feature of pre-eclampsia?
1. AThe platelet count of 160 x10^9/L
2. BThe protein:creatinine ratio of 280 mg/mmol
3. CThe blood pressure of 150/98 mmHg
4. DThe creatinine of 102 µmol/L
Answer and explanation in LearnFree account
Question 17 · Easy
At a routine antenatal visit at 30 weeks, which fetal heart rate is within the normal baseline range?
1. A175 beats/min
2. B90 beats/min
3. C145 beats/min
4. D100 beats/min
Answer and explanation in LearnFree account
Question 18 · Medium
A woman with chronic hypertension who takes enalapril has a positive pregnancy test at 6 weeks. The nurse expects the provider to:
1. AContinue enalapril at the same dose
2. BDouble the enalapril to protect the placenta
3. CStop all antihypertensives until 20 weeks
4. DChange enalapril to labetalol or nifedipine
Answer and explanation in LearnFree account
Question 19 · Medium
Which advice best helps a pregnant woman with sickle cell disease avoid a painful crisis during the hot Gulf summer?
1. AExercise outdoors at midday to stay fit
2. BDrink plenty of fluids and avoid overheating
3. CRestrict fluids to lower the risk of oedema
4. DTake an iron tablet with every meal
Answer and explanation in LearnFree account
Question 20 · Medium
A woman at 33 weeks with a suspected placental abruption has only a small visible vaginal bleed. Which finding most suggests significant concealed bleeding?
1. ARising fundal height with a pulse of 122/min
2. BA fetal heart rate of 140 beats/min
3. CA blood pressure of 118/76 mmHg
4. DMild backache relieved by changing position
Answer and explanation in LearnFree account
Question 21 · Easy
A woman's antenatal blood tests show she is not immune to rubella. When should the nurse plan for her to receive the MMR vaccine?
1. ASoon after birth, before discharge
2. BOnly once breastfeeding has stopped
3. CAt the next visit, in the second trimester
4. DImmediately, at this antenatal visit
Answer and explanation in LearnFree account
Question 22 · Easy
The bluish-purple colour of the cervix and vaginal walls that appears in early pregnancy is known as:
1. AChadwick's sign
2. BGoodell's sign
3. CBallottement
4. DHegar's sign
Answer and explanation in LearnFree account
Question 23 · Medium
An Rh-negative, unsensitised woman at 26 weeks is seen after a minor road-traffic collision. She and the fetus are well. What should the nurse expect?
1. ANo anti-D now, as the routine dose is due at 28 weeks
2. BA transfusion of Rh-negative red cells as a precaution
3. CAnti-D only if she develops any vaginal bleeding
4. DAnti-D within 72 hours and a test to measure fetal cells
Answer and explanation in LearnFree account
Question 24 · Medium
Diet and exercise have not kept a woman's gestational diabetes within target. Under ADA standards, the preferred medication is:
1. AInsulin
2. BSitagliptin
3. CMetformin
4. DGlibenclamide (glyburide)
Answer and explanation in LearnFree account
Question 25 · Hard
A woman at 31 weeks with gestational diabetes on insulin is admitted in threatened preterm labour and given betamethasone 12 mg IM. Over the next 2 days her glucose readings rise. What best explains this and what should the nurse expect?
1. AFailure of insulin therapy; a permanent switch to metformin
2. BInfection from the injection site; blood cultures are taken
3. CA meter error; glucose checks stop until the course ends
4. DSteroid-induced hyperglycaemia; a temporary rise in insulin dose
Answer and explanation in LearnFree account

25 more Antenatal care and high-risk pregnancy questions

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Antenatal care and high-risk pregnancy

A woman at 7 weeks by dates has sudden lower abdominal pain, pain in her right shoulder tip and dizziness. The shoulder-tip pain most likely comes from:

A woman at 26 weeks has a 75 g OGTT: fasting 5.3 mmol/L, 1 hour 9.4 mmol/L, 2 hours 7.6 mmol/L. Using IADPSG cut-offs (fasting 5.1, 1 hour 10.0, 2 hours 8.5 mmol/L), how should the nurse read this result?

At booking, a woman is 1.60 m tall and weighed 70 kg before pregnancy. Using the US Institute of Medicine (IOM) guidance for a singleton pregnancy, what total weight gain should the nurse advise?

Which instruction helps a pregnant woman absorb the most iron from her ferrous sulfate tablet?

An Rh-negative mother with a negative antibody screen gives birth. Cord blood shows the baby is O Rh-negative. Regarding anti-D, the nurse should:

In a woman with severe pre-eclampsia, the main purpose of giving magnesium sulfate is to:

After methotrexate for an unruptured ectopic pregnancy, which statement shows the woman has understood the teaching?

A woman had gestational diabetes controlled with diet. After birth her glucose readings are normal. What follow-up should the nurse explain to her?

For a healthy woman planning a pregnancy who has no history of a baby with a neural tube defect, the recommended daily dose of folic acid is:

After suction evacuation of a complete hydatidiform mole, what is the main purpose of the follow-up she will have?

Two weeks after starting ferrous sulfate, a pregnant woman says her stools have become black but formed. She has no pain or dizziness and her vital signs are normal. The nurse should:

A woman with severe pre-eclampsia gave birth 2 hours ago and is still on magnesium sulfate. She asks when it will stop. The nurse explains that it is usually continued for about:

After handover, the nurse reviews the antenatal ward list. Whose new problem carries the greatest immediate risk to mother and fetus?

A woman at 30 weeks with sickle cell disease is admitted with a painful crisis. On day 2 she develops chest pain, fever 38.4 °C, respiratory rate 28/min and SpO2 90% on room air, and the chest X-ray shows a new infiltrate. What is the most likely complication?

A woman at 9 weeks has light vaginal bleeding and mild cramps. The cervical os is closed and the ultrasound shows a live fetus with a heartbeat. This is classified as:

A woman at 32 weeks with pre-eclampsia has BP 150/98 mmHg and no headache, visual change or pain. Results: protein:creatinine ratio 280 mg/mmol, platelets 160 x10^9/L, ALT 30 U/L, creatinine 102 µmol/L (1.15 mg/dL). Which finding is a severe feature of pre-eclampsia?

At a routine antenatal visit at 30 weeks, which fetal heart rate is within the normal baseline range?

A woman with chronic hypertension who takes enalapril has a positive pregnancy test at 6 weeks. The nurse expects the provider to:

Which advice best helps a pregnant woman with sickle cell disease avoid a painful crisis during the hot Gulf summer?

A woman at 33 weeks with a suspected placental abruption has only a small visible vaginal bleed. Which finding most suggests significant concealed bleeding?

A woman's antenatal blood tests show she is not immune to rubella. When should the nurse plan for her to receive the MMR vaccine?

The bluish-purple colour of the cervix and vaginal walls that appears in early pregnancy is known as:

An Rh-negative, unsensitised woman at 26 weeks is seen after a minor road-traffic collision. She and the fetus are well. What should the nurse expect?

Diet and exercise have not kept a woman's gestational diabetes within target. Under ADA standards, the preferred medication is:

A woman at 31 weeks with gestational diabetes on insulin is admitted in threatened preterm labour and given betamethasone 12 mg IM. Over the next 2 days her glucose readings rise. What best explains this and what should the nurse expect?