MIDWIFERY AND OBSTETRICAL NURSING MCQS (50)

1. Which of the following client statements indicates that the nurse's

teaching about oral contraceptive agents has been successful?

A. "Despite their effectiveness, about 25% of women stop taking them

after 1 year."
B. "These agents usually only cause a few minor side effects when you take them."
C. "Oral contraceptives inhibit ovulation and change the consistency of cervical
mucus."
D. "I can make these drugs more effective by monitoring my basal body
temperature."

2. A client's gestational diabetes is poorly controlled throughout her

pregnancy. She goes into labor at 38 weeks and delivers a boy. Which
priority intervention should be included in the care plan for the neonate
during his first 24 hours?

A. Administer insulin subcutaneously.

B. Administer a bolus of glucose I.V.
C. Provide frequent early feedings with formula.
D. Avoid oral feedings.

3. Which finding is considered normal in a neonate during the first few days
after birth?

A. Weight loss of 25%

B. Birth weight of 2,000 to 2,500 g
C. Weight loss then return to birth weight
D. Weight gain of 25%

4. 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 side effects, which of the following would the nurse
include in the teaching plan?

A. Multiple pregnancies.
B. Increase in spontaneous abortions.
C. Increase in fibrocystic breast disease.
D. Increase in congenital anomalies.

5. 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
6. After the nurse instructs a client who is scheduled for in vitro fertilization
(IVF) about the procedure, which of the following statements by the client
indicates to the nurse that the instructions have been successful?

A. "I know that the chances of getting pregnant with this procedure are about
50%."
B. "I'll need to receive a series of estrogen injections after I have the procedure."
C. "After fertilization, three or four embryos will be transferred through
the cervix."
D. "My risk for a multiple births is less with this procedure than with the GIFT
procedure."

7. On the 9th postpartum day, a client breast-feeding her neonate

experiences pain, redness, and swelling of her left breast. She's diagnosed
with mastitis. The nurse teaching the client how to care for her infected
breast should include which information?

A. Wear a loose-fitting bra to avoid constricting the milk ducts.

B. Stop breast-feeding permanently.
C. Take antibiotics until the pain is relieved.
D. Use a warm moist compress over the painful area.

8. 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.

9. 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

10. 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."

11. The nurse is helping to prepare a client for discharge following childbirth.
During a teaching session, the nurse instructs the client to do Kegel
exercises. What's the purpose of these exercises?

A. To prevent urine retention

B. To relieve lower back pain
C. To tone the abdominal muscles
D. To strengthen the perineal muscles

12. The client, 11 weeks pregnant, tells the nurse that she has been vomiting
after breakfast nearly every morning. Which of the following measures
should the nurse suggest to help the client cope with early morning nausea
and vomiting?

A. Limiting fluid intake between meals.

B. Increasing her intake of high-fat foods.
C. Eating dry, unsalted crackers before arising.
D. Drinking a carbonated beverage before bedtime.

13. 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. 11 weeks
C. 17 weeks
D. 21 weeks

14. A 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.
15. The nurse is planning care for a 16-year-old client in the prenatal clinic.
Adolescents are prone to which complication during pregnancy?

A. Iron deficiency anemia

B. Varicosities
C. Nausea and vomiting
D. Gestational diabetes

16. When explaining to a pregnant client about the need to take

supplemental vitamins with iron during her pregnancy, the nurse would
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.

17. The nurse is caring for a 16-year-old pregnant client. The client is taking
an iron supplement. What should this client drink to increase the absorption
of iron?

A. A glass of milk
B. A cup of hot tea
C. A liquid antacid
D. A glass of orange juice

18. A client asks the nurse why vitamin C intake is so important during
pregnancy. Which of the following would be the nurse's best response?

A. "Vitamin C is required to promote blood clot and collagen formation."

B. "Supplemental vitamin C in large doses can prevent neural tube defects."
C. "Eating moderate amounts of foods high in vitamin C helps metabolize fats and
carbohydrates."
D. "Studies have shown that vitamin C helps the growth of fetal bones."

19. The nurse is caring for a client who is on ritodrine therapy to halt
premature labor. What condition indicates an adverse reaction to ritodrine
therapy?

A. Hypoglycemia
B. Crackles
C. Bradycardia
D. Hyperkalemia

20. A pregnant client tells the nurse that she has been having discomfort
from her hemorrhoids. After giving instruction about strategies to decrease
the discomfort, which of the following client statements would alert the
nurse to the need for additional instruction?

A. "I'll avoid straining to have a bowel movement."

B. "I'll be sure to change positions frequently during the day."
C. "I'll stop using my prescribed iron supplements."
D. "I'll use warm sitz baths frequently during the day."

21. The nurse is caring for a client in her 34th week of pregnancy who wears
an external monitor. Which statement by the client would indicate an
understanding of the nurse's teaching?

A. "I'll need to lie perfectly still."

B. "You won't need to come in and check on me while I'm wearing this monitor."
C. ”I can lie in any comfortable position, but I should stay off my back."
D. "I know that the external monitor increases my risk of a uterine infection."

22. 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 after swimming."
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."

23. The 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

24. When the nurse instructs a pregnant client with a history of varicose
veins about strategies to promote comfort, which of the 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."

25. A client treated for premature labor is ready for discharge. Which
instruction should the nurse include in the discharge teaching plan?

A. Report a heart rate greater than 120 beats/minute to the physician.

B. Take terbutaline every 4 hours, during waking hours only.
 C. Call the physician if the fetus moves 10 times in 1 hour.
D. Increase activity daily if not fatigued.

26. 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. Complete.

27. The nurse is caring for a client in labor. Which assessment finding
indicates fetal distress?

A. Lack of meconium staining

B. Early decelerations in fetal heart rate during contractions
C. An increase in fetal heart rate with fetal scalp stimulation
D. Fetal blood pH less than 7.20

28. 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.

29. The nurse is assessing a woman in labor. Her cervix is dilated 8 cm. Her
contractions are occurring every 2 minutes. She's irritable and in
considerable pain. What type of breathing should the nurse instruct the
woman to use during the peak of a contraction?

A. Deep breathing
B. Shallow chest breathing
C. Deep, cleansing breaths
D. Chest panting

30. 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 the 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.

31. The nurse is caring for a woman receiving a lumbar epidural anesthetic
block to control labor pain. What should the nurse do to prevent
hypotension?

A. Administer ephedrine to raise her blood pressure.

B. Administer oxygen using a mask.
C. Place the woman flat on her back with her legs raised.
D. Ensure adequate hydration before the anesthetic is administered.

32. Which of the following drugs would the nurse expect to administer to the
client receiving intravenous magnesium sulfate for pregnancy-induced
hypertension if the client develops magnesium toxicity?

A. Calcium gluconate.
B. Diazepam (Valium).
C. Phenytoin (Dilantin).
D. Furosemide (Lasix).

33. A woman in labor shouts to the nurse, "My baby is coming right now! I
feel like I have to push!" An immediate nursing assessment reveals that the
head of the fetus is crowning. After asking another staff member to notify
the physician and setting up for delivery, which nursing intervention is most
appropriate?

A. Gently pulling at the neonate 's head as it's delivered

B. Holding the neonate 's head back until the physician arrives
C. Applying gentle pressure to the neonate 's head as it's delivered
D. Placing the mother in a Trendelenburg position until the physician arrives

34. Which of the following would the nurse expect to administer as the drug
of choice to a pregnant client with chronic hypertension?

A. Phenobarbital.
B. Diazepam (Valium).
C. Methyldopa (Aldomet).
D. Magnesium sulfate.

35. The nurse is caring for a client who is in labor. The physician still isn't
present. After the neonate's head is delivered, which nursing intervention
would be most appropriate?

A. Checking for the umbilical cord around the neonate 's neck
B. Placing antibiotic ointment in the neonate 's eyes
C. Turning the neonate's head to the side, to drain secretions
D. Assessing the neonate for respirations
36. Which of the following would 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.

37. 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.

38. 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.
E.
39. The nurse is assessing a client on the second postpartum day. Under
normal circumstances, the tone and location of the client's fundus is:

A. soft and one fingerbreadth below the umbilicus.

B. firm and two fingerbreadths below the umbilicus.
C. firm and to the right or left of midline.
D. soft and at the level of the umbilicus.

40. Which of the following would 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.

41. A 23-year-old primigravida delivers a healthy 3090.1-g boy by vaginal

delivery. During an assessment the next day, the nurse is examining her
lower extremities for signs and symptoms of thrombophlebitis. Which of the
following signs should be assessed?
 A. Chadwick's sign
B. Hegar's sign
C. Homans' sign
D. Goodell's sign

42. The 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.

43. A client with hyperemesis gravidarum is on a clear liquid diet. The nurse
should serve this client:

A. milk and ice pops.

B. decaffeinated coffee and scrambled eggs.
C. tea and gelatin dessert.
D. apple juice and oatmeal.

44. What's the best way to teach new parents about the care of their
neonate?

A. Relate stories of other parents' experiences.

B. Focus on the behavior of their own neonate.
C. Show videotapes about neonate care.
D. Distribute literature with photographs of neonate-care skills.

45. When monitoring the laboratory studies of a pregnant client receiving

terbutaline (Brethine) therapy, which of the following would lead the nurse
to suspect that the client's blood plasma volume has increased?

A. Decreased hematocrit level.

B. Glycosuria.
C. Hyperkalemia.
D. Increased serum calcium levels.

46. The nurse is caring for a client on her second postpartum day. The nurse
should expect the client's lochia to be:

A. red and moderate.

B. continuous with red clots.
C. brown and scant.
D. thin and white.
47. The nurse is caring for a client in labor. The external fetal monitor shows
a pattern of variable decelerations in fetal heart rate. What should the nurse
do first?

A. Change the client's position.

B. Prepare for emergency cesarean delivery.
C. Check for placenta previa.
D. Administer oxygen.

48. The nurse is teaching a client how to perform perineal care to reduce the
risk of puerperal infection. Which activity indicates that the client
understands proper perineal care?

A. Using a peri bottle to clean the perineum after each voiding or bowel
movement
B. Cleaning the perineum from back to front after a bowel movement
C. Spraying water from peri bottle into the vagina
D. Changing perineal pads every 8 hours

49. 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.

50. A client with type 1 diabetes mellitus is pregnant for the second time. Her
previous pregnancy ended in spontaneous abortion at 18 weeks' gestation.
She's now at 22 weeks' gestation. The nurse is responsible for teaching the
client about exercise during her pregnancy. Which of the following
statements indicates that the client has an appropriate understanding of her
exercise needs?

A. "I know I need to walk with a friend or family member."

B. "I know I need to vary the times of day when I exercise."
C. "I know I need to exercise before meals."
D. "I know I need to drink fluids while I walk."