SAS 1

1. A 26-year-old pregnant client has a history of Heart Disease and she told the doctor that ordinary
physical activity causes no discomfort and has no symptoms of cardiac insufficiency and no anginal pain.
Which of the following class of heart disease does the client has?
A. Compromised
B. Slightly compromised
C. Markedly compromised
D. Severely compromised
E. Uncompromised
RATIONALE: Class 1 or Uncompromised has the following criteria: ordinary physical activity
causes no discomfort. No symptoms of cardiac insufficiency and no anginal pain.

2. A 28-year-old pregnant client has Uncorrected Coarctation of Aorta and she told the doctor that when
she do ordinary physical activity it causes excessive fatigue, palpitation, and dyspnea or anginal pain.
Which of the following class of heart disease does the client has?
A. Compromised
B. Slightly compromised
C. Markedly compromised
D. Severely compromised
E. Uncompromised
RATIONALE: Class 2 or Slightly compromised has the following criteria: Ordinary physical
activity causes excessive fatigue, palpitation, and dyspnea or anginal pain.

3. A pregnant patient was diagnosed when she was a child with Atrial Septal Defect and now pregnant,
she went to the hospital due to extreme fatigue, dyspneic and palpitations every time she takes the stairs
or walk a couple of meters. According to the Classification of Heart Disease which class does the patient
belongs to?
A. Class 1
B. Class 2
C. Class 3
D. Class 4
RATIONALE: Class 2 is Slightly compromised that ordinary physical activity causes excessive
fatigue, palpitation, and dyspnea or anginal pain.
4. A pregnant client is experiencing chest pain and was diagnosed with Chronic Hypertensive Vascular
Disorder; her doctor ordered a medication called Nitroglycerin. The following are correct statement
regarding Nitroglycerin,
EXCEPT:
A. Nitroglycerin works by relaxing the smooth muscle and blood vessels in the body.
B. A vasodilator drug used for the treatment of chest pain and high blood pressure.
C. Nitroglycerin sublingual tablets should not be chewed, crushed, or swallowed.
D. It is taken within 5 mins up to 3 tablets and if the chest pain is not relieved after 15 minutes the
patient will take a rest.
 RATIONALE: It is taken within 5 mins up to 3 tablets and if the chest pain is not relieved after
15 minutes the patient will go to Emergency Room Department for further evaluation of her
chest pain.

5. A 28 weeks pregnant woman came to the Outpatient Department for her prenatal check-up and was
requested
to do Ultrasound of her heart. Which of the following diagnostic test is called Ultrasound of the Heart?
A. Electrocardiogram
B. Electrocardiography
C. Echocardiogram
D. Electroencephalogram
RATIONALE: An echocardiogram (echo) is a test that uses high frequency sound waves
(ultrasound) to make pictures of your heart. The test is also called echocardiography or
diagnostic cardiac ultrasound

6. A pregnant client ask you what are the common causes of heart disorder in pregnancy. The following
are most common cause of cardiovascular disorder during pregnancy, EXCEPT:
A. Atrial Septal Defect
B. Uncorrected Coarctation of Aorta
C. Marfan Syndrome
D. Pulmonary Embolism
RATIONALE: Pulmonary Embolism is a complication associated with women who has
thromboembolic disease that can be associated with Increases with a combination of Stasis of
blood in the lower extremities from uterine pressure, Hypercoagulability (effect of elevated
estrogen levels) and Vessel damage.

7. A 29 weeks pregnant came to the emergency room department due to severe dyspnea, hemoptysis,
nocturnal tachycardia and angina. What makes the client prompt actions means?
A. requires no intervention.
B. requires referral to her doctor.
C. requires immediate intervention.
D. requires rest and oxygen therapy
RATIONALE: Presence of severe dyspnea, syncope with exertion, hemoptysis, nocturnal
tachycardia and angina require prompt evaluation.

8. Althea, an 18 weeks pregnant client with an Aortic Dilatation was advised to decrease the workload of
the heart. The following conditions increases the workload of the heart.
A. Infection
B. Eupnea
C. Weight Loss
D. Vasodilation
RATIONALE: A pregnant woman with heart disease should avoid infection, excessive weight
gain, edema and anemia because these conditions increase the workload of the heart.
9. A pregnant client is taking Furosemide for the treatment of her edema and she asked you what are the
side effects of Potassium-wasting diuretics. The following are side effects of potassium-wasting diuretics,
EXCEPT:
A. Hyperkalemia
B. Hypokalemia
C. Bradycardia
D. Xanthopsia
RATIONALE: Hyperkalemia is not part of the side effects of potassium-wasting diuretics but
of potassium-sparing diuretics that are mainly used in combination with thiazide or loop diuretics
to prevent hypokalemia.
10. A 28-year-old pregnant client has Marfan Syndrome and she told the doctor that during less than
ordinary activity, woman experiences excessive fatigue, palpitations, dyspnea, or anginal pain. Which of
the following class of heart disease does the client has?
A. Compromised
B. Slightly compromised
C. Markedly compromised
D. Severely compromised
E. Uncompromised
RATIONALE: Markedly compromised. During less than ordinary activity, woman experiences
excessive fatigue, palpitations, dyspnea, or anginal pain.

SAS 2

1. A 36-year-old female is currently 18 weeks pregnant. You’re collecting the patient’s health history. She
has the following health history: gravida 5, para 4, BMI 28, hypertension, depression, and family history
of Type 2 diabetes. Select below all the risk factors in this scenario that increases this patient’s risk for
developing gestational diabetes?
1. 34-years-old
2. 16 weeks pregnant
3. Gravida 5, para 4
4. BMI 28
5. Hypertension
6. Depression
7. Family history of Type 2 diabetes
A. 1,2,3 and 4
B. 1,3,4 and 5
C. 1,2,3 and 6
D. 1,3,4 and 6
RATIONALE: Maternal age > 25, Obese or overweight (BMI >25), Macrosomia (fetal)
previous babies greater than 9 lbs, Multiple pregnancies, A history (previous diagnoses of
gestational diabetes or family history of diabetes).
2. A pregnant client is currently diagnosed with Gestational Diabetes at 30 weeks ask you when do most
pregnant women develop gestational diabetes?
A. usually during the 1-3 month of pregnancy
B. usually during the 2-3 month of pregnancy
C. usually during the 1-2 trimester of pregnancy
D. usually during the 2-3 trimester of pregnancy
RATIONALE: Gestational diabetes is a form of diabetes that develops during pregnancy,
usually during 2nd or 3rd trimester.

3. You are having your duty in the out-patient department and you are providing an educational class for
pregnant women about gestational diabetes. You discuss the role of insulin in the body. Select all the
CORRECT statements about the role and function of insulin:
A. “Insulin is a type of cell that provides glucose to the body from the blood.”
B. “Insulin is a hormone secreted by the beta cells of the pancreas.”
C. “Insulin does influences cells by causing them to uptake glucose from the blood.”
D. “Insulin is a protein that helps carry glucose into the cell for energy.”
RATIONALE: Insulin is a HORMONE secreted by the beta cells found in the pancreas. It
influences or causes cells to take in glucose from the blood. Option A,C and D are incorrect
statements about insulin.
4. Michelle, a 32-year-old female is diagnosed with gestational diabetes. As the nurse you know that what
test
below is used to diagnose a patient with this condition?
A. 1 hour glucose tolerance test
B. 24 hour urine collection
C. Hemoglobin A1C
D. 3 hour glucose tolerance test
RATIONALE: If a patient has a positive 1 hour glucose tolerance test (which is administered at
about 24-28 weeks), a 3 hour glucose tolerance test is ordered. If this test is abnormal, it is used
to diagnose gestational diabetes.
5. Erina, a 25-year-old pregnant female is diagnosed with gestational diabetes at 28 weeks gestation.
You’re educating Tara Jing about her condition. Which statement by the patient demonstrates they
understood your teaching about gestational diabetes?
A. “Once I deliver the baby, it will go away, and I will not need any further testing.”
B. “It is important I try to get my fasting blood glucose around 70-95 mg/dL and <140 mg/dL 1
hour after meals.”
C. “There are no risks or complications related to gestational diabetes other than hyperglycemia.”
D. “I’m at risk for delivering a baby that is too small for its gestational age due to this condition.”
RATIONALE: It is important the mother monitors her blood glucose level regularly and tries to
maintain an euglycemic level (normal blood glucose level): 70-95 mg/dL fasting and
6. The following are true regarding contraception in Diabetes Mellitus, EXCEPT:
A. Diabetic Women can use Intrauterine Device
B. Clients can use COC type of oral contraceptives
C. Norplant or progestin only pills(minipills) may be used safely by diabetic women
D. Diabetic Women cannot use Intrauterine Device
 RATIONALE: There are high incidence of Pelvic Inflammatory Disease in women who are
diabetic
7. Glaiza, a 36 weeks pregnant woman and has gestational diabetes. As a part of her prenatal check-up,
her
doctor requested to check her blood glucose level. Which of the following lab results is below normal?
A. Blood glucose 55 mg/dL
B. Blood glucose 82 mg/dL
C. Blood glucose 148 mg/dL
D. Blood glucose 325 mg/Dl
RATIONALE: Euglycemic means “normal” blood glucose level. Typically a normal blood
glucose level is about 70-140 mg/dL. The only option that reflects a normal blood glucose level
is option B: 82 mg/dL…Option A is HYPOglycemic, Option C is slightly HYPERglycemic,
Option D is HYPERglycemic.

8. A client with gestational diabetes and is currently 34 weeks pregnant came to the hospital for her
prenatal
check-up. Which assessment findings below should you immediately report to the physician?
129 mg/dL
B. Blood pressure 190/102
C. Proteinuria
D. Linea nigra
RATIONALE: Preeclampsia is a potential complication of gestational diabetes. It can cause
hypertension (option B). Option A is a normal blood glucose reading, option D is a normal
finding during pregnancy.
9. Kris a 35 weeks pregnant woman has gestational diabetes and uncontrolled hyperglycemia. Her current
blood
glucose is 290 mg/dL. You administer insulin per physician’s order and recheck the blood glucose level
per
protocol. It is now 135 mg/dL. Which statement by the patient requires you to notify the physician?
A. “It burns when I urinate.”
B. “My back is hurting.”
C. “I feel tired.”
D. “I feel the baby kick about 10 times an hour.”
RATIONALE: Gestational diabetes places a patient at risk for urinary tract infections because
the glucose can leak into the urine leading to infection (remember bacteria thrive on glucose).
This scenario tells us the patient has uncontrolled hyperglycemia, which definitely puts her at
risk for glycosuria (glucose in the urine). The physician should be notified if the patient reports
burning on urination so a urine analysis can be performed. All the other options are normal
findings in a pregnancy at this stage
10. Jenny, a mother with gestational diabetes gave birth to a baby at 37 weeks gestation. As the nurse you
know
at birth that the newborn is at risk for? SELECT ALL THAT APPLY
A. Hyperglycemia
B. Hypoglycemia
C. Respiratory distress
D. Jaundice
E. Hyperthermia
RATIONALE: The newborn is at risk for hypoglycemia and respiratory distress. When a baby
of a mom, who has gestational diabetes, is still in utero there is a constant high supply of
glucose. This causes the baby to increase its fat stores (producing a large baby) and create a lot of
insulin to deal with the high glucose it is receiving from mom. BUT once the baby leaves utero,
the glucose supply decreases but the baby still has a lot of insulin on board. This can lead to a
drop in blood glucose (hypoglycemia) at birth. In addition, uncontrolled gestational diabetes can
affect lung maturity in babies and this increases the newborn’s risk of respiratory distress at birth.

SAS 3

1. A newborn has a condition that results from alcohol exposure during the mother's pregnancy that causes
brain damage and growth problems. Which of the following condition does the newborn has?
A. Substance Abuse
B. Fetal Alcohol Syndrome
C. Drug Abuse
D. HIV/AIDS
1. ANSWER: B RATIONALE: Fetal Alcohol Syndrome is a condition in a child that
results from alcohol exposure during the mother's pregnancy that causes brain damage
and growth problems.

2. An 18-week pregnant client was caught sniffing cooking spray at the Female comfort room You know
using
this type of drug may lead to severe cardiac and respiratory irregularities and may limit fetal oxygen
supply.
Which of the following does the pregnant client is using?
A. Heroin
B. Marijuana
C. Phencyclidine
D. Inhalants
1. : D RATIONALE: Inhalants such as airplane glue, cooking sprays, computer keyboard
cleaner may lead to severe cardiac and respiratory irregularities and may limit fetal
oxygen supply.

3. A 24-week pregnant client is using a drug recreationally she use it by “snorting”. What drug does the
client is
using?
A. Heroin
B. Marijuana
C. Phencyclidine
D. Inhalants
 1. : A RATIONALE: Heroin is a type of opiate narcotic drug that is used recreationally &
is used intradermal, by snorting or intravenous. It produces immediate but short-lived
euphoria followed by sedation.

4. A 12-week pregnant client is smoking a “weed”. You know that this type of substance that when
smoked
causes tachycardia & a sense of well-being and is used to counteract nausea in early pregnancy.
A. Heroin
B. Marijuana
C. Phencyclidine
D. Inhalants
1. : B RATIONALE: Marijuana when smoked causes tachycardia & a sense of well-being
and is used to counteract nausea in early pregnancy.
5. A 27-week pregnant client is using an “animal tranquilizer”. You know as a nurse that frequent use or a
street
drug that increases cardiac output, gives a sense of euphoria and causes hallucinations. Which of the
following
drug is the pregnant woman is using?
A. Heroin
B. Marijuana
C. Phencyclidine
D. Inhalants
1. : C RATIONALE: Phencyclidine is an animal tranquilizer frequently used as a street
drug that increases cardiac output, gives a sense of euphoria and causes hallucinations.
6. A 37-week pregnant woman gave birth to a newborn and is experiencing Heroin withdrawal symptoms.
The
following are Heroin Withdrawal Symptoms, EXCEPT:
A. Intracranial hemorrhage
B. Restlessness
C. Shivering
D. Insomnia
RATIONALE: Intracranial Hemorrhage is a Cocaine Withdrawal Symptoms and not part of
Heroin Withdrawal Symptoms.
7. A pregnant woman is using cocaine. You know as a nurse that once she will give birth, her child will
experience Cocaine Withdrawal Symptoms. The following are Withdrawal symptoms for Cocaine,
EXCEPT:
A. tremulousness
B. irritability
C. muscle rigidity
D. restlessness
E. intracranial hemorrhage
RATIONALE: Restlessness is a part of Heroin Withdrawal Symptoms not Cocaine Withdrawal
Symptoms.
8. You interviewed a pregnant client using a Marijuana to manage her nausea. You know the effect of
Marijuana
use in pregnant women and with the fetus. EXCEPT:
A. loss of short-term memory
B. reduced milk production
C. intracranial hemorrhage
D. incidence or respiratory infection
RATIONALE: Intracranial Hemorrhage are effects of Cocaine withdrawal. Cocaine-associated
ICH patients had higher admission blood pressures, significantly more subcortical hemorrhages,
and higher rates of intraventricular hemorrhage compared to patients with cocaine-negative ICH.
9. A pregnant woman asked you what are the effects of Narcotic use with the fetus. You answered the
following,
EXCEPT:
A. Small for Gestational Age
B. Increased incidence of fetal distress
C. Meconium aspiration
D. Restlessness
RATIONALE: Restlessness is a withdrawal symptom for Narcotic use. It is recommended that
pregnant women who are opioid dependent do not undergo opioid withdrawal as this can cause
miscarriage or premature delivery. The recommended treatment approach for pregnant, opioid
dependent women is methadone maintenance treatment.

10. A pregnant client asked you what are the effects of Phencyclidine (PCP). You answered the following,
EXCEPT:
A. increases cardiac output
B. gives a sense of euphoria
C. loss of short-term memory
D. causes hallucinations
RATIONALE: Loss of short-term memory is an effect of Marijuana use. Current evidence
shows that cannabis intoxication may temporarily alter or distort short-term memory processing.
This seems to be caused by compounds in cannabis that disrupt neural signaling when binding to
receptors responsible for memory in the brain. Interrupted short-term memory can indeed impact
on learning, and may also cause loss of interest or problems with concentration.

SAS 4

1. A 26-week pregnant client was diagnosed with ABO incompatibility. She asked you what her diagnosis
means.
Which of the following is incorrect regarding ABO incompatibility?
A. The mother has inborn antibodies vs blood type A and B in her bloodstream.
B. Uncommon during pregnancy since antibodies is the large IgM type & cannot cross placental barrier
C. During delivery when placenta separates from the decidua, the barrier is broken allowing maternal
blood to enter the
fetal bloodstream.
D. Antibodies vs Rh antigen are not naturally-occurring but are produced when Rh+ blood enters
the bloodstream of an
Rh- person.
RATIONALE: Antibodies vs Rh antigen are not naturally-occurring but are produced when
Rh+ blood enters the bloodstream of an Rh- person refers to Rh incompatibility.
2. An 18-week pregnant client ask you what is Rh incompatibility. Which of the following is correct
regarding Rh
Incompatibility? EXCEPT:
A. Rh (D) factor is a protein antigen present on the surface of some people’s RBC (Rh+)
B. Antibodies vs Rh antigen are not naturally-occurring but are produced when Rh+ blood enters the
bloodstream of an
Rh- person.
C. The mother has inborn antibodies vs blood type A and B in her bloodstream.
D. The Rh + gene is a dominant and therefore if either the mother or the father or both parents are Rh+,
the baby will be
Rh+
RATIONALE: The mother has inborn antibodies vs blood type A and B in her bloodstream
refers to ABO incompatibility not with Rh incompatibility.
3. Kyra a client who gave birth to a female newborn and was diagnosed as having ABO incompatibility.
Which of
the following is incorrect for the laboratory findings of a newborn with ABO incompatibility?
A. Blood Smear result is microspherocytosis
B. <95, microcytic for a newborn
C. Direct Coombs test is often weakly +
D. Direct Coombs test is often weakly –
RATIONALE: A negative Coombs test indicates that the fetus is not presently in danger from
problems relating to Rh incompatibility. An abnormal (positive) result means that the mother has
developed antibodies to the fetal red blood cells and is sensitized.
4. Kyra’s child was ordered to have Exchange Transfusion. She asked you what are the possible
complications of
the procedure. The following are complications of Exchange Transfusion, EXCEPT:
A. Hypothermia
B. Hypocalcemia
C. Hyperkalemia
D. Hypoglycemia
E. Hypernatremia
RATIONALE: The potential complications of exchange transfusion are: infection, rebound
hypoglycemia, hypocalcemia (due to citrate anticoagulant in the transfused blood), hyperkalemia
(if older red cells are used), late onset alkalosis, volume overload, hemolysis, thrombocytopenia,
neutropenia, coagulopathy, Graft versus host disease (GvHD) and hypothermia. These
complications can be avoided or minimized by careful technique and good general patient care,
although because many of these patients are quite ill and unstable, exchange transfusion can be a
risky procedure.
5. A patient was diagnosed with Habitual Abortion due to Rh incompatibility and had a fetal complication
of
Erythroblastosis Fetalis. She asked you what will be the complication if she will get pregnant again. The
following are complications of Rh Incompatibility, EXCEPT:
A. Anemia
B. Splenomegaly & hepatomegaly
C. Hyperbilirubinemia
D. Wilms Tumor
E. Hydrops fetalis
RATIONALE: Wilms Tumor is a form of kidney cancer that primarily develops in children.
Nearly all cases of Wilms tumor are diagnosed before the age of 10, with two-thirds being found
before age 5. Wilms tumor is often first noticed because of abdominal swelling or a mass in the
kidney that can be felt upon physical examination.
6. The following are true regarding HIV/AIDS, EXCEPT:
A. HIV infection and AIDS can be caused by placental transfer or direct contact with maternal blood
during birth.
B. HIV is a slowly replicating retrovirus and has at least two main divisions, HIV-1 and HIV-2, followed
by a variety of
further subtypes.
C. The virus acts by attacking the lymphoreticular system, in particular CD4-bearing helper T
lymphocytes.
D. HIV/AIDS is spread through saliva.
RATIONALE: Contact between broken skin, wounds, or mucous membranes and HIV/AIDS
infected blood or bloodcontaminated body fluids. Deep, open-mouth kissing if both partners
have sores or bleeding gums and blood from the HIV-positive partner gets into the bloodstream
of the HIV/AIDS negative partner. HIV/AIDS is not spread through saliva.
7. Reme a pregnant client asked you what are the risk factors for having HIV/AIDS. The following are
risk factors
of HIV/AIDS, EXCEPT:
A. Multiple sexual partners of the individual or sexual partner
B. Bisexual partner
C. IV drug use by the individual or partner
D. Deep, open-mouth kissing without mouth sores
RATIONALE: Deep, open-mouth kissing if both partners don’t have sores or bleeding gums.
HIV/AIDS is not spread through saliva.
8. A patient asked you regarding HIV/AIDS on what is Seroconversion. You know that Seroconversion is:
A. Seroconversion is the production of antibodies versus HIV that happens in 5 weeks to a year.
B. Seroconversion is the production of antibodies versus HIV that happens in 6 weeks to a year
C. Seroconversion is the production of antibodies versus HIV that happens in 7 weeks to a year.
D. Seroconversion is the production of antibodies versus HIV that happens in 4 weeks to a year.
RATIONALE: Seroconversion is the production of antibodies versus HIV that happens in 6
weeks to a year. Seroconversion is a sign that the immune system is reacting to the presence of
the virus in the body. It's also the point at which the body produces antibodies to HIV. Once
seroconversion has happened, an HIV test will detect antibodies and give a positive result.
9. A pregnant client was admitted with a lung infection that can affect people with weakened immune
systems,
such as those infected with HIV, the virus that causes AIDS. Which of the following condition pertains to
the
client’s condition?
A. Hospital Acquired Pneumonia
B. Community Acquired Pneumonia
C. Pneumocystis Carinii Pneumonia
D. Fungal Pneumonia
RATIONALE: PCP (Pneumocystis Carinii Pneumonia)- a life-threatening lung infection that
can affect people with weakened immune systems, such as those infected with HIV, the virus that
causes AIDS.
10. You were conducting a physical examination to a pregnant client. Upon examining the skin of the
patient you
saw red to purplish skin patches and was told that she is taking Zidovudine. You know that the patient is
having:
A. Angiosarcoma
B. Fibroblastic Sarcoma
C. Kaposi’s Sarcoma
D. Leiomyosarcoma
RATIONALE: Kaposi’s Sarcoma is a cancer that causes patches of abnormal tissue to grow
under the skin, in the lining of the mouth, nose, and throat, in lymph nodes, or in other organs.
These patches, or lesions, are usually red or purple.

SAS 5

1. Berta a pregnant patient was diagnosed with Iron Deficiency Anemia. She asked you what are the other
types
of Anemia that can be seen in pregnancy. Which of the following are Anemias of Pregnancy, EXCEPT:
A. Vitamin B12 Anemia
B. Anemia due to Blood Loss
C. Folate Deficiency
D. Thalassemia
RATIONALE: Thalassemia is a blood disorder passed down through families (inherited) in
which the body makes an abnormal form or inadequate amount of hemoglobin. Hemoglobin is
the protein in red blood cells that carries oxygen. The disorder results in large numbers of red
blood cells being destroyed, which leads to anemia.
2. Cilla a student-nurse who takes care of Berta asked you what are the factors that puts the patient at risk
of
developing anemia in pregnancy. All but one are risk factors of Anemia, EXCEPT:
A. Poor nutrition
B. Excess alcohol consumption
C. Illnesses that reduce absorption of nutrients
D. Use of anticonvulsant drugs
E. Elevated hematocrit due to hemoconcentration
RATIONALE: Elevated hematocrit due to hemoconcentration is a part of assessment for Iron
Deficiency Anemia.
3. Cilla a student nurse asked you what is the difference between Folic Acid and Folate. Which of the
following
are the correct definition of Folic acid and Folate?
A. Folic Acid is the common form of vitamin B9 present in many whole foods, including leafy greens,
beans, eggs, citrus
fruit, avocados, and beef liver while Folate is a synthesized version of vitamin B9 that is added to
processed foods and the
common version used in supplements.
B. Folate is the common form of vitamin B9 present in many whole foods, including leafy greens,
beans, eggs, citrus fruit,
avocados, and beef liver while Folic acid is a synthesized version of vitamin B9 that is added to
processed foods and the
common version used in supplements.
C. Folate is the common form of vitamin B9 present in many synthesized version of vitamin B9 that is
added to processed
foods and the common version used in supplements while Folic acid is the common form of vitamin B9
present in many
whole foods, including leafy greens, beans, eggs, citrus fruit, avocados, and beef liver.
D. Folate and Folic Acid is both present in many whole foods, including leafy greens, beans, eggs, citrus
fruit, avocados,
and beef liver
RATIONALE: Folate can be found in food including leafy greens, beans, eggs, citrus fruit,
avocados, and beef liver And Folic Acid is a synthesized version of vitamin B9.
4. 4 patients came to the Out Patient Department with Iron Deficiency Anemia EXCEPT:
A. Multiple pregnancies because of the increased fetal demand
B. A woman with secondary hemolytic illness
C. Poor gastric absorption due to gastric bypass for morbid obesity
D. A woman at 36 years of age
RATIONALE: A woman at 36 years of age is at higher risk of developing Vitamin B12
Deficiency/ Addison Pernicious Anemia
5. Erina will be having a case presentation regarding the complications of Anemia in pregnancy. The
following
are part of Complications of Anemia in Pregnancy, EXCEPT:
A. Premature labor
B. Intrauterine growth retardation (IUGR)
C. Dangerous anemia from normal blood loss during labor, requiring transfusions
D. Poor diet & poor nutrition
RATIONALE: Poor diet and nutrition is a part of predisposing factors for patients who have an
Iron Deficiency Anemia.
6. Belle is diagnosed with Hyperemesis Gravidarum, Which of the following is true regarding
Hyperemesis
Gravidarum?
A. Extreme nausea and vomiting that is prolonged past week 12 of pregnancy or is so severe
B. Nausea and Vomiting is so severe that nutrition cannot be maintained and weight loss is severe
C. Urine may be (+) for ketones due to breakdown of protein & fat for cell growth
D. Intrauterine Growth Restriction or preterm birth
E. All of the choices are true
RATIONALE: All of the choices are true that pertains to Hyperemesis Gravidarum
7. Belle was confined to the hospital due to Hyperemesis Gravidarum, The following are part of
management for
Hyperemesis Gravidarum, EXCEPT:
A. 24-hour Hospitalization
B. If no vomiting after the first 24 hours, sips of clear fluid gradually advanced to a soft, then normal,
diet.
C. If vomiting returns, TPN or enteral nutrition may be prescribed
D. Provide oxygen therapy
RATIONALE: Providing oxygen therapy is a part of management for ectopic pregnancy and it
is not part of the management for hyperemesis gravidarum due to its problem--fluid and
electrolyte imbalance.
8. Karlie is diagnosed with Ectopic Pregnancy. Your instructor ask you which of the following is the
common site
of Ectopic Pregnancy?
A. ovary
B. cervix
C. peritoneal cavity
D. fallopian tube
RATIONALE: The majority of ectopic pregnancies (95%) occur in the ampullary, infundibular,
and isthmic segments of the fallopian tube. Fewer than 5% of ectopic pregnancies occur in the
interstitial segment of the fallopian tube, cervix, anterior lower uterine segment in a cesarean
delivery scar, ovary, or peritoneal cavity.
9. Karlie is experiencing sharp shoulder pain. Which of the following conditions is experiencing?
A. Cullen’s Sign
B. Charcot’s Sign
C. Kehr’s Sign
D. Leopold’s Sign
RATIONALE: Referred shoulder pain (KEHR’S SIGN) due to blood in the peritoneum
irritating the phrenic nerve
10. As you do physical examination on Karlie, you saw that her abdomen has an ecchymotic blueness
around the
umbilicus. You know that its:
A. Cullen’s Sign
B. Charcot’s Sign
C. Kehr’s Sign
D. Leopold’s Sign
RATIONALE: Cullen’s Sign is an ecchymotic blueness around the umbilicus indicating blood
pooling in the peritoneum

SAS 6

1. A woman of 16-weeks gestation telephones the nurse because she has passed some “berry-like” blood
clots
and now has continued dark brown vaginal bleeding. Which action would the nurse instruct the woman to
do?
A. “Maintain bedrest, and count the number of perineal pads used.”
B. “Come to the health care facility if uterine contractions begin.”
C. “Continue normal activity, but take the pulse every hour.”
D. “Come to the health facility with any vaginal material passed.”
RATIONALE: Gestational trophoblastic disease is abnormal proliferation and then
degeneration of the trophoblastic villi (Jean-Jacques, 2016). As the cells degenerate, they become
filled with fluid and appear as clear fluid-filled, grape-sized vesicles. Expulsion of molar cyst by
16th-18th week.
2. A woman with Hydatidiform Mole develops HELLP Syndrome. During labor, which prescription
would the
nurse question?
A. Prepare her epidural anesthesia.
B. Assess her blood pressure every 15 minutes.
C. Assess the urine output every hour.
D. Urge her to lie on her left side during labor.
RATIONALE: Epidural labor analgesia lowers maternal labor pain with higher satisfaction
scores and has been shown to improve pulmonary and maternal cardiovascular physiology with
better neonatal outcomes. With low levels of platelets, the most-feared complication is spinal
epidural hematoma -- a collection of blood placing pressure on the spine due to low platelet
count.
3. A pregnant patient was diagnosed with Hydatidiform Mole. She asked you what does Hydatidiform
Mole
means. You answer which of the following?
A. Gestational trophoblastic disease is abnormal proliferation and then degeneration of the trophoblastic
villi
B. The cells degenerate, they become filled with fluid and appear as clear fluid-filled, grape-sized
vesicles.
C. The embryo fails to develop beyond a primitive start.
D. All of the above
RATIONALE: All of the choices mention were correct regarding Hydatidiform Mole
4. A pregnant client is asking you what are the types of Hydatidiform Mole. Which type of Hydatidiform
that all
trophoblastic villi swell and become cystic that embryo dies and may early lead to choriocarcinoma?
A. Incomplete Hydatidiform Mole
B. Complete Hydatidiform Mole
C. Partial Hydatidiform Mole
D. Partial Complete Mole
RATIONALE: Complete Hydatidiform Mole chromosomes are normal, 44xy or 44xx but are
contributed by only by the father or an empty ovum was fertilized & the chromosome material
from the sperm was duplicated and may lead to choriocarcinoma.
5. Which type of Hydatidiform Mole that some of the villi form normally and rarely leads to
choriocarcinoma?
A. Incomplete Hydatidiform Mole
B. Complete Hydatidiform Mole
C. Partial Hydatidiform Mole
D. Partial Complete Mole
RATIONALE: Partial Hydatidiform Mole has 69 chromosomes (3 chromosomes instead of 2
for every pair) resulting from 2 sperms fertilizing an ovum and rarely leads to choriocarcinoma
6. A pregnant client with a history of premature cervical dilation undergoes cervical cerclage. Which
outcomes
indicates that this procedure has been successful?
A. The client delivers a full-term fetus at 39 weeks gestation.
B. The client membranes spontaneously rupture at week 30 of gestation.
C. The client experiences minimal vaginal bleeding throughout the pregnancy.
D. The client has reduced shortness of breath and abdominal pain.
RATIONALE: At weeks 12 to 14, Cervical Cerclage is performed by purse-string sutures that
are placed in the cervix by the vaginal route under regional anesthesia. Sutures strengthen the
cervix & prevents it from dilating. Sutures are then removed at weeks 37 to 38 so that the fetus
can be born vaginally.
7. A pregnant client with a history of premature cervical dilation will undergo cervical cerclage with
McDonald’s
Cerclage procedure. She asked you what is McDonald’s Cerclage. You answered:
A. McDonald’s cerclage is performed by purse-string sutures that are placed in the cervix by the vaginal
route under
regional anesthesia. Sutures strengthen the cervix & prevents it from dilating.
B. McDonald’s cerclage is a temporary type of cervical cerclage that are placed horizontally and
vertically across the
cervix & pulled tight to reduce the cervical canal to a few millimeters in diameter.
C. McDonald’s cerclage is a permanent type of cervical cerclage that they place a sterile tape is threaded
in a purse-string
manner under the submucous layer of the cervix & sutured in place to achieve a closed cervix.
D. McDonald’s cerclage refers to a variety of procedures that use sutures or synthetic tape to reinforce the
cervix during
pregnancy in women with a history of a short cervix.
RATIONALE: McDonald’s cerclage is a temporary type of cervical cerclage where nylon
suture are placed horizontally and vertically across the cervix & pulled tight to reduce the
cervical canal to a few millimeters in diameter.
8. A pregnant client with a history of premature cervical dilation will undergo cervical cerclage with
Shirodkar
Procedure. She asked you what is Shirodkar Procedure. You answered:
A. Shirodkar Procedure is performed by purse-string sutures that are placed in the cervix by the vaginal
route under
regional anesthesia. Sutures strengthen the cervix & prevents it from dilating.
B. Shirodkar Procedure is a temporary type of cervical cerclage that are placed horizontally and vertically
across the
cervix & pulled tight to reduce the cervical canal to a few millimeters in diameter.
C. Shirodkar Procedure is a permanent type of cervical cerclage that they place a sterile tape is
threaded in a purse-string
manner under the submucous layer of the cervix & sutured in place to achieve a closed cervix.
D. Shirodkar Procedure refers to a variety of procedures that use sutures or synthetic tape to reinforce the
cervix during
pregnancy in women with a history of a short cervix.
RATIONALE: Shirodkar Procedure is a permanent type of cervical cerclage that they place a
sterile tape is threaded in a purse-string manner under the submucous layer of the cervix &
sutured in place to achieve a closed cervix.
9. The following are true regarding Premature Cervical Dilation, EXCEPT:
A. The cervix that dilates prematurely and cannot hold a fetus until term
B. It is one cause of habitual abortion
C. The dilatation is usually painless
D. Uterine contractions begin and after a short labor, the fetus is stillbirth.
RATIONALE: Premature Cervical Dilation’s uterine contractions begin and after a short labor,
the fetus is born.
10. The following are management for Premature Cervical Dilation, EXCEPT:
A. Ultrasound is done to confirm that the fetus is healthy
B. At weeks 12 to 14, purse-string sutures are placed in the cervix by the vaginal route under regional
anesthesia
C. Sutures are then removed at weeks 37 to 38 so that the fetus can be born vaginally.
D. Chest X-ray is done to detect early lung metastasis
RATIONALE: Chest X-ray is a management for Hydatidiform Mole to detect early lung
metastasis.
SAS 7
1. A 16th week pregnant client had undergone Dilatation and Curettage related to her
vaginal bleeding and was diagnose to have Spontaneous Miscarriage. She asked you what
are the possible causes of her Condition. The following are causes of Spontaneous
Miscarriage, EXCEPT:
A. Abnormal fetal formation
B. Immunologic factors: Rh/ABO incompatibility
C. Abruptio Placenta
D. Incompetent cervix
ANSWER: C
RATIONALE: Abruptio Placenta is defined as the premature detachment of a
normally implanted placenta after the 20th week of gestation.
2. A patient who is 17 weeks pregnant is passing pieces of body tissue along with blood
clots and dark red blood from the vagina. What should the nurse direct the patient to do at
this time?
A. Begin immediate bed rest.
B. Count the number of perineal pads that are saturated with blood.
C. Continue with the normal daily activity and monitor pulse rate every hour.
D. Seek immediate medical attention and bring the expressed vaginal material.
ANSWER: D
RATIONALE: Seeking immediate medical attention and bringing the expressed
vaginal material will help the doctor how much fragments are still inside the
woman’s uterus and to prevent bleeding.

3. A 16-week pregnant client was diagnosed to have Threatened Miscarriage. You know
that this type of miscarriage presents which of the following sign and symptoms?
A. Her vaginal bleeding is scant, usually bright red there is slight cramping or
backache but there is no cervical dilatation.
B. The entire products of conception (fetus, placenta, membranes) are expelled there is
bleeding, cramping &amp; expulsion of conceptus
C. Bleeding, cramping &amp; part of the conceptus (usually the fetus) is expelled but the rest
are retained and her cervix is dilated
D. The fetus dies in utero but is not expelled &amp; the client experiences decreasing signs of
pregnancy.
ANSWER: A
RATIONALE: Threatened Miscarriage vaginal bleeding is scant, usually bright red
there is slight cramping or backache but there is no cervical dilatation

4. An 18-week pregnant client was diagnosed with Incomplete Miscarriage. Which of the
following is the best definition of the patient’s diagnosis?
A. Her vaginal bleeding is scant, usually bright red there is slight cramping or backache
but there is no cervical dilatation.
B. The entire products of conception (fetus, placenta, membranes) are expelled there is
bleeding, cramping &amp; expulsion of conceptus
C. Bleeding, cramping &amp; part of the conceptus (usually the fetus) is expelled but the
rest are retained and her cervix is dilated
D. The fetus dies in utero but is not expelled &amp; the client experiences decreasing signs of
pregnancy.
ANSWER: C
RATIONALE: Incomplete Miscarriage bleeding, cramping &amp; part of the conceptus
(usually the fetus) is expelled but the rest are retained and her cervix is dilated

5. A 20-week pregnant client was diagnosed with Missed Miscarriage/ Early Pregnancy
Failure. Which of the following is the best description for the patient’s diagnosis?
A. Her vaginal bleeding is scant, usually bright red there is slight cramping or backache
but there is no cervical dilatation.
B. The entire products of conception (fetus, placenta, membranes) are expelled there is
bleeding, cramping &amp; expulsion of conceptus
C. Bleeding, cramping &amp; part of the conceptus (usually the fetus) is expelled but the rest
are retained and her cervix is dilated
D. The fetus dies in utero but is not expelled &amp; the client experiences decreasing
signs of pregnancy.
ANSWER: D
RATIONALE: The fetus dies in utero but is not expelled &amp; the client experiences
decreasing signs of pregnancy. Cervix is closed, dark brown vaginal discharge,
Pregnancy test is negative and the fundal height does not increase in size.

6. A 19-week pregnant client was referred to the hospital and was diagnosed with Complete
Miscarriage. Which of the following is the best description for the patient’s diagnosis?
A. Her vaginal bleeding is scant, usually bright red there is slight cramping or backache
but there is no cervical dilatation.
B. The entire products of conception (fetus, placenta, membranes) are expelled there
is bleeding, cramping &amp; expulsion of conceptus
C. Bleeding, cramping &amp; part of the conceptus (usually the fetus) is expelled but the rest
are retained and her cervix is dilated
D. The fetus dies in utero but is not expelled &amp; the client experiences decreasing signs of
pregnancy.
ANSWER: B
RATIONALE: Complete Miscarriage is a type of miscarriage wherein the entire
products of conception (fetus, placenta, membranes) are expelled there is bleeding,
cramping &amp; expulsion of conceptus

7. A 16-week pregnant client was diagnosed to have Threatened Miscarriage. The following
are management of Threatened Miscarriage, EXCEPT:
A. Assess fetal viability via Ultrasound and Fetal Heart Tone
B. Complete bed rest for 24 to 48 hours
C. Coitus is restricted for 2 weeks after bleeding
D. Save any tissue fragments passed
ANSWER: D
RATIONALE: Save any tissue fragments passed is a management for Incomplete
Miscarriage.

8. A patient came to the hospital with fever, abdominal pain and foul-smelling discharge.
Which of the following complications of Miscarriage is the patient experiencing?
A. Septic Abortion
B. Isoimmunization
C. Infection
D. Hemorrhage
ANSWER: C
RATIONALE: Fever, abdominal pain and foul-smelling discharge is a sign and
symptoms for Infection.

9. A patient came to the hospital for check-up and she told you that she try to self-abort with
a knitting needle. Which of the following complications of Miscarriage is the patient
experiencing?
A. Septic Abortion
B. Isoimmunization
C. Infection
D. Hemorrhage
ANSWER: A
RATIONALE: Septic Abortion is an abortion complicated by infection that occurs
in women who have tried to self-abort or whose pregnancy was aborted illegally
using a nonsterile instrument such as a knitting needle. The patient could experience
fever and crampy abdominal pain; her uterus will feel tender to palpation.

10. A pregnant patient came to the hospital and told you that she is dizzy, pale in appearance
and she is having “heavy bleeding” and soaked 10 maternal pads in a period of 4 hours
per day. Which of the complication of Miscarriage is the patient experiencing?
A. Septic Abortion
B. Isoimmunization
C. Infection
D. Hemorrhage
ANSWER: D
RATIONALE: Hemorrhage happens when a woman had an incomplete miscarriage
or in a woman who develops an accompanying coagulation defect (usually DIC)-
major hemorrhage becomes a possibility

SAS 8
1. A pregnant woman is admitted to the hospital with a diagnosis of placenta previa. Which
of the following statement would best describe the patient’s diagnosis?
A. It is the low implantation of the placenta in the uterus as the cervix softens &amp;
begins to efface &amp; dilate, placental sinuses are opened causing progressive
hemorrhages
B. It is the premature separation of the normally implanted placenta after the 20th week
of pregnancy, typically with severe hemorrhage
C. It separates only at the edges causing vaginal bleeding &amp; a little pain
D. The placenta separates first at the center, blood pools under the placenta &amp; is hidden
from view
ANSWER: A
RATIONALE: Placenta Previa is the low implantation of the placenta in the uterus
as the cervix softens &amp; begins to efface &amp; dilate, placental sinuses are opened
causing progressive hemorrhages

2. A patient came to the Out Patient department to have her check-up but was referred to the
Delivery Room due to dark red vaginal bleeding with sharp stabbing pain on her
abdomen and she did not felt any fetal movement since yesterday and was diagnosed with
Abruptio Placenta. What grade of placental abruption does the patient had?
A. Grade 0 Abruptio Placenta
B. Grade 1 Abruptio Placenta
C. Grade 2 Abruptio Placenta
D. Grade 3 Abruptio Placenta
ANSWER: D
 RATIONALE: Grade 3 means there is Extreme separation; without immediate
interventions, maternal hypovolemic shock and fetal death will result

3. A patient came to the Out Patient department to have her check-up but was referred to the
Delivery Room due to dark red vaginal bleeding, FHT of 116 bpm and upon palpation
her uterus hard, tense and painful when palpated. She was diagnosed with Abruptio
Placenta. What grade of placental abruption does the patient had?
A. Grade 0 Abruptio Placenta
B. Grade 1 Abruptio Placenta
C. Grade 2 Abruptio Placenta
D. Grade 3 Abruptio Placenta
ANSWER: C
RATIONALE: Grade 2 means there is Moderate separation; there is evidence of
fetal distress; the uterus is tense and painful on palpation.

4. A patient gave birth to healthy newborn. Upon delivering her placenta you examined a
segment of the placenta shows a recent adherent clot on the maternal surface. What grade
of placental abruption does the patient had?
A. Grade 0 Abruptio Placenta
B. Grade 1 Abruptio Placenta
C. Grade 2 Abruptio Placenta
D. Grade 3 Abruptio Placenta
ANSWER: A
RATIONALE: Grade 0 means that there is no symptoms of separation are apparent
from maternal or fetal signs; the diagnosis is made after birth, when the placenta is
examined and a segment of the placenta shows a recent adherent clot on the
maternal surface.

5. A patient was diagnosed with Abruptio Placenta with Minimal Separation. With the
knowledge you have regarding Abruptio Placenta, What grade of placental abruption
does the patient had?
A. Grade 0 Abruptio Placenta
B. Grade 1 Abruptio Placenta
C. Grade 2 Abruptio Placenta
D. Grade 3 Abruptio Placenta
ANSWER: B
RATIONALE: Grade 1 means minimal separation, but enough to cause vaginal
bleeding and changes in the maternal vital signs; no fetal distress or hemorrhagic
shock occurs.

6. A pregnant woman is admitted to the hospital with a diagnosis of abruptio placenta.

Which of the following statement would best describe the patient’s diagnosis?
A. It is the low implantation of the placenta in the uterus as the cervix softens &amp; begins to
efface &amp; dilate, placental sinuses are opened causing progressive hemorrhages
B. It is the premature separation of the normally implanted placenta after the 20th
week of pregnancy, typically with severe hemorrhage
C. It separates only at the edges causing vaginal bleeding &amp; a little pain
D. The placenta separates first at the center, blood pools under the placenta &amp; is hidden
from view
ANSWER: B
RATIONALE: Abruptio Placenta is the premature separation of the normally
implanted placenta after the 20th week of pregnancy, typically with severe
hemorrhage

7. A pregnant woman is admitted to the hospital with a diagnosis of uteroplacental

apoplexy. Which of the following statement would best describe the patient’s diagnosis?
A. It is the low implantation of the placenta in the uterus as the cervix softens &amp; begins to
efface &amp; dilate, placental sinuses are opened causing progressive hemorrhages
B. It is the premature separation of the normally implanted placenta after the 20th week
of pregnancy, typically with severe hemorrhage
C. It separates only at the edges causing vaginal bleeding &amp; a little pain

D. The placenta separates first at the center, blood pools under the placenta &amp; is
hidden from view
ANSWER: D
RATIONALE: Uteroplacental Apoplexy is a complication of Abruptio placenta
wherein the placenta separates first at the center, blood pools under the placenta &amp;
is hidden from view

8. A 38-week pregnant woman had an ultrasound and was diagnosed with a type of Placenta
Previa that totally obstruct the cervical os. With this diagnosis it means that the patient
has:
A. Placenta Previa
B. Low-lying Placenta
C. Marginal Implantation
D. Total Placenta Previa
ANSWER: D
RATIONALE: Total Placenta Previa is the implantation that totally obstruct the
cervical os

9. A 37-week pregnant woman had an ultrasound and was diagnosed with a type of Placenta
Previa where the placental edge approaches that of the cervical os. With this diagnosis it
means that the patient has:
A. Placenta Previa
B. Low-lying Placenta
C. Marginal Implantation
D. Total Placenta Previa
ANSWER: C
RATIONALE: Marginal Implantation happens when the placenta edge approaches
that of the cervical os.

10. A 36-week pregnant woman had an ultrasound and was diagnosed with a type of Placenta
Previa that the implantation in the lower rather than in the upper portion of the uterus.
With this diagnosis it means that the patient has:
A. Placenta Previa
B. Low-lying Placenta
C. Marginal Implantation
D. Total Placenta Previa
ANSWER: B
RATIONALE: Low-lying Placenta is the implantation in the lower rather than in
the upper portion of the uterus

SAS 9

1. A pregnant client was admitted to the hospital with a diagnosis of Premature Rupture of
Membrane as an initial diagnosis. All of the following is true regarding PROM,
EXCEPT:
A. Sudden gush of clear fluid from her vagina with continued minimal leakage
B. Turns nitrazine paper to red
C. Positive test for ferning
D. Increased WBC count and C-reactive protein
ANSWER: B
RATIONALE: When a nitrazine paper turns red it means the fluid that is tested is
acidic in content. In PROM it if it turns red it is the urine not the amniotic fluid.

2. A pregnant client came to the hospital with a complaint of sudden pop and burst of fluid.
Upon assessment she is diagnosed with Premature Rupture of Membranes. Which of the
following is true regarding PROM?
A. Loss of amniotic fluid before 40 weeks AOG
B. Not associated with infections of membranes (Chorioamnionitis)
C. Preterm labor follows rupture of membranes and ends the pregnancy
D. Not associated with vaginal infection (Neisseria Gonorrhea, Group B streptococcus
and chlamydia)
ANSWER: C
RATIONALE: Premature Rupture of Membranes is defined as loss of amniotic
fluid before 37 weeks AOG, strongly associated with infections of membranes
(Chorioamnionitis), preterm labor follows rupture of membranes and ends the
pregnancy and is associated with vaginal infection (Neisseria Gonorrhea, Group B
streptococcus and chlamydia)

3. A pregnant client was admitted to the hospital with a diagnosis of Premature Rupture of
Membrane as an initial diagnosis. All of the following true regarding the management of
PROM, EXCEPT:
A. Preterm babies should delay the delivery for them to fully mature.
B. Administer corticosteroid to hasten lung maturity
C. Prophylactic administration of Broad-spectrum antibiotics
D. Amnioinfusion to reduce pressure on the fetus or cord to allow a safer transfer
ANSWER: A
RATIONALE: Preterm babies should be delivered immediately due to risk of
infection
4. A woman has been diagnosed as having Premature Rupture of Membranes, Which of the
following condition is the most typical for PROM?
A. Increased perspiration
B. Weight loss
C. Susceptibility to infection
D. Blood pressure elevation
ANSWER: C
RATIONALE: Premature Rupture of Membranes is strongly associated with
infections of membranes—Chorioamnionitis.

5. The following are associated with vaginal infection that can cause Premature Rupture of
Membranes in pregnant women, EXCEPT:
A. Neisseria Gonorrhea
B. Group B streptococcus
C. Chlamydia Trachomatis
D. Mycobacterium Tuberculosis
ANSWER: D
RATIONALE: Mycobacterium Tuberculosis is the least type of microorganism that
can cause vaginal infection.

6. A pregnant woman came to the hospital with BP of 140/90 mm Hg, urinalysis show no
proteinuria and no edema. Which type of Hypertensive Disorder of Pregnancy does the
woman is classified into:
A. Eclampsia
B. Preeclampsia
C. Severe Preeclampsia
D. Gestational Hypertension
E. HELLP Syndrome
ANSWER: D
RATIONALE: Gestational Hypertension has elevated 30 mm Hg or diastole
elevated 15 mm Hg above pre-pregnancy level but will return to normal after
childbirth.

7. A pregnant woman came to the hospital with BP of 210/180 mm Hg and was having a
seizure. Which type of Hypertensive Disorder of Pregnancy does the woman is classified
into:
A. Eclampsia
B. Preeclampsia
C. Severe Preeclampsia
D. Gestational Hypertension
E. HELLP Syndrome
ANSWER: A
RATIONALE: Eclampsia is the most severe classification of Hypertensive Disorder
of Pregnancy that cerebral edema is so acute that seizure or coma occurs and can
happen late in pregnancy &amp; up to 48 hours after birth.

8. The following are management for pregnant woman who is diagnosed with Eclampsia
who had seizure, EXCEPT:
A. Complete bed rest at their home
B. Maintain patent airway
C. Position on her side to prevent aspiration
D. Raise side rails, remove sharp or pointed objects
E. Keep her NPO
ANSWER: A
RATIONALE: Pregnant women who had a seizure cannot be sent home due to the
possibility that there can be occurrence of seizure.

9. You are administering Magnesium Sulfate for patient who is diagnosed with Eclampsia.
Which of the following should be on the bedside?
A. Tongue blade
B. Oxygen tank
C. Calcium Gluconate
D. Suction machine
ANSWER: C
RATIONALE: Calcium Gluconate should be available at bedside in the event that
patient could have Magnesium Sulfate toxicity.

10. You are caring for a pregnant patient who is diagnosed with Eclampsia and had a
doctor’s order to give Magnesium Sulfate. Before giving the medication, which of the
following is a sign that your patient is having Magnesium Sulfate Toxicity?
A. Blood pressure of 210/100
B. Urine output is &gt; 100 ml in 4 hours
C. Respiratory rate of 21 breaths/min
D. Patellar reflexes are absent
ANSWER: D
RATIONALE: The patellar reflex occurs when an abrupt change arises in muscle
length; in this case, it is produced by the tendon stretching, which is caused when
the hammer stroke is applied. The normal response must be a sudden leg extension.

SAS 10

1. You are caring for a pregnant patient who was rushed to the delivery room due to Cord
Prolapse. The following are predisposing factors for this diagnosis, EXCEPT:
A. Premature rupture of membranes
B. Intrauterine tumors preventing the presenting part from engaging
C. A small fetus
D. CPD preventing firm engagement
E. Oligohydramnios
ANSWER: E
RATIONALE: Polyhydramnios or excessive amniotic has been shown to increase
the risk of umbilical cord prolapse.

2. The following are assessment findings for Cord Prolapse, EXCEPT:

A. The cord may be felt as the presenting part on an initial vaginal examination during
labor
B. Ultrasound evidence of prolapse of umbilical cord
C. Late deceleration pattern becomes apparent
D. The cord may be visible at the vulva
ANSWER: C
RATIONALE: Variable decelerations are irregular, often jagged dips in the fetal
heart rate that look more dramatic than late decelerations. Variable decelerations
happen when the baby’s umbilical cord is temporarily compressed which is the
complication for Cord prolapse.

3. The following are nursing consideration with Cord Prolapse, EXCEPT:

A. If cord is exposed to air, cover with saline-moistened sterile compress to prevent
drying.
B. Replace the cord back into the vagina to avoid kinking and knotting obstructing
blood flow
C. Administer O2 at 10 LPM by face mask to the mother to increase oxygenation to the
fetus
D. Reduce pressure on the cord by placing the pregnant client in Knee-chest or
Trendelenburg position
ANSWER: B
RATIONALE: Never replace the cord back into the vagina as it may result in
kinking and knotting obstructing blood flow

4. You are explaining to a patient regarding possible fetal complications with Cephalopelvic
Disproportion. The following are fetal complications of Cephalopelvic Disproportion,
EXCEPT
A. Postpartum hemorrhage
B. Hypoxia
C. Fractures to the clavicle
D. Injury to neck and head
ANSWER: A
RATIONALE: Postpartum hemorrhage is not part of the fetal complication but of
the mother.

5. Which of the following statement is true regarding Cephalopelvic Disproportion:

A. A loop of the umbilical cord slips down in front of the presenting fetal part
B. Narrowing of the anteroposterior diameter of the pelvis to &lt; 11 cm
C. Narrowing of the transverse diameter of the outlet to &lt; 11 cm
D. Fetal head is too large to pass through the bony pelvis
ANSWER: D
RATIONALE: Cephalopelvic disproportion (CPD) occurs when a baby’s head or
body is too large to fit through the mother’s pelvis. It is believed that true CPD is
rare, but many cases of “failure to progress” during labor are given a diagnosis of
CPD. When an accurate diagnosis of CPD has been made, the safest type of delivery
for mother and baby is a cesarean.

6. It is the narrowing of the anteroposterior diameter of the pelvis to &lt; 11 cm, or the
transverse diameter to 12 cm or less that is usually caused by rickets in early life or
inherited pelvic size.
A. Outlet Contraction
B. Inlet Contraction
C. Cervical Contraction
D. Vaginal Contraction
ANSWER: B
RATIONALE: Usually caused by rickets in early life or inherited pelvic size “what
goes in comes out”- a head that engages proves it fits into the pelvic brim &amp; will
probably be able to fit through the midpelvis and outlet and common in
primigravida women

7. A type of placental abnormality wherein the placenta has 1 or more accessory lobes
connected to the main placenta that the small lobes may be retained in the uterus leading
to hemorrhage and therefore must be removed:
A. Battledore Placenta
B. Velamentous Insertion of the Cord
C. Placenta Circumvallata
D. Placenta Succenturiata
ANSWER: D
RATIONALE: Placenta Succenturiata happens when the small lobes may be
retained in the uterus leading to hemorrhage and therefore must be removed. The
placenta appears torn at the edges.

8. A type of placental abnormality wherein the placenta is cup-shaped with raised margins
with the whitish opaque chorion covering the periphery:
A. Battledore Placenta
B. Velamentous Insertion of the Cord
C. Placenta Circumvallata
D. Placenta Succenturiata
ANSWER: C
RATIONALE: The fetal side of the placenta with Placenta Circumvallata is covered
to some extent by the chorion that’s why the placenta is cup-shaped with raised
margins with the whitish opaque chorion covering the periphery

9. A type of placental abnormality where the cord is inserted marginally rather than
centrally giving the appearance of a tennis racket:
A. Battledore Placenta
B. Velamentous Insertion of the Cord
C. Placenta Circumvallata
D. Placenta Succenturiata
ANSWER: A
RATIONALE: Battledore Placenta is a type of placental abnormality where the
cord is inserted marginally rather than centrally giving the appearance of a tennis
racket

10. A type of placental abnormality wherein the cord, instead of entering the placenta
directly, separates into small vessels that reach the placenta by spreading cross a fold of
amnion:
A. Battledore Placenta
B. Velamentous Insertion of the Cord
C. Placenta Circumvallata
D. Placenta Succenturiata
ANSWER: B
RATIONALE: Velamentous Insertion of the Cord is a type of placental abnormality
wherein the cord, instead of entering the placenta directly, separates into small
vessels that reach the placenta by spreading cross a fold of amnion

SAS 11

1. The following are common causes of dysfunctional labor, EXCEPT:

A. Inappropriate use of analgesia
B. Poor fetal position
C. Extension rather than flexion of the fetal head
D. Flexion rather than extension of the fetal head
ANSWER: D
RATIONALE: Normally when a woman gives birth flexion rather than extension of
the fetal head. It becomes dysfunctional labor when the fetal head extends rather
than flexion and causes prolonged labor.

2. The number of contractions is low or infrequent, common in active phase of labor and it
is not increasing beyond 2 or 3 in a 10-minute period.
A. Hypotonic Contraction
B. Hypertonic Contraction
C. Isotonic Contraction
D. Prolonged Descent
ANSWER: A
RATIONALE: Hypotonic Contraction increases length of labor &amp; uterus does not
contract effectively postpartally due to exhaustion, increasing chance for postpartal
hemorrhage.

3. You are caring for a woman that came to the delivery room whose labor pain is out of
proportion to the quality of her contractions.
A. Hypotonic Contraction
B. Hypertonic Contraction
C. Isotonic Contraction
D. Prolonged Descent
ANSWER: B
RATIONALE: Hypertonic Contraction increases in resting tone to &gt; 15 mm Hg,
mostly seen in the LATENT PHASE Lack of relaxation between contractions may
not allow uterine artery filling leading to fetal anoxia

4. It is a hard band that forms across the uterus at the junction of the upper and lower uterine
segments and interferes with fetal descent.
A. Contraction Ring
B. Post-term Ring
C. Hypotonic Ring
D. Hypertonic Ring
ANSWER: A
RATIONALE: Pathologic Retraction Ring/Bandl’s Ring/Contraction Ring is a type
of contraction ring that usually appears at the 2nd stage of labor &amp; can be palpated
as a horizontal indentation across the abdomen.

5. A type of dysfunctional labor in first stage of labor that is usually associated with fetal
malposition or Cephalopelvic Disproportion and prolonged cervical dilation.
A. Prolonged Latent Phase
B. Protracted Active Phase
C. Prolonged Deceleration Phase
D. Secondary Arrest of Dilatation
ANSWER: B
RATIONALE: Protracted Active Phase of Labor is usually associated with fetal
malposition or Cephalopelvic Disproportion and prolonged cervical dilation that
can be augmented by labor with Oxytocin if CPD is not present.

6. All but one is not associated with premature labor.

A. Dehydration
B. Urinary tract infection
C. Periodontal disease
D. Chorioamnionitis
E. Cephalopelvic Disproportion
ANSWER: E
RATIONALE: Cephalopelvic Disproportion can be associated with prolonged labor
not with premature labor

7. The following are causes of precipitate labor, EXCEPT:

A. Chorioamnionitis
B. Grand multiparity
C. Large Pelvis
D. Small Fetus
ANSWER: A
RATIONALE: Chorioamnionitis is one cause of premature labor not precipitate
labor.

8. A woman gave birth in a birthing facility and was brought to the hospital with a globular
mass on her vaginal orifice. You know that this condition is which of the following?
A. Uterine Atony
B. Uteroplacental Apoplexy
C. Uterine Inversion
D. Myoma Uteri
ANSWER: C
RATIONALE: Uterine Inversion is a condition wherein turning inside out of the
uterus with either birth of the fetus or the delivery of the placenta.

9. Most often results from abnormal fetal head position that the deceleration phase is
prolonged beyond 3hrs in nullipara or 1hr in multigravida.
A. Prolonged Latent Phase
B. Protracted Active Phase
C. Prolonged Deceleration Phase
D. Secondary Arrest of Dilatation
ANSWER: C
RATIONALE: Prolonged Deceleration Phase often results from abnormal fetal
head position that the deceleration phase is prolonged beyond 3hrs in nullipara or
1hr in multigravida

10. A pregnant client was admitted at 2:00 pm with a cervical dilation of 5cm and was
ordered by the Obstetrician to monitor her progress of labor after 4 hours you checked
her cervical dilation is still the same. What type of dysfunctional labor in first trimester
does the client is experiencing?
A. Prolonged Latent Phase
B. Protracted Active Phase
C. Prolonged Deceleration Phase
D. Secondary Arrest of Dilatation
ANSWER: D
RATIONALE: Secondary Arrest of Dilatation means that the labor of the client has
no progress in cervical dilatation for longer than 2 hours and the management for it
is by Cesarean Delivery.

SAS 12

1. A type of fetal malposition that occurs in 1/10 of all labors and during internal rotation
the head must rotate through 135 degrees instead of 90 degrees.
A. Occipitoposterior Position
B. Occiput Transverse Position
C. Breech Presentation
D. Face Presentation
E. Brow Presentation
ANSWER: A
RATIONALE: Occipito posterior Position is a type of fetal malposition that occurs
in 1/10 of all labors and during internal rotation the head must rotate through 135
degrees instead of 90 degrees that is common in women with android, anthropoid or
contracted pelvis

2. A type of fetal malposition that is due to ineffective contractions or a flattened bony

pelvis, vaginal delivery is possible with oxytocin administration and application of
forceps for delivery.
A. Occipitoposterior Position
B. Occiput Transverse Position
C. Breech Presentation
D. Face Presentation
E. Brow Presentation
ANSWER: B
RATIONALE: Occiput Transverse Position is a type of fetal malposition that is due
to ineffective contractions or a flattened bony pelvis, vaginal delivery is possible
with oxytocin administration and application of forceps for delivery.

3. You are giving health teachings regarding fetal presentation. The following are types of
breech presentation, EXCEPT:
A. Complete Breech
B. Frank Breech
C. Compound
D. Footling Breech
ANSWER: C
RATIONALE: Compound presentation is not a type of breech presentation.
Compound presentation is more than 1 part of the fetus presents; most commonly
hand or arm prolapsing with the head

4. This type of fetal malpresentation occurs in women with pendulous abdomens, uterine
fibroid tumors, contraction of the pelvic brim, congenital anomalies of the uterus,
hydramnios, fetus with hydrocephalus or anything that prevents engagement, prematurity,
multiple gestation or short umbilical cord.
A. Shoulder Presentation
B. Compound Presentation
C. Brow Presentation
D. Face Presentation
ANSWER: A
RATIONALE: Shoulder presentation/Transverse Lie a type of fetal
malpresentation occurs in women with pendulous abdomens, uterine fibroid
tumors, contraction of the pelvic brim, congenital anomalies of the uterus,
hydramnios, fetus with hydrocephalus or anything that prevents engagement,
prematurity, multiple gestation or short umbilical cord

5. It is a type of fetal malpresentation which is the rarest type, occurs in multipara or woman
with relaxed abdominal muscles that often leads to obstructed labor because the head
becomes jammed in the brim of the pelvis.
A. Shoulder Presentation
B. Compound Presentation
C. Brow Presentation
D. Face Presentation
ANSWER: C
RATIONALE: Brow presentation is a type of fetal malpresentation which is the
rarest type, occurs in multipara or woman with relaxed abdominal muscles that
often leads to obstructed labor because the head becomes jammed in the brim of the
pelvis
6. It is a type of fetal malpresentation wherein more than 1 part of the fetus presents; most
commonly hand or arm prolapsing with the head that there is high risk of cord
compression and prolapse.
A. Shoulder Presentation
B. Compound Presentation
C. Brow Presentation
D. Face Presentation
ANSWER: B
RATIONALE: Compound Presentation is a type of fetal malpresentation wherein
more than 1 part of the fetus presents; most commonly hand or arm prolapsing with
the head that there is high risk of cord compression and prolapse.

7. It is a type of fetal malpresentation wherein the fetal head is presenting at a different

angle than expected:
A. Shoulder Presentation
B. Compound Presentation
C. Brow Presentation
D. Face Presentation
ANSWER: D
RATIONALE: Face presentation is a type of fetal malpresentation wherein the fetal
head is presenting at a different angle than expected and is termed as
ASYNCLITISM.

8. A type of fetal distress that the fetal heart rate is repeatedly decelerating less 90bpm for
over 60 sec before returning to baseline that can lead to Fetal Hypoxia if it is not properly
managed.
A. Early Deceleration
B. Late deceleration pattern
C. Severe variable deceleration pattern
D. Variable Deceleration
ANSWER: C
RATIONALE: Severe Variable Deceleration pattern’s FHR repeatedly decelerates

9. A type of fetal distress that occurs early in labor before the head has fully descended due
to cephalopelvic disproportion can cause head compression:
A. Early Deceleration
B. Late deceleration pattern
C. Severe variable deceleration pattern
D. Variable Deceleration
ANSWER: A
RATIONALE: Early Deceleration is a type of fetal distress that occurs early in
labor before the head has fully descended due to cephalopelvic disproportion can
cause head compression.

10. A type of fetal distress that occurs when the fetal heart rate slows down following the
peak of a contraction &amp; slowly returns to baseline rate during the resting phase.
A. Early Deceleration
B. Late deceleration pattern
C. Severe variable deceleration pattern
D. Variable Deceleration
ANSWER: B
RATIONALE: Late Deceleration pattern is a type of fetal distress that occurs when
the fetal heart rate slows down following the peak of a contraction &amp; slowly returns
to baseline rate during the resting phase

SAS 13

1. The following are causes of postpartum hemorrhage, EXCEPT:

A. Uterine Atony
B. Trauma
C. Retained Placental Fragments
D. Chorioamnionitis
ANSWER: D
RATIONALE: Chorioamnionitis is a bacterial infection that occurs before or
during labor. The name refers to the membranes surrounding the fetus: the
“chorion” (outer membrane) and the “amnion” (fluid-filled sac). The condition
occurs when bacteria infect the chorion, amnion, and amniotic fluid around the
fetus

2. Lack of uterine muscle tone or relaxation of the uterus; hemostasis is due to contraction
of the muscles occluding the open vessels:
A. Uterine Rupture
B. Uterine Atony
C. Retained Placental Fragments
D. Placenta Accreta
ANSWER: B
RATIONALE: Uterine Atony is the lack of uterine muscle tone or relaxation of the
uterus; hemostasis is due to contraction of the muscles occluding the open vessels.

3. The following are predisposing factors of Uterine Atony, EXCEPT:

A. dysfunctional labor
B. retained placental fragments
C. anesthesia
D. forceps delivery
ANSWER: D
RATIONALE: Forceps delivery is a predisposing factor for vaginal/cervical
trauma.

4. A collection of blood in the subcutaneous layer of the tissue of the perineum.

A. Uterine Rupture
B. Vaginal, Cervical and Perineal Lacerations
C. Retained Placental Fragments
D. Perineal Hematoma
ANSWER: D
 RATIONALE: Perineal Hematoma is a collection of blood in the subcutaneous layer
of the tissue of the perineum.

5. Portion of placenta are left still attached to the uterus that keeps it from contracting fully
and uterine bleeding occurs:
A. Uterine Rupture
B. Uterine Atony
C. Retained Placental Fragments
D. Placenta Accreta
ANSWER: C
RATIONALE: Retained Placental Fragments is a portion of placenta are left still
attached to the uterus that keeps it from contracting fully and uterine bleeding
occurs.

6. The following are contributing factors for Uterine Inversion/Rupture, EXCEPT:

A. Perineal Varicosities
B. Prolonged Labor
C. Abnormal presentation
D. Multiple gestation
E. Unwise use of oxytocin
ANSWER: A
RATIONALE: Perineal varicosities is a contributing factor for Perineal Hematoma.

7. Failure of the uterus to return to its normal prepregnant size and shape after pregnancy:
A. Uterine Rupture
B. Uterine Atony
C. Uterine Subinvolution
D. Placenta Accreta
ANSWER: C
RATIONALE: Uterine Subinvolution causes bleeding &amp; occurs often within 1 to 2
weeks after childbirth because of retained placental fragments; blood loss is
excessive but is less risky than immediate postpartal hemorrhage

8. A classification of vaginal/perineal laceration wherein the entire perineum, rectal

sphincter and some of the mucous membrane of the rectum is lacerated:
A. First Degree Laceration
B. Second Degree Laceration
C. Third Degree Laceration
D. Fourth Degree Laceration
ANSWER: D
RATIONALE: Fourth Degree Laceration is a classification of vaginal/perineal
laceration wherein the entire perineum, rectal sphincter and some of the mucous
membrane of the rectum is lacerated.

9. A classification of vaginal/perineal laceration wherein the vaginal mucous membrane and

skin of the fourchette is lacerated:
A. First Degree Laceration
B. Second Degree Laceration
C. Third Degree Laceration
D. Fourth Degree Laceration
ANSWER: A
RATIONALE: First Degree Laceration is a classification of vaginal/perineal
laceration wherein the vaginal mucous membrane and skin of the fourchette is
lacerated.

10. A classification of vaginal/perineal laceration wherein the entire perineum is lacerated up

to the rectal sphincter:
A. First Degree Laceration
B. Second Degree Laceration
C. Third Degree Laceration
D. Fourth Degree Laceration
ANSWER: C
RATIONALE: Third Degree Laceration is a classification of vaginal/perineal
laceration wherein the entire perineum is lacerated up to the rectal sphincter.

SAS 14

1. The following are common infective agents that causes puerperal sepsis, EXCEPT:
A. Group B streptococci
B. Aerobic gram (-) bacilli like E. coli
C. Staphylococcus aureus
D. Helicobacter Pylori
ANSWER: D
RATIONALE: Helicobacter pylori (H. pylori) is a type of bacteria. These germs can
enter your body and live in your digestive tract. After many years, they can cause
sores, called ulcers, in the lining of your stomach or the upper part of your small
intestine.

2. The following are conditions that increases the risk for Post-partal Infection, EXCEPT:
A. Rupture of membranes greater than 24 hours before birth
B. Retained placental fragments
C. Postpartal hemorrhage- weakens the woman’s general condition
D. Prolonged &amp; difficult labor, particularly instrument births (forceps, etc.)
E. Degree of uterine involution at the time of microorganism invasion
ANSWER: E
RATIONALE: Degree of uterine involution at the time of microorganism invasion is
a part of conditions that affect prognosis for complete recovery from puerperal
sepsis.

3. The following are conditions that affect prognosis for complete recovery from Puerperal
Sepsis, EXCEPT:
A. Local vaginal infection at the time of birth
B. Virulence of the invading microorganism
C. The woman’s general health
D. Portal of entry
E. Degree of uterine involution at the time of microorganism invasion
ANSWER: A
RATIONALE: Local vaginal infection at the time of birth is a part of condition that
increases the risk for post-partal infection.

4. You are caring for a client who is suspected to have an Endometriosis. The following are
correct assessment for Endometriosis, EXCEPT:
A. Chills, anorexia, general malaise
B. The uterus is not well-contracted, painful to the touch with strong afterpains
C. Lochia is usually dark brown &amp; foul-smelling, increased in amount
D. Fever usually on the 3rd or 4th postpartal birth
E. Retained placental fragments
ANSWER: E
RATIONALE: Retained placental fragments is a part of conditions that increases
the risk for Post-partal Infection.

5. You are caring for a client who is experiencing Infection of the perineum. The following
are correct assessment for Infection of the perineum, EXCEPT:
A. Chills, anorexia, general malaise
B. Usually localized
C. May or may not have fever
D.1 or 2 stitches may be sloughed from the suture line or an area of the suture line may
be open with purulent drainage present
ANSWER: A
RATIONALE: Chills, anorexia, general malaise is a part of assessment for
Endometriosis

6. You are caring for a client who is diagnosed with Infection of the perineum, EXCEPT:
A. Oxytocic agent to encourage contraction
B. Drainage of infected site and packing with iodoform gauze on the open lesion
C. Topical or systemic antibiotic even before culture results are available
D. Advise the woman to wipe from front to back after bowel movement
ANSWER: A
RATIONALE: Oxytocic agent to encourage contraction is a part of management of
Endometriosis.

7. You are giving a health teaching to a patient who is diagnosed with Infection of the
Perineum. Which of the following health teaching that you cannot give for home
management?
A. Drainage of infected site and packing with iodoform gauze on the open lesion
B. Sitz baths, moist, warm compresses, Hubbard tank treatments to hasten drainage &amp;
cleanse the area
C. Remind woman to change perineal pads frequently to prevent recontamination or
vaginal infection
D. Ask woman to wipe from front to back after bowel movement
ANSWER: A
 RATIONALE: Drainage of infected site and packing with iodoform gauze on the
open lesion can be done at the hospital and it is not part of home management.

8. The following conditions are classified as Local infection, EXCEPT:

A. Lesions of perineum
B. Lesions of vulva
C. Endometritis
D. Chorioamnionitis
ANSWER: D
RATIONALE: Chorioamnionitis is a complication of pregnancy caused by bacterial
infection or inflammation of the fetal amnion and chorion membranes.

9. You are caring for patient who is diagnosed with Endometriosis and you are asked by
your instructor which of the following statement is incorrect regarding Endometriosis?
A. The lochia is usually dark brown &amp; foul-smelling, increased in amount
B. Analgesics can be taken for afterpains &amp; abdominal discomfort
C. Antipyretics can be taken for fever
D. 1 or 2 stitches may be sloughed from the suture line or an area of the suture line
may be open with purulent drainage present
ANSWER: D
RATIONALE: 1 or 2 stitches may be sloughed from the suture line or an area of the
suture line may be open with purulent drainage present is a definition for infection
of the perineum.

10. Your instructor ask you which of the following is incorrect regarding the assessment for
Endometriosis:
A. Chills, anorexia, general malaise
B. The uterus is not well-contracted, painful to the touch with strong afterpains
C. Lochia is usually dark brown &amp; foul-smelling, increased in amount
D. 1 or 2 stitches may be sloughed from the suture line or an area of the suture line
may be open with purulent drainage present
ANSWER: D
RATIONALE: 1 or 2 stitches may be sloughed from the suture line or an area of the suture line may be
open with purulent drainage present is a definition for infection
of the perineum.