Premature Rupture of Membranes (PROM) Practice Exam

Practice Mode – Questions and choices are randomly arranged, the answer is revealed instantly after each question, and there is no time limit for the exam.

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Exam Mode – Questions and choices are randomly arranged, time limit of 1min per question, answers and grade will be revealed after finishing the exam.

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Text Mode – Text version of the exam

1. The nurse is reviewing orders on a patient admitted for preterm premature rupture of membranes. Which physician order will the nurse question?

1. Perform a vaginal exam every shift
2. Monitor maternal temperature every 4 hours
3. Continuous fetal heart rate monitoring
4. Ampicillin 1 gm IVPB q 6 hours

2.When considering assessment history of a G3 P2 admitted for preterm labor, which risk factor in the woman’s history places her at greatest risk for preterm labor?

1. Prepregnancy BMI of 18.5
2. ½ ppd smoker during pregnancy
3. History of preterm labor
4. Previous cesarean delivery

3. Infection in the uterus may cause PROM and may also be a complication following PROM.

1. True
2. False

4. PROM may occur if the uterus is over-stretched by malpresentation of the fetus, multiple pregnancy or excess amniotic fluid.

1. True
2. False

5. Cervical incompetence in combination with PROM can be a cause of umbilical cord prolapse.

1. True
2. False

6.  The fetal membranes are so strong that blunt trauma to the abdomen is unlikely to cause PROM.

1. True
2. False

7. Hypoxia and asphyxia of the woman in labour is a common complication of prolonged PROM.

1. True
2. False

8. A sudden gush of clear watery fluid from the vagina is always seen in cases of PROM.

1. True
2. False

9. Which of the following would the nurse Sandra most likely expect to find when assessing a pregnant client with abruption placenta?

1. Excessive vaginal bleeding
2. Rigid, boardlike abdomen
3. Titanic uterine contractions
4. Premature rupture of membranes

10. Which of the following increases the risk of placental abruption?

1. Age < 35 years
2. Gestational diabetes
3. Previous placental abruption
4. Strenuous exercise

Answers & Rationale

1. A. Perform a vaginal exam every shift
2. C. History of preterm labor
3. A. True.  Infection in the uterus may cause PROM and may also be a complication following PROM.
4. A. True. Prom may occur if the uterus is over-stretched by malpresentation of the fetus, multiple pregnancy or excess amniotic fluid.
5. A. True. Cervical incompetence in combination with PROM can be a cause of umbilical cord prolapse.
6. B. False. Blunt trauma to the abdomen is a common cause of PROM.
7. B. False. Hypoxia and asphyxia of the fetus (not the woman in labour) is a common complication of prolonged PROM.
8. B. False. Some cases of PROM occur without a sudden gush of clear watery fluid from the vagina, so you should always take account of other diagnostic signs such as reduction in size of the abdomen and clearly palpable fetal parts.
9. B. Rigid, boardlike abdomen. The most common assessment finding in a client with abruption placenta is a rigid or boardlike abdomen. Pain, usually reported as a sharp stabbing sensation high in the uterine fundus with the initial separation, also is common.
10. C. Previous placental abruption. The risk of placental abruption is increased 15- to 20-fold if an earlier pregnancy had been complicated by placental abruption.6 Other risk factors include chronic hypertension, cocaine use, preeclampsia, age over 35 years, trauma, thrombophilia, cigarette smoking, preterm premature rupture of membranes, chorioamnionitis, and multiparity