POWERHOUSE TRAINING AND REVIEW CENTER

MARIA LORETO SIA MATERNITY NURSING REVIEW CP. 09081946699

TEST 1
1.

d.
9.

Fainting

A student asked the CI discussing gynecology what the organ of menstruation is. The correct response of the CI is: a. Ovaries b. Uterus c. Fallopian tube d. Vagina The non-pregnant uterus is lined by the a. Deciduas basalis b. Endometrium c. Myometrium d. Deciduas capsularis A nurse is teaching a client about menstruation. She explains that the predominant hormone produced by the ovaries in the secretory phase of the menstrual cycle is: a. estrogen. b. progesterone. c. oxytocin. d. prolactin. The physiologic effects of progesterone do not include: a. muscular peristalsis of the fallopian tube b. increased basal metabolism c. placental growth d. development of acini cells in the breasts The nurse should anticipate which psychological reactions during the second trimester of pregnancy? a. Self-centeredness and concentration on the behavior and appearance of children b. Extroversion and emotional lability c. Ambivalence and uncertainty d. Dismay over body image and readiness for the end of pregnancy A client is in the second trimester of her first pregnancy. Which of the following findings should the nurse bring to the attention of the obstetrician or nurse midwife? a. Diagonal conjugate of 12.5 cm b. Fundal height of 22 cm on August 20 (last menstrual period March 20) c. Rubella titer of 1:10. d. No ballottement A pregnant client is taking folic acid. During prenatal teaching, which of the following foods would the nurse recommend as high in folic acid? a. Egg yolks b. Fruit c. Bread d. Milk A 27-year-old primipara in her 5th month of pregnancy has been receiving regular prenatal care since week 8. She complains of feeling dizzy, breathless, and clammy on rising from bed in the morning. In responding to the client, the nurse would assess for which of the following conditions? a. Shock b. Hemorrhage c. Supine hypotension

In assessing a client for pregnancy, the nurse would look for which positive sign? a. Quickening b. Amenorrhea c. Fetal movement felt by the examiner d. Enlarged uterus A 35-year-old client is in the 8th month of her first pregnancy. Her physician orders a biophysical profile to be conducted the next day. What equipment would the nurse assemble to conduct this test? a. Sphygmomanometer and thermometer b. Ultrasound machine and fetal monitor c. Ultrasound machine and sphygmomanometer d. Fetal monitor and electronic blood pressure measuring device A client is 22 weeks pregnant with her first child. Her weight gain is normal, but she complains of constipation. What's the most effective recommendation the nurse can make? a. "Take a mild laxative daily." b. "Increase intake of fluids and high-fiber foods." c. "Relax when trying to move the bowels." d. "Start a strenuous exercise program." A nurse caring for a client who is 4 weeks pregnant should expect to collect which assessment findings? a. Presence of menses b. Uterine enlargement c. Breast sensitivity d. Fetal heart tones A woman who is 10 weeks pregnant tells the nurse that she's worried about her fatigue and frequent urination. The nurse should: a. Recognize these as normal early pregnancy signs and symptoms. b. Question her further about these signs and symptoms. c. Tell her that she'll need blood work and urinalysis. d. Tell her that she may be excessively worried. A newly pregnant woman tells the nurse that she hasn't been taking her prenatal vitamins because they make her nauseated. In addition to stressing the importance of taking the vitamins, the nurse should advise the client to: a. Switch brands. b. Take the vitamin on a full stomach. c. Take the vitamin with orange juice for better absorption. d. Take the vitamin first thing in the morning. The nurse is using Doppler ultrasound to assess a pregnant woman. When should the nurse expect to hear fetal heart tones? a. 7 weeks b. 12 weeks c. 17 weeks d. 21 weeks

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POWERHOUSE TRAINING AND REVIEW CENTER

MARIA LORETO SIA MATERNITY NURSING REVIEW
16.

CP. 09081946699
22.

A primipara at 32 weeks gestation presents complaining of vaginal bleeding. She has soaked one peripad. She has no pain or cramps. In performing an assessment, the nurse would suspect which of the following? a. Placenta previa b. Abruptio placentae c. Vasa previa d. Incompetent cervix A primigravida client with acquired immunodeficiency syndrome (AIDS) is in labor at term. In preparing her nursing care plan, the nurse should include which of the following nursing diagnoses? a. Risk for fetal or maternal injury related to the crisis of childbearing b. Risk for infection related to suppressed immune status c. Risk for deficient fluid volume related to dehydration d. Risk for fetal injury related to uteroplacental insufficiency A woman in her 8th month of pregnancy is having dinner with her husband at their favorite restaurant. The woman suddenly chokes on a piece of chicken and appears to lose consciousness. What would be the best action by a nurse sitting at the next table? a. Apply abdominal thrust. b. Apply chest thrust. c. Begin cardiopulmonary resuscitation (CPR). d. Reposition the client on her side. The nurse is assessing a pregnant woman. Which signs or symptoms indicate a hydatidiform mole? a. Rapid fetal heart tones b. Abnormally high human chorionic gonadotropin (hCG) levels c. Slow uterine growth d. Lack of symptoms of pregnancy Early detection of an ectopic pregnancy is paramount in preventing a life-threatening rupture. Which symptoms should alert the nurse to the possibility of an ectopic pregnancy? a. Abdominal pain, vaginal bleeding, and a positive pregnancy test b. Hyperemesis and weight loss c. Amenorrhea and a negative pregnancy test d. Copious discharge of clear mucus and prolonged epigastric pain A client is in labor with her first child. Which of the following would indicate that the client has moved into the second stage of labor? a. The client has an uncontrollable urge to bear down. b. The client has a decrease in bloody show. c. The client becomes increasingly talkative. d. The client takes three deep cleansing breaths.

17.

The client states that her baby has been very active. Contractions are strong, occurring every 3 to 4 minutes and lasting 40 to 60 seconds. What part of this assessment data would indicate fetal distress? a. Uterine contractions lasting 40 to 60 seconds b. Strong uterine contractions c. Uterine contractions occurring every 3 to 4 minutes d. FHR ranging from 160 to 190 beats/minute During labor, meconium in the amniotic fluid is a normal finding in which of the following situations? a. Preterm labor b. Cephalopelvic disproportion c. Prolonged latent phase d. Breech presentation A client is admitted to the labor and delivery department in preterm labor. To help manage preterm labor the nurse would expect to administer: a. Ritodrine (Yutopar). b. Bromocriptine (Parlodel). c. Magnesium sulfate. d. Betamethasone (Celestone). A client delivered a healthy full-term baby girl 2 hours ago by cesarean delivery. When assessing this client, which finding requires immediate nursing action? a. Tachycardia and hypotension b. Gush of vaginal blood when she stands up c. Blood stain 2 (5.1 cm) in diameter on the abdominal dressing d. Complaints of abdominal pain The nurse is assessing a client who gave birth yesterday. Where should the nurse expect to find the top of the client's fundus? a. One fingerbreadth above the umbilicus b. One fingerbreadth below the umbilicus c. At the level of the umbilicus d. Below the symphysis pubis The nurse is caring for a client during the first postpartum day. The client asks the nurse how to relieve pain from her episiotomy. What should the nurse instruct the woman to do? a. Apply an ice pack to her perineum. b. Take a Sitz bath. c. Perform perineal care after voiding or a bowel movement. d. Drink plenty of fluids. A client has a boggy uterus during stage IV of her delivery. Four hours postpartum, the nurse is preparing to administer methylergonovine maleate (Methergine) 0.2 mg P.O. as prescribed every 6 hours. The client's vital signs are: temperature, 100.4 F (38C); pulse, 60 beats/minute; respirations, 14 breaths/minute; blood pressure, 146/90 mm Hg. Which is the most appropriate intervention? a. Immediately administer the drug. b. Administer the drug and call the physician.

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POWERHOUSE TRAINING AND REVIEW CENTER

MARIA LORETO SIA MATERNITY NURSING REVIEW CP. 09081946699

c. d.
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Administer the drug and recheck vital signs. Don't administer the drug.

d. 10 days after the start of the last menses.

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Which of the following descriptions is not true of the clitoris? a. The significance of clitoris in obstetrics is its usefulness in guiding catheterization. b. The clitoris is the most erectile part of the female external genitalia. c. It is said to be the seat of womans sexual arousal and orgasm. d. Its equivalent in the male reproductive organs is the testes. The main blood supply of the uterus comes from the a. internal iliac artery b. aorta c. renal artery d. ovarian artery Damage to this ligament during delivery will result to uterine prolapse: a. broad ligaments b. round ligaments c. cardinal ligaments d. anterior ligaments In which portion of the fallopian tube does fertilization normally occur? a. the ampulla b. the infundibulum c. the interstitial segment d. the isthmus The fallopian tube has a muscular layer of tissue that is responsible for its peristaltic like movements. This motility is most often seen: a. During pregnancy b. Around ovulation c. Near menstruation d. During labor

Perineal muscle tone is important to prevent extensive lacerations during childbirth. Performing kegels exercise benefits most which muscle of the perineum? a. Bulbocavernous muscle b. Coccygeous and constrictor of the urethra c. Deep transverse and constrictor of the urethra d. Levator ani The physician prescribes clomiphene citrate (Clomid) for a woman who has been having difficulty getting pregnant. When teaching the client about this drug's potential adverse effects, which of the following should the nurse include in the teaching plan? a. Chance of multiple gestation. b. Increase in spontaneous abortions. c. Increase in fibrocystic breast disease. d. Increase in congenital anomalies. A client who tells the nurse that she would like to use the basal body temperature method for family planning receives instructions about the method. Which of the following client statements indicates to the nurse that the teaching has been successful? a. "When my temperature remains elevated for 7 days, ovulation has occurred. b. "Taking my temperature in the evening just after dinner or before I go to bed is best." c. "Because this method is not very effective, I should use other forms of contraception too." d. "It's important to take my temperature at about the same time every morning before arising." After instructing a pregnant client about third trimester edema, the nurse determines that the client needs instruction when the client states which of the following? a. "Swelling of my feet and ankles is normal." b. "I'll continue to drink six to eight glasses of water a day. c. "I need to avoid standing in one place for too long." d. "Swelling in my hands and face is to be expected." After the nurse instructs a pregnant client about swimming and bathing during pregnancy, which of the following client statements indicates the need for additional teaching? a. "I can continue to swim as long as my membranes aren't ruptured." b. "I can relax in a hot tub for about 20 minutes." c. "I can take a bath daily but should be careful not to fall." d. "I should avoid sitting in a sauna for prolonged periods." When the nurse instructs a pregnant client with a history of varicose veins about strategies to promote comfort, which of the

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Which phase is a part of the normal uterine cycle? a. Follicular b. Luteal c. Ovulation d. Proliferative A nursing instructor is reviewing the menstrual cycle with a nursing student who will be conducting a prenatal teaching session. The instructor asks the student to describe the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH. The student Accurately responds by stating that a. FSH and LH are released from the anterior pituitary gland. b. FSH and LH are secreted by the corpus luteum of the ovary. c. FSH and LH are secreted by the adrenal glands. d. FSH and LH stimulate the formation of milk during pregnancy

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In a regular 32-day menstrual cycle, the client will probably ovulate: a. on day 11. b. on day 18. c. on day 22.

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POWERHOUSE TRAINING AND REVIEW CENTER

MARIA LORETO SIA MATERNITY NURSING REVIEW CP. 09081946699

following client statements indicates that the teaching has been successful? a. "Lying down with my feet elevated should help." b. "Support hose can be put on just before bedtime." c. "Restricting milk intake may provide some relief." d. "Wearing knee-high stockings is better than pantyhose."
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c. d.
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Immediate cesarean delivery Labor induction with oxytocin

A primigravida, admitted to the hospital at 12 weeks' gestation complaining of abdominal cramping, exhibits bright red vaginal spotting without cervical dilation. The nurse determines that the client is most likely experiencing which of the following types of abortion? a. Missed b. Threatened c. Inevitable d. Incomplete A pregnant woman states that she frequently ingests laundry starch. When assessing the client, for which of the following should the nurse be alert? a. Muscle spasms b. Lactose intolerance c. Diabetes mellitus d. Anemia A 26-year-old primigravida visiting the prenatal clinic for her regular visit at 34 weeks' gestation tells the nurse that she takes mineral oil for occasional constipation. The nurse should instruct the client to do which of the following? a. Take mineral oil with fruit juice to increase the action of the mineral oil b. Avoid mineral oil because it interferes with the absorption of fat-soluble vitamins c. Avoid mineral oil because it can lead to vitamin C deficiency in pregnant clients d. Use the mineral oil regularly on a weekly basis to prevent constipation A client with eclampsia begins to experience a seizure. Which of the following should the nurse do? a. Pad the side rails b. Place a pillow under the left buttock c. Insert a padded tongue blade into the mouth d. Maintain a patent airway

Which of the following should the nurse use to assess a client for possible uterine atony after a cesarean delivery? a. Check the abdominal dressing every 15 minutes for the first hour b. Palpate the fundus every 15 minutes for at least 1 hour c. Observe the amount of lochia immediately after delivery d. Assess blood pressure and pulse every 15 minutes for 1 hour Terbutaline (Brethine) therapy is ordered for a client with preterm labor. Before beginning therapy, which of the following assessments would be most important? a. Contraction intensity b. Deep tendon reflexes c. Estimated fetal size d. Maternal heart rate After teaching a pregnant client about potential complications of amniocentesis that must be reported immediately, the nurse determines that the client understands the instruction when she says that she should immediately report which of the following? a. Nausea b. Vaginal bleeding c. Urinary frequency d. Irregular, painless uterine tightness A client at 36 weeks' gestation with Type 1 diabetes is scheduled for a contraction stress test. After explaining the purpose of the test, the nurse determines that the client understands the instruction when she states that the test is done to detect which of the following? a. Cardiac anomalies b. Uteroplacental sufficiency c. Kidney anomalies d. Amniotic fluid volume A client with diabetes mellitus that is well controlled reports that she participated in strenuous aerobic exercise before becoming pregnant. She asks the nurse if she can continue exercising. Which of the following should be the nurse's best response? a. "You probably should discontinue your strenuous exercise program while you are pregnant so you don't injure the fetus." b. "You need to curtail your exercise program a little so that you don't overexert yourself while you are pregnant." c. "You can continue exercising while pregnant, but make sure that you eat a carbohydrate or protein snack before exercising d. "It's probably a good idea for you to check your blood sugar before beginning any exercise program." A 24-year-old client admitted to the hospital is suspected of having an ectopic pregnancy. On admission, which of the following would be most important to assess? a. Sexual practices

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Which of the following should the nurse most likely expect to find when assessing a pregnant client with abruptio placenta? a. Excessive vaginal bleeding b. Rigid, boardlike abdomen c. Tetanic uterine contractions d. Premature rupture of membranes A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following? a. Activity limited to bed rest b. Platelet infusion

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POWERHOUSE TRAINING AND REVIEW CENTER

MARIA LORETO SIA MATERNITY NURSING REVIEW CP. 09081946699

b. c. d.
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Use of a diaphragm Type of oral contraceptives Date of last menstrual period

A 36-year-old client is admitted with a possible ruptured ectopic pregnancy. When planning the client's care, which of the following procedures should the nurse anticipate preparing the client for soon after admission? a. Dilation and curettage b. Ultrasound c. Evacuation of the uterus d. Oophorectomy When caring for the pregnant client with hyperemesis gravidarum, the nurse would further assess the client for which of the following? a. Abdominal pain b. Leaking amniotic fluid c. Pinkish vaginal discharge d. Dehydration The nurse should assess a 26-year-old multigravida at 30 weeks' gestation with premature rupture of the membranes (PROM) for symptoms of which of the following? a. Foul-smelling amniotic fluid b. Uterine prolapse c. Small-for-gestational-age fetus d. Tetanic uterine contractions The physician orders magnesium sulfate intravenously for a pregnant client with premature rupture of the membranes who begins to have contractions every 10 minutes. The nurse explains to the client that the primary purpose of magnesium sulfate is to do which of the following? a. Provide sedation b. Combat hypomagnesemia c. Improve fetal lung function d. Prevent seizures. The physician orders betamethasone (Celestone) intramuscularly for a pregnant client admitted to the hospital at 34 weeks' gestation who is receiving intravenous tocolytic therapy for preterm labor. After administering the drug, the nurse should assess the client for which of the following as a possible side effect? a. Hypoglycemia b. Infection c. Urinary frequency d. Decreased skin turgor A 25-year-old woman who is in the first stage of labor receives a continuous lumbar epidural block when the cervix is 6 cm dilated. After administration of this anesthesia, which of the following assessments would be most important? a. Fetal heart rate b. Amniotic fluid color c. Level of anesthesia d. Level of consciousness A 32-year-old primigravida at 39 weeks' gestation is admitted to the hospital in active labor accompanied by her husband. While the nurse performs Leopold's maneuvers, the

client asks why these maneuvers are being done. The nurse explains that the major purpose of these maneuvers is to determine which of the following? a. Fetal presentation b. A multifetal pregnancy c. Estimated gestational age d. Intensity of contractions
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The client asks the nurse why she can have only fluids while in labor. After providing an explanation, which of the following client statements would indicate to the nurse that the teaching has been effective? a. "Intravenous fluids will be started if I get hungry." b. "The digestive process is normally slow during labor." c. "Most clients don't get hungry during labor." d. "Eating solid foods during labor is unnecessary." After explaining about the second stage of labor, which of the following client statements would indicate to the nurse that the client understands the information discussed? a. "I'm going to have a higher blood pressure." b. "My membranes are likely to have a foul odor." c. "My contractions are going to be less painful." d. "I should try to push with each contraction." A pregnant client's labor is progressing, but her cervix is still only 5 cm dilated and 100% effaced. Although she appears relaxed, she is aware of labor contractions. At this time, which of the following suggestions would be most helpful for the client's husband? a. "Keep a record of her contraction pattern." b. "Encourage her to rest between contractions." c. "Suggest that she receive an epidural anesthetic." d. "Have her practice rapid, shallow breathing." External monitoring of contractions and fetal heart rate of a multigravida in labor reveal a variable deceleration pattern on the fetal heart rate. Which of the following should the nurse do first? a. Notify the anesthesiologist b. Change the client's position c. Administer oxygen at 2 liters by mask d. Prepare the client for a cesarean delivery A client whose cervix is 10 cm dilated begins to push. The nurse notes early decelerations of the fetal heart rate. Which of the following should the nurse anticipate as the most likely cause of this fetal heart rate pattern? a. Cord compression b. Fetal Bradycardia c. Fetal head compression d. Inadequate uteroplacental perfusion A 39-year-old multiparous client at 39 weeks' gestation diagnosed with class II heart disease

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POWERHOUSE TRAINING AND REVIEW CENTER

MARIA LORETO SIA MATERNITY NURSING REVIEW CP. 09081946699

is admitted to the hospital in active labor. Which of the following should the nurse assess first after admission to the birthing area? a. Time of last food and fluid intake b. Fetal position and station c. Contraction frequency and intensity d. Ability to follow directions
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For a primigravid client with the fetal presenting part at -1 station, which of the following would be the nurse's priority immediately after a spontaneous rupture of the membranes? a. Positioning the client on her left side b. Preparing the client for a cesarean delivery c. Assessing the client's blood pressure d. Checking the fetal heart rate After teaching a woman who is in labor about the purpose of the episiotomy, which of the following purposes stated by the client would indicate to the nurse that the teaching was effective? a. Shortens the second stage of labor b. Enlarges the pelvic inlet c. Prevents perineal edema d. Ensures quick placental delivery The multigravid client with a history of rapid labor who is in active labor calls out to the nurse, "The baby is coming!" Which of the following should be the nurse's first action? a. Inspect the perineum b. Time the contractions c. Auscultate the fetal heart rate d. Contact the birth attendant While waiting for the placenta to deliver, the nurse should not take any action until she has done which of the following? a. Asked the client to push down forcefully b. Massaged the fundus forcefully c. Observed for signs of placental separation d. Reached into the uterus with sterile gloves During the immediate postpartum period after delivering twins, the client experiences uterine atony. Which of the following should the nurse do first? a. Gently massage the fundus b. Assess the client for infection c. Determine if the uterus has ruptured d. Increase the intravenous fluid rate Umbilical cord prolapse occurs after spontaneous rupture of the membranes. Which of the following should the nurse do immediately? a. Place the client in a Trendelenburg position b. Administer oxytocin intravenously c. Ask the client to begin pushing d. Cover the cord with sterile towels A primipara has delivered her baby, with labor, delivery, recovery, and the postpartum period in the same hospital room. The client had a midline episiotomy and epidural anesthesia. While assessing the client's pulse 30 minutes after the delivery, the nurse

determines that the pulse rate is 60 bpm. Which of the following should the nurse do? a. Nothing, because this pulse rate is considered a normal finding b. Contact the client's physician to notify about the pulse rate c. Check the client's record to determine the amount of blood loss d. Recheck the pulse in 30 minutes, and compare the two readings
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Menopause is said to have occurred in the following women except: a. Are 40 years old and above and have not menstruated for 1 year b. Are fifty years old and above and have not menstruated for one year c. In women who have undergone bilateral oophorectomy d. In women who have undergone hysterectomy Mrs. Quintos is beginning menopause, she asks the nurse, What can I expect if I dont go on hormone replacement therapy? The best response of the nurse should be a. You will eventually be symptomfree once your body adjusts to the withdrawal of estrogen from your ovaries. b. You may be more prone to fracturing a bone if you fall or injure yourself, so you will need to be very careful. c. You will have occasional periods of spotting, which is normal for the first few tears, and then it will stop. d. You will be free of your monthly periods and wont have to worry about getting pregnant from here on. Josh a 15 year old high school student asks the doctor, what body structure is responsible for the production of Follicle Stimulating Hormone (FSH)? The nurses response will likely be: a. Testes b. Hypothalamus c. Anterior pituitary gland d. Kidney The male hormone testosterone, which maintains spermatogenesis, is synthesized and released by: a. Seminiferous tubules b. Sertolis cells c. Seminal vesicles d. Leydigs cells A male gland located behind the bladder that is the source of about 60% of seminal fluid? a. Cowpers gland b. Prostate gland c. Seminal Vesicles d. Testes Which male hormone is responsible for maintaining spermatogenesis, increasing sperm production, and producing seminal fluid? a. Human chorionic gonadotropin (hCG) b. Insulin c. Semen

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POWERHOUSE TRAINING AND REVIEW CENTER

MARIA LORETO SIA MATERNITY NURSING REVIEW CP. 09081946699

d. Testosterone
Situation: Mrs. Olga C, 28 years old, comes to the clinic for her yearly gynecologic examination. She is concerned because she has been unable to conceive.
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c. Keep the specimen warm by placing it in a glass of hot water. d. Entire specimen is collected in a clean, dry container and immediately transported to the laboratory
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Mrs. Olga says, I cant understand why I havent gotten pregnant. What could be wrong. Which of the following ideas should be incorporated into the nurses answer to her? a. infertility is due chiefly to congenital anomalies of the reproductive organs b. infertility is often caused by the use of nonprescription drugs c. infertility is usually due to emotional difficulties d. infertility is frequently caused by multiple, rather than single factors Because of Mrs. Olgas inability to conceive, the nurse should assess her history for which of the following factors? a. mumps before puberty b. recurrent kidney infection c. essential hypertension d. pelvic infection The physician prescribed clomiphine citrate (Clomid). The nurse should explain that the action of this drug is to a. promote ovulation b. lower the pH of the cervical mucus c. strengthen the peristaltic movement of the fallopian tubes d. prepare the endometrium for implantation The normal volume and sperm content of seminal fluid per ejaculation to be considered fertile is: a. 1ml/100 million sperm cells b. 3 ml/300 million sperm cells c. 3 ml/30 million sperm cells d. 1 ml/ 20 millions sperm cells The following are characteristics of normal sperms. Which one is not included? a. Life span is 72 hrs. b. Normal count is 60-120 million per ml c. pH is acidic d. volume per ejaculation in 3-5 ml

When assessing the adequacy of sperm for conception to occur, which of the following is the most useful criterion? a. Sperm count b. Sperm maturity c. Sperm motility d. Semen volume Post-coital test is ordered after normal semen analysis. Which TWO of the following results are normal? I. 15 20 live motile sperm hpf II. Mucus stretches 8-10 cm III. More than 5 live motile sperm per hpf IV. Mucus stretches 5-7 cm
a. b. c. d. II and III I and II I and IV III and IV

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After thorough evaluation, the doctor confirmed that all findings are normal. Cecille asked the nurse What does it mean to be diagnosed with primary infertility? The nurse appropriate reply is that: a. The diagnosis means that she and her husband have never achieved any pregnancy before. b. The diagnosis means that she will never be able to conceive and adoption is an alternative for her. c. The diagnosis means that she and her husband are normal but they just could not get pregnant yet. d. The diagnosis means that she has never been able to conceive but her husband may have already fathered children in other women. The average life span of the ovum is a. 12 hours b. 36 hours c. 24 hours d. 48 hours Which is the correct chronological sequence? a. ovulation -fertilization-implantation morula b. implantation-blastocyst -ovulationfertilization c. ovulation-fertilization-blastocystimplantation d. ovulation-fertilization-morula-zygote The average duration of a normal human pregnancy is: a. 260 days b. 10 lunar months c. 9 months d. 38 weeks A nurse is caring for a client during the prenatal period. The client tells that nurse that she wants to know the sex of the fetus as soon as it can be determined. The nurse responds to the client, knowing the sex of the fetus can be visually recognizable as early as week a. 4

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Situation: Hamil and Cecille have been married for almost 18 months already. They came to the clinic because they have been trying to get pregnant during the entire duration of their marriage without success.
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Semen analysis has been requested for Hamil, a middle eastern man married to a Filipina for five years. Which of the following should be part of the instruction to be given to the husband? a. Abstain from intercourse for about a month then collect fresh ejaculate for testing b. Immerse the specimen in a tumbler of ice cubes and transport it immediately to the testing facility

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MARIA LORETO SIA MATERNITY NURSING REVIEW CP. 09081946699

b. 6 c. 8 d. 12
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A nurse prepares to assess a fetal heartbeat. The nurse uses a fetoscope, knowing that the fetal heartbeat first can be heard with a regular (nonelectronic) fetoscope at gestational week a. 5 b. 10 c. 16 d. 20 The protection of the fetus from being infected by syphilis during the first trimester is attributed to: a. Amniotic membrane b. Langhans layer c. Syncytiotrophoblasts d. Placenta Which of the following is derived from the mesoderm? a. lining of the GI tract b. liver c. brain d. skeletal system HCG levels are elevated from the day after implantation until: a. 8 days after conception b. 60 days after fertilization c. 120 days after fertilization d. 2 weeks after delivery Oxygen and carbon dioxide are exchanged in the placenta through the process of: a. Pinocytosis b. Diffusion c. Facilitated diffusion d. Active transport The fetus begins to move by itself around: a. 12 weeks b. 14 weeks c. 16 weeks d. 20 weeks earliest time that a fetus can hear sound in utero is at: a. 12 weeks b. 16 weeks c. 20 weeks d. 24 weeks

the client that urinary frequency often occurs because the capacity of the bladder during pregnancy is diminished by: a. Atony of the detrusor muscle b. Compression by the enlarging uterus c. Compromise of the autonomic reflexes d. Constriction of the ureteral entrance at the trigone.
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Fainting is common in pregnant clients during the first trimester due to: a. Hyperglycemia b. Hypertension c. Hyperventilation d. Hypoglycemia While reviewing laboratory results of Karylle at 20 weeks' gestation, the nurse notes her hemoglobin (Hb) level has decreased from 13 to 11 g/dl. The most likely explanation for this decrease is: a. internal bleeding b. exacerbation of a hemolytic disease c. irregular use of prenatal vitamins d. hemodilution related to increased maternal blood volume What significant cardiovascular change occurs during the second trimester of a normal pregnancy? a. Decreased pulse b. Decreased blood pressure c. Increased central venous pressure (CVP) d. Increased pulmonary artery wedge pressure (PAWP) Women may occasionally develop bizarre eating habits during pregnancy, eating such nonedible items as coal or laundry detergent. This type of behavior is referred to as: a. Couvades b. Delusions c. Pica d. Prenatal psychosis Which statement regarding physiologic changes in the GI system during pregnancy is accurate? a. Demineralization of teeth occurs when calcium intake is insufficient. b. Delayed emptying of the stomach contributes to many GI symptoms. c. Nausea is related to high levels of relaxin and estrogen early in pregnancy. d. Gums bleed easily because of high levels of human chorionic gonadotropin (hCG). A 20-year-old client, having missed one menstrual period, visits the prenatal clinic because she suspects that she is pregnant. Besides amenorrhea, the client tells the nurse that she has experienced nausea and vomiting, urinary frequency, and fatigue. The nurse determines that the client has been experiencing signs of pregnancy categorized as which of the following? a. Presumptive b. Probable c. Positive d. Predictive

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TEST 2
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Mrs. Tena history revealed ectopic pregnancy in 2001, abortion in 2008, and preterm birth at 35 weeks in 2009. She is a: a. primigravida b. nulligravida c. nullipara d. primipara Which of the following is not a criterion for 1 live birth? a. Birth weight greater than 2,500 grams b. Spontaneous breathing c. Presence of heart beat d. Spontaneous movement In her 8th week of pregnancy, the client complains of having to go to the bathroom more often to urinate. The nurse explains to

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MARIA LORETO SIA MATERNITY NURSING REVIEW
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To determine the clients expected date of delivery, which day of the last menstrual period will you ask? a. First b. Last c. Third d. Second Vina tearfully states that she used drugs before she knew she was pregnant. According to her last menstrual period, she was at approximately 1 week of gestational age when she last used drugs. The nurse knows that: a. Drug use in the first trimester always causes congenital anomalies. b. Drug use before implantation has as smaller incidence of teratogenic effect. c. It is only important to avoid drug use during the period of organ formation, weeks 3-10. d. Selected drug use is not harmful in pregnancy. The client asks, "Can my partner and I still engage in sexual intercourse while I'm pregnant?" The nurse's response is based on which of the following? a. Throughout the pregnancy, coitus interruptus is the preferred method for sexual activity. b. Although sexual desire may change, intercourse is safe during an uncomplicated pregnancy. c. Engaging in intercourse must be avoided until the client is at least 16 weeks pregnant. d. The couple should refrain from engaging in sexual intercourse during the last trimester. The client is given instructions to notify the nurse if she notices any of the following signs EXCEPT: a. Tight finger rings, puffy eyelids b. Severe persistent headache c. Vaginal bleeding d. Nausea and vomiting in the 1st trimester When explaining to Vina about the need to take supplemental vitamins with iron during her pregnancy, the nurse should instruct the client to take the iron with which of the following to promote maximum absorption? a. Milk b. Tea c. Hot chocolate d. Orange juice The nurse instructs her to observe the occurrence of normal physiologic change in pregnancy which include? a. Increased blood pressure b. Palpitations c. Anemia d. Blurring of visions Vina is to have a transabdominal ultrasound. The nurse would include which of the following instructions?
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Nothing by mouth (NPO) from 6:00 A.M. the morning of the test b. Drink one to two quarts of water and do not urinate before the test. c. Come to the clinic first for injection of the contrast dye. d. No special instructions are needed for this test.
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During which clinic visit of Vina will you be able to palpate the uterus abdominally? a. 1st visit b. 2nd visit c. 3rd visit d. 4th visit The nurse understands that the client has achieved the first psychological task of pregnancy when she verbalizes which statement: a. I am going to make some adjustments in my household chores schedule after I deliver my baby. b. I am going to name my baby Daniel. c. I am 12 weeks pregnant. d. I wander what my baby will look like. On her next clinic visit, Vinas husband went with her to the clinic. The soon to be father told you that his wife confuses her at times because there are days when Rosario would tell her that shes happy to be having a baby and on certain days would comment that having a baby is not on her plans yet. You tell the husband that this emotional reaction is typical among pregnant women and is called: a. Introversion b. Ambivalence c. Fear d. Uncertainty The nurse advised Vina to avoid smoking during pregnancy as babies of mothers who smoke tend to be a. Smaller in size and lighter in weight b. Have heart disease c. Have lower blood count d. Have more birth defects Vina asked the nurse When will I feel my baby move? The nurse tells Vina that for first time mothers like her, she will feel the baby moves around: a. 4 months in her pregnancy b. 5 months in her pregnancy c. 6 months in her pregnancy d. 7 months in her pregnancy The client is worried about gaining too much weight. She asks what the average weight gain in pregnancy is. You answer: a. 15 lbs b. 35 lbs c. 40 lbs d. 24 lbs On one of her clinic visits, Vina tells you that she wants to return to her vegetarian diet. As her nurse, you told her to do it after pregnancy as vegetarianism can lead to a deficiency in:

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MARIA LORETO SIA MATERNITY NURSING REVIEW
a. b. c. d. 24.

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Vitamin A Vitamin B12 Iron deficiency anemia Folic acid deficiency anemia

Vina has just received her second dose of tetanus toxoid immunization. She asked how much protection her latest shot gives her and her baby against tetanus. The nurses correct response is: a. Her latest injection gives her five years immunity from tetanus and her baby will not acquire neonatal tetanus. b. The second injection gives pregnant women 10 years of protection and their babies protection during the infancy period. c. She is protected from tetanus only during this pregnancy and must receive the third dose to be protected for the next five years. Her baby will be protected when she receives the third dose. d. It provides her with immunity from tetanus infection for the next three years and protects her baby from acquiring neonatal tetanus. The nurse plans to do Leopolds Maneuver to Vina. Which of the following instructions will help make her comfortable? a. Do deep breathing during the procedure b. Empty your bladder before the procedure c. Drink one glass of water d. Lie on your left side

During a nonstress test (NST), the nurse notes three fetal heart rate (FHR) increases of 20 beats/min, each lasting 20 seconds. These increases occur only with fetal movement. What does this finding suggest? a. The test is nonreactive and further evaluation is necessary. b. The test result is inconclusive, and the test must be repeated. c. The test result is reactive at this is time. d. The fetus is nonreactive and hypoxic.

Because of your findings, you referred Charo to the doctor. At eight months, Charo had contraction stress test and the result is negative. Charo asked when she should go back to the doctors clinic for her next checkup? monthly within 24 hours within a week weekly for 2 weeks then monthly
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When preparing a client for an amniocentesis procedure, the nurse should: a. Instruct the client to drink 1 L (1 qt) of fluid. b. Ask the client to void first. c. Prepare her arm for starting an IV. d. Place her on her left side with knees flexed. On her third trimester, Glydel developed cardiac complication. She is scheduled for an amniocentesis at 32 weeks gestation to determine the L/S ratio and phosphatidyl glycerol level. The L/S ratio is 1:1 and the presence of phosphatidyl glycerol is noted. The nurses assessment this data: a. The infant is at low risk for congenital anomalies b. The infant is at risk for intrauterine growth retardation c. The infant is at high risk for respiratory distress syndrome d. The infant is at high risks for birth trauma At 14 weeks gestation, Maisa is scheduled for an alpha-fetoprotein test. She asks the nurse, What does the alpha-fetaprotein test indicate? The nurse bases a response on the knowledge that this test can detect: a. Kidney defects b. Cardiac defects c. Neural tube defects d. Urinary tract defects A primigravida, age 42, is 6 weeks pregnant. Based on the clients age, her infant is at risk for: a. Down syndrome b. Respiratory distress syndrome c. Turners syndrome d. Pathological jaundice The registered nurse is making assignments for the day. Which client should not be assigned to the pregnant nurse? a. The client receiving linear accelerator radiation therapy for lung cancer

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At a prenatal visit at 36 weeks gestation, the client complains of discomfort with irregularly occurring contractions. The nurse instructs the client to: a. Lie down until they stop b. Walk around until they subside c. Time the contractions for 30 minutes d. Take 10 grains of aspirin for the discomfort
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During prenatal visit at 38 weeks, a nurse assesses the fetal heart rate. The nurse determines that fetal heart rate is normal if which of the following is noted? a. 80 beats per minute b. 100 beats per minute c. 150 beats per minute d. 180 beats per minute What would be most important for the nurse to teach Vina if her membranes rupture before admission to the hospital? a. Begin timing contractions. b. Begin pushing. c. Take a warm bath. d. Refrain from sexual intercourse. An obstetrical score of 4-1-2-5 shows a woman has had how many living children? a. 4 b. 1 c. 2 d. 5

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MARIA LORETO SIA MATERNITY NURSING REVIEW CP. 09081946699
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b. The client with a radium implant for cervical cancer c. The client who has just been administered soluble brachycardia for thyroid cancer d. The client who returned from an intravenous pyelogram
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Large for gestational age infant

The nurse in the prenatal clinic is taking a history from a client who is 26 weeks pregnant. The client states that she has not felt the baby move yet. On physical exam, the nurse notes that the fundus is below the umbilicus. The nurse should: a. Record the findings as normal. b. Reassure the client that she will feel the baby move in the next week. c. Notify the physician that there is a discrepancy between the gestational age of the pregnancy and the findings from this prenatal visit. d. Tell the client that the baby has been moving for the past several weeks but that the movements are too weak to be felt.

What should not be done to ascertain the significance of vaginal bleeding in late pregnancy? a. Internal examination b. Leopold's maneuver c. Determination of fundic height d. Ultrasonography A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following? a. Activity limited to bed rest b. Platelet infusion c. Immediate cesarean delivery d. Labor induction with oxytocin Which of the following signs and symptoms will you not consider in H-mole? a. Vaginal bleeding b. Excessive vomiting c. FHT at 80BPM d. Hypertension Preeclampsia is first suspected in a pregnant woman when there is: Fluctuation of the BP Presence of proteinuria A progressive weight gain Daytime dependent ankle edema Which of the following should prompt the nurse to refer to the obstetrician prior to magnesium sulfate administration? a. BP = 180 / 100 b. Urine output is 40 ml/hr c. RR = 12 heaths for minute d. (+) Deep tendon reflex The nurse instructs a preeclamptic client to report prodromal symptom of seizures so that timely intervention can be instituted such as: a. Urine output of 15 ml/hr b. (-) Deep tendon reflex c. Sudden increase in BP d. Epigastric pain An eclamptic client asked the midwife when the likelihood of her having a convulsion end. The midwife replies that the danger of a convulsion in a woman with eclampsia ends: a. After labor begins b. After delivery occurs c. 24 hours post partum d. 48 hours postpartum The first assessable objective sign of convulsion in a client with preeclampsia is frequently: a. Rolling of the eyes to one side with fixed stare b. Spots or flashes of light before the eyes c. Persistent headache and blurred vision d. Epigastric pain, nausea and vomiting An obstetrical client has just been diagnosed with cardiac disease. The nurse should give priority to:

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Early in the ninth month of pregnancy, a client experiences painless vaginal bleeding and is admitted to the hospital. The nursing care plan for this client should include: a. Administering vitamin K to promote clotting b. Performing a rectal examination to determine cervical dilation c. Administering an enema to prevent contamination during birth d. Placing her in a semi-Fowlers position to increase cervical pressure
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a. b. c. d.
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a. b. c. d.
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If a vaginal examination is to be performed on a client with a marginal placenta previa who is in early labor, the nurse must be prepared for an immediate: Amniotomy Nonstress test Cesarean birth Induction of labor

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Which of the following should the nurse most likely expect to find when assessing a pregnant client with abruptio placenta? a. Excessive vaginal bleeding b. Rigid, boardlike abdomen c. Tetanic uterine contractions d. Premature rupture of membranes The nurse should assess a 26-year-old multigravida at 30 weeks' gestation with premature rupture of the membranes (PROM) for symptoms of which of the following? a. Foul-smelling amniotic fluid b. Uterine prolapse c. Small-for-gestational-age fetus d. Tetanic uterine contractions Which of the following will bring small for dates uterus? a. Polyhydramnios b. Twin pregnancy c. Intrauterine fetal death

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a. Instructing the client to remain strict bed rest b. Telling the client to monitor her pulse and respirations c. Instructing the client to check her temperature in the evening. d. Telling the client to weigh herself monthly Carmen is a 28 year old gravidocardiac patient pregnant for the first time. She had rheumatic fever when she was 10 years old. She regularly visits to the clinic for her prenatal check-up.
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The result of Marias Pap test is class I. This means that: a. Presence of malignant cells b. Presence of infections c. Normal findings d. Presence of atypical but not malignant cells The nurse has implemented education about HIV in pregnancy. Which statement illustrates that the pregnant HIV-positive client understood the nurses teaching about HIV and pregnancy? a. My baby will not have aids. b. I will need to take a drug throughout my pregnancy. c. They will start giving me a drug for HIV when I come in to delivery. d. I will need to continue taking the HIV drug the entire time I breast-feed. A young woman describes experiencing a heavy vaginal discharge and severe itching for the past 3 days. She is diagnosed as having Trichomonas vaginalis infection. Health teaching for this woman should include dosage, administration, and signs of symptoms of side effects of which medication as treatment for this condition? Tetracycline Erythromycin Nystatin Metronidazole

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Carmen does not complain of any signs and symptoms under ordinary conditions. In fact, she continues to work as a bank teller and plans to file her sick leave 2 weeks before EDC. You classify Carmen as: a. Class I b. Class II c. Class III d. Class IV
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Carmen is concerned about the delivery of her baby and asks what to expect. The nurse should mention that a term her care will probably include: a. An elective cesarean birth b. Instruction of labor c. General anesthesia and forceps-assisted delivery d. Regional anesthesia and forceps-assisted delivery
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You counseled one of your clients who developed herpes genitalis concerning follow-up care. Women who have this disease are at risk of developing: a. Heart disease and CNS damage b. Cervical cancer c. Infant pneumonia and eye infection d. Sterility in both sexes The nurse should explain to Joanne, 15 years old, that untreated gonorrhea in the female frequently leads to a. Obstruction of the fallopian tube b. Ovarian cysts c. Ulceration of the cervix d. Endometrial polyps A 16-year-old female high school student has syphilis. Treatment is initiated. Before the client leaves the clinic, which of the following actions is essential for the nurse to take? a. Advise the client to avoid sexual activity for 2 months b. Ask the client to identify her sexual contacts c. Arrange for the client to have hearing and vision screening tests d. Have the client return to the clinic weekly for blood test Judy complains of a fishy smelling cheesy white vaginal discharge with pruritus. You suspect that Judy may be infected with: a. Moniliasis b. Trichomonas c. Syphillis d. Gonorrhea

a. b. c. d.
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The nurse teaches a woman with diabetes that the oral hypoglycemic pills used prior to pregnancy cannot be used during pregnancy because: a. They may produce abnormalities in the fetus b. The effect of exogenous insulin on the fetus is uncertain c. Diet alone can usually control diabetes in the latter part of pregnancy d. The fetal pancreas compensates for the mothers inability to secrete adequate insulin
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A diabetic mothers metabolism is significantly altered during pregnancy as a result of: a. Increased glucose tolerance level of the blood b. Increased effect of insulin c. Decreased renal threshold for glucose d. Hormonal effect of pregnancy on carbohydrate and fat metabolism Mrs. Ocampo delivers a baby girl weighing 4,545 grams. She asks how many pounds does her baby weigh. The baby weighs________ pounds. a. 12 b. 9 c. 10 d. 11 For which complication of pregnancy is a woman who is Rh-negative at risk? a. Spontaneous abortion b. Preeclampsia

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c. Maternal anemia d. Erythroblastosis fetalis

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d. Fetal presenting part On IE, the fetus is at +1 station, this is interpreted as: a. I cm below ischial spine b. 1 cm above ischial spine c. 1 fingerbreadth above ischial spine d. 1 fingerbreadth below ischial spine On auscultation of FHT, the nurse noted FHT to be 114 beats per minute. Which of the following actions should be done FIRST? a. Monitor FHT every 15 minutes b. Administer oxygen inhalation c. Ask the charge nurse to notify the obstetrician d. Place her on left lateral position The nurse checks the perineum of the client. Which of the following characteristics of the amniotic fluid would cause alarm to the nurse? a. Greenish b. Scantly c. Colorless d. Straw colored I.E. of 4 cm indicates: a. The cervical canal is 4 cm in diameter b. The cervix is 4 cm thick c. The cervical external os is 4 cm wide d. The cervical internal os is 4 cm in diameter The client asked to be transferred to the delivery room because she feels that her baby is coming out anytime soon. You understand that in the case of a multigravid patient, transfer to the delivery room is done as soon as the: a. Patient feels the urge to push. b. Cervical dilatation is at least 7-8 cm. c. Cervix is fully dilated. d. Labor has started with regular uterine contractions. The cardinal movements of labor occur in this order: a. Descent, flexion, extension, internal rotation, external rotation, expulsion b. Descent, flexion, internal rotation, extension, external rotation, expulsion c. Engagement, descent, internal rotation, flexion, external rotation, extension, expulsion d. Descent, internal rotation, flexion, extension, external rotation, expulsion The nurse places the client in this most common position used for normal vaginal delivery when surgical operation in the perineum is not anticipated: a. Dorsal recumbent position b. Left sidelying c. Lithotomy position d. Squatting position The DR nurse notes that the vulvar ring encircles the largest diameter of the fetal head, this is known as: a. Crowning b. Caput succedaneum c. Ballottement

The nurse is explaining how RhoGAM works to a Lamaze class of couples who are expecting. The best explanation would be: a. RhoGAM prevents the immune system of the mother who is Rhnegative from attacking the red blood cells of the baby who is Rh-positive. b. RhoGAM prevents the immune system of the mother who is Rhnegative from attacking the red blood cells of a baby who is Rh-negative. c. RhoGAM prevents the immune system of a baby who is Rhpositive from attacking the red blood cells of a mother who is Rh-negative. d. RhoGAM prevents the immune system of a baby who is Rhnegative from attacking the red blood cells of a mother who is Rh-negative. A pregnant client with a history of alcohol addiction is scheduled for a nonstress test. The nonostress test: a. Determines the lung maturity of the fetus b. Measures the activity of the fetus c. Shows the effect of contractions on the fetal heart rate d. Measures the neurological well-being of the fetus A first-time mother-to-be is in the labor room, her husband at her bedside. The client states that her contractions began 6 hours ago. Which of the following assessment findings would confirm that the client is in true labor? a. Discomfort located chiefly in the abdomen b. Constant intensity of contractions c. Contractions occurring every 10 to 15 minutes and lasting 20 to 30 seconds d. Cervix that's 100% effaced and 2 cm dilated When is the first stage of labor considered to be achieved? a. Presenting part is t station + 1 b. Cervix is 10 cm dilated c. Uterine contractions occur every 2-3 min. interval d. Cervix is fully effaced Which pure pelvic shape has the poorest prognosis for vaginal delivery? a. Platypelloid b. Anthropoid c. Android d. Gynecoid In what presentation is the head in extreme flexion? a. Sinciput b. Brow c. Vertex d. Face

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The middle letter when describing position denotes: a. Side of maternal pelvis b. Portion of maternal pelvis c. Location of sagittal suture

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d. Quickening
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Supporting the perineum when the head is already visible at the introitus facilitates: a. Flexion of fetal head b. External rotation c. Extension of fetal head d. Expulsion After the nurse instructs a pregnant client about swimming and bathing during pregnancy, which of the following client statements indicates the need for additional teaching? a. "I can continue to swim as long as my membranes aren't ruptured." b. "I can relax in a hot tub for about 20 minutes." c. "I can take a bath daily but should be careful not to fall." d. "I should avoid sitting in a sauna for prolonged periods." In 4th degree perineal laceration the tearing of tissue reach up to: a. Anal sphincter b. Rectal mucosa c. Fascia and muscles of perineal body d. Vaginal mucous and perineal skin The nurse observed Mel bear down at every uterine contraction. The nurse told her not to do so and taught her how to perform breathing exercises. She asked when she will start to push. The nurse replied that it is alright to push when: a. Presenting part is t station + 1 b. Cervix is 10 cm dilated c. Uterine contractions occur every 2-3 min. interval d. Cervix is fully effaced It important to encourage a woman in labor to void: a. Every 5 hours b. Every 2 to 3 hours c. Every hour d. Every 30 minutes Upon IE, the nurse note that the cervix is 1/4 its original length. This means that effacement is: a. 25% b. 75% c. 100% d. 50% The most reliable indicator of rupture of membrane is: a. Positive nitrazine paper test b. Fluid per cervical os c. Positive ferning pattern d. Verbalization of the mother that her fluid has already ruptured
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The client has elected to have epidural anesthesia to relieve labor pain. If the client experiences hypotension, the nurse would: a. Place her in Tredelenburg position b. Decrease the rate of IV infusion c. Administer oxygen per nasal cannula d. Increase the rate of the IV infusion The client is having fetal heart rates of 90-110 bpm during the contractions. The first action the nurse should take is: a. Reposition the monitor b. Turn the client to her left side c. Ask the client to ambulate d. Prepare the client for delivery The nurse is making room assignments for four obstetrical clients. If only one private room is available, it should be assigned to: a. A multigravida with diabetes mellitus b. A multigravida with preeclampsia c. A multigravida with preterm labor d. A multigravida with hyperremesis gravidum A client in labor has epidural anesthesia with Marcaine (bupivacaine). To reverse hypotension associated with epidural anesthesia, the nurse should have available: a. Narcan (naloxone) b. Dobutrex (dobutamine) c. Romazicon (flumazenil) d. Adrenalin (epinephrine) A client with hypotonic labor dysfunction is receiving oxytocin augmentation. Her contractions become more frequent and intense. Dilation progresses to 8 cm, but the fetal head remains at station +1. The nurse notes a soft bulge just above the symphysis. Which of the following actions is best? a. Re-evaluate the fetal presentation. b. Change the client's position. c. Offer a narcotic analgesic. d. Help the client urinate. After a delivery of twins, a client may be predisposed to experiencing a postpartum hemorrhage. Which is the most likely cause of hemorrhage in this client? Atony of the uterus Secondary infection Laceration of the cervix Retained placental fragments Which of the following amount of blood loss following birth marks the criterion for describing postpartum hemorrhage? a. More than 200 ml b. More than 400 ml c. More than 300 ml d. More than 500 ml On the second day postpartum. The nurse expects the client to describe her vaginal bleeding as: a. Moderate and similar to menstrual flow b. Red with clots that increases in amount sometimes c. Scant and brown d. Thin and white

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Which of the following should the nurse plan to do to facilitate placental expulsion? a. Instruct the mother to vigorously bear down b. Have the mother breastfeed the baby c. Gentle continuous tension on the cord d. Push down slowly on the fundus

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a. It is unusual for the client to experience afterpains if she is: a. Primipara b. Breastfeeding c. Have retained placental fragments d. Have blood clots in the uterus The client is scheduled to receive rubella immunization after discharge. The nurse would include which of the following instructions in the teaching plan? a. Teaching the client to avoid exposure to possible sources of infections b. Instructing the client that contraception is necessary during the first three months after immunization c. Telling client not to breastfeed her baby for at least two weeks after immunization d. Informing the client of the need to avoid coitus for a month after the injection The physician ordered an injection of RhoGam for the postpartum client whose blood type is A negative but whose baby is O positive. To provide postpartum prophylaxis, RhoGam should be administered: a. Within 72 hours of delivery b. Within 1 week of delivery c. Within 2 weeks of delivery d. Within 1 month of delivery Which nursing assessment indicates that involutional changes have occurred in a client who is 3 days postpartum? a. The fundus is firm and 3 finger widths below the umbilicus b. The client has a moderate amount of lochia serosa. c. The fundus is firm and even with the umbilicus d. The uterus is approximately the size of a small grapefruit nurse is caring for a client after evacuation of a hydatidiform molar pregnancy. The nurse should instruct the client to: a. Wait 1 month before trying to become pregnant again. b. Make an appointment for follow-up human chorionic gonadotropin (hCG) level monitoring at the end of 1 year. c. Discuss options for sterilization with the physician. d. Use birth control for at least 1 year. nurse is developing a care plan for a client in her 34th week of gestation who is experiencing premature labor. What nonpharmacologic intervention should the plan include to halt premature labor? a. Encouraging ambulation b. Serving a nutritious diet c. Promoting adequate hydration d. Performing nipple stimulation nurse is providing care for a pregnant client with gestational diabetes. The client asks the nurse if her gestational diabetes will affect her delivery. The nurse should know that: b. c. d.
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The delivery may need to be induced early. The delivery must be by cesarean. The mother will carry to term safely. Its too early to tell.

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pregnant client is making her first antepartum visit. She has a 2-year-old son born at 40 weeks, a 5-year-old daughter born at 38 weeks, and 7-year-old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. Using the GTPAL format, the nurse should identify that the client is: a. G4 T3 P2 A1 L4 b. G5 T2 P2 A1 L4 c. G5 T2 P1 A1 L4 d. G4 T3 P1 A1 L4

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