Ob 1. A nurse midwife is conducting a session on the process of fertilization with a group of nursing students.

The nurse instructs the students that fertilization of an ovum takes place at which of the following structures? a. b. c. d. Fundus of the uterus Body of the uterus Isthmus of the uterus Fallopian tube

2. When during the menstrual cycle do most women ovulate ? a. during the menstrual period b. shortly before the menstrual period c. shortly following the menstrual period d. approximately two weeks before the beginning of the menstrual period 3. When the ovum is expelled from the graafian follicle, it is next received by the: a. ovary b. vagina c. uterus d. fallopian tube 4. The anatomical structure in which fertilization of the ovum normally occurs is the a. uterus b. corpus luteum c. fallopian tube d. graafian follicle 5. The uterus receives its blood supply directly from the uterine artery and the: a. iliac artery b. ovarian artery c. hypogastria artery d. uterosacral artery 6. Which of the following hormones stimulates ovulation and the development of the corpus luteum ? a. Estrogenic hormone b. Luteinizing hormone c, Adrenocorticotropic hormone d. Follicle-stimulating hormone

7. For approximately how many hours after ovulation does the ovum normally viable ? a. 1 to 2 hours b. 3 to 6 hours

c. 10 to 12 hours d. 22 to 26 hours 8. For approximately how long a period of time is the sperm capable of fertilizing the ovum ? a. 12 to 24 hours b. 24 to 48 hours c. 2 to 3 days d. 3 to 7 days 9. In approximately how many days after conception does the fertilized ovum normally implant itself in the uterine wall ? a. 3 days b. 7 days c. 11 days d. 15 days 10. The placenta is formed by the fusion of the chorionic villi and the : a. deciduas vera b. chorion levae c. deciduas basalis d. chorion frondosum 11. Which of the following statements does not describe the function of the placenta ? a. The placenta acts to bring maternal blood directly to the fetal circulatory system. b. The placenta acta as an organ to provide nourishment between the mother and the fetus c. The placenta acts as a gland producing hormones which affect both the mother and the fetus. d. The placenta acts as a barrier to certain substances from entering the fetal circulation . 12. A nurse is assisting in preparing a pregnant client for Leopold maneuver. Which of the following would be included in the pre-procedure plan of care? a. b. c. d. Locate the fetal heart sound Ask the client to drink 8 ounces of water before the examination Warm the sonogram gel Ask the client to empty her bladder before the examination

13. During the initial prenatal visit, a nurse spends time with a client with known cardiac disease explaining the importance of an adequate diet and iron and folic acid supplementation during pregnancy. The nurse instructs the client that these dietary supplements are important to prevent:

a. b. c. d.

Intrauterine growth restriction Maternal urinary tract infection Maternal thromboembolitic disease Hyperemesis gravidarum

14. A clinic nurse is interviewing an antenatal client. Which assessment question would the nurse ask the client to identify the risk for toxoplasmosis parasite infection during pregnancy? a. How many sexual partners have you had since u became sexually active? b. Have you experienced any fever or unusual rashes during the first 6 weeks of your pregnancy? c. Have you been exposed to children with rashes or GI symptoms? d. Do you have any cats at home and do you handle any cat litter? 15. A clinic nurse is discussing the importance of the antenatal period with a human immunodeficiency virus (HIV) infected pregnant client and informs the client that the clients weight gain pattern will be plotted on a regular basis. The client asks the nurse why this is so important. The nurse appropriately responds by telling the client that it is important to: a. Document trends in weight gain b. Observe for early signs of pregnancy induced hypertension c. Identify adequate weight gain throughout pregnancy to ensure appropriate fetal development d. Compare weight gain patterns among HIV-positive clients 16. A nurse is monitoring a pregnant woman for the presence of pitting edema. Which method would the nurse implement to check the level of the edema? a. The nurse presses the fingertips of the index finger and middle finger against shin and holds pressure for 2-3 seconds b. The nurse uses the fingertips of the index finger and middle finger against toes and holds pressure for 2-3 seconds c. The nurse uses the fingertips of the index finger and middle finger against abdomen and holds pressure for 2-3 seconds d. The nurse uses the fingertips of the index finger and middle finger against upper arm and holds pressure for 3-4 seconds the the the the

17. A clinic nurse teaches a pregnant client with herpes genitalis about the measures that will be implemented during the pregnancy. Which statement by the client indicates an understanding of these measures? a. I must continue to take my acyclovir (Zorivax) b. I need to abstain from sexual intercourse during the entire pregnancy

c. I need to take sitz bath 4 times a day d. I may need a caesarian section if the lesions are present at the time of labor 18. A client arrives at the prenatal clinic for the first time prenatal assessment. The client tells the nurse that the first day of the last menstrual period was August 19, 2006. using the Naegeles rule, the nurse determines the estimated date of delivery as: a. b. c. d. May 26, 2007 June 12, 2007 June 26, 2007 May 12, 2006

19. A pregnant client is seen in the clinic and reports that she has been experiencing pain due to hemorrhoids. The nurse provides information to the client regarding the hemorrhoids. Which statement by the client indicates the need for further information? a. Hemorrhoids are caused by my changes in hormones and will disappear after my baby is born. b. Its important to lie down periodically during the day to relieve the pressure. c. The hemorrhoids can be gently pushed back inside the body using a lubricant. e. Its important to drink plenty of liquids and include bulk in my diet. 20. A nurse provides instructions to a pregnant woman regarding measures to relieve low back pain. Which statement by the client indicates an understanding of these measures? a. I will wear an abdominal support b. I will do the pelvic tilt exercises c. I need to work at relaxing my abdominal muscles when I stand d. I need to wear shoes with a higher heel of at least 2 inches 21. A clinic nurse is collecting data on a client who has just been told that she is pregnant. Laboratory results indicate that the client is RH negative and Coombs antibody negative. The nurse instructs the client regarding the necessary measures related to the results of the laboratory report. Which statement by the client indicates an adequate understanding of the instructions? a. b. c. d. I need to receive a shot of RhoGam today but it will protect me for life I will need an injection of Rhogam once per month until the baby is born I will need a shot of RhoGam when I am 28 weeks pregnant a am glad I wont have to have these RhoGam shots if I have another child

22. A nurse has provided instructions to a pregnant woman about food items to consume that contain folic acid. Which statement by the client indicates adequate understanding of the food items that contain folic acid? a. I will eat banana everyday b. peanuts, sunflower seeds and raising are sufficient c. A glass of milk a day is high in folic acid

d. I will eat yogurt everyday 23. A maternity nurse is teaching a pregnant woman about the physiological effects and hormone changes that occurs in pregnancy, and a woman asks the nurse about the purpose of estrogen. The nurse bases the response on which of the ff? a. It maintains the uterine lining for implantation b. It stimulates metabolism of glucose and converts the glucose to fat c. It prevents the involution of the corpus luteum and maintains the production of progesterone until the placenta is formed d. It stimulates uterine development to provide an environment for the fetus and stimulates the breasts to prepare for lactation 24. A nurse is preparing a woman in labor for an amniotomy. The nurse would assess which priority data before the procedure? a. Maternal BP b. Maternal HR c. FHR d. Fetal scalp sampling 25. A nurse in the prenatal clinic is taking a nutritional history from a 16-year-old adolescent. Which statement by the client indicates a possible problem? a. I only need to gain 7-10 lbs because I want a small, petite baby girl b. I will continue eating my afternoon snack of popcorn and coke c. I can tolerate some dairy products d. I dont know if I can tolerate all this extra food 26. A perinatal client with a history of heart disease has been instructed on care at home. Which statement by the client would indicate that the client understands her need? a. There is no restriction on people who visit me. b. I should avoid stressful situations c. My weight gain is not important d. I should rest on my right side

27. The nurse is teaching a series of classes on maintaining a healthy pregnancy and the goal for the class is: the pregnant woman will verbalize measures to prevent traumatic conditions that will cause distress to the fetus and cause placental separation. Which measure is specific to this goal? a. Travel precautions and the use of seat belts b. Use of over-the-counter medications c. Fetotoxic substances in the work place d. Effects of primary and secondary cigarette smoke on the fetus

28. A pregnant client of 28 weeks gestation is scheduled for a routine 1-hour oral glucose tolerance test. The nurse tells the client to do which of the ff for 3 days before the test? a. Eat a daily diet with at least 150 grams of carbohydrate b. Eat a daily diet with at least 60 grams of fat c. Refrain from physical activity d. Push fluids of 3000 ml 29. Which of the following should the nurse do first when dealing with a couple having sexual problems after 20 years of marriage? a. Provide the couple with the information about common sexual problems b. Arrange physical examination for both partners c. Refer the couple to a support group for sexual dysfunction d. Allow the couple to talk about their sexual problems 30. The layer of the nonpregnant uterus that sloughs off during menstruation is the: a. Myometrium b. Deciduas c. Endometrium d. Parametrium 31. The bluish discoloration of the vaginal mucosa, which is a presumptive sign of pregnancy is called : a. Babcocks sign b. Goodells sign c. Chadwicks sign d. Hegars sign 32. An early sign of pregnancy is present when upon manual manipulation , the examiner feels the walls of the uterine segment to be: a. nodular b. softened c. elongated d. thickened

33. The purplish streaks that sometimes appear on the breasts and abdomen during pregnancy are called: a. alveoli b. chloasma c. linea nigra d. striae gravidarum 34. The nursess discussion of the discoloration and the enlargement of the areola during pregnancy should be based on knowledge that these changes are:

a. without significance in relation to physical health b. more pronounce when the fetus is a male c. more common in blondes than brunettes d. related to an allergic response of the body Situation: you are attending to Mary, G1P0 who is on late pregnancy, labor and delivery 35. The nurse explains that late in pregnancy, showers rather than tub bath is recommended. Which of one of the following statements provides the best rationale for this recommendation? a. Bath water is likely to introduce bacteria from the body into the vagina b. A change into the center of gravity of the mother predisposes her to accidental when using a tub. c. Sitting in warm water increases the frequency of Braxton Hicks contraction d. The shower spray provides necessary stimulation f the skin for optimal elimination of wastes 36. Lightening , which the nurse explains as a typical sign of approaching labor is best defined as : a. intermittent painless contractions b. settling of the fetal head into the pelvis c. loss of weight which occurs just prior to the onset of labor d. shortening the cervix that occurs prior to the onset of the true labor 37. It is theorized that an increase in all of the following secretions of the body plays a role in initiating the onset of labor except for secretions of : a. relaxin b. oxytoxin c. progesterone d. fetal corticosteroids 38. The major distinction between true labor and false labor is that when true labor is present, the patient will demonstrate a. an increase in vaginal discharge b. discomfort with uterine contravtions c. regular and rhythmic uterine contractions d. progressive dilatation of the cervix with effacement

39. The nurse explains that effacement means a normal change during labor which is described as : a. a decrease in the length of the cervical canal b. an increase in the opening of the cerfvical canal c. relaxation of perineal musculature d. contraction of abdominal musculature 40. The unit of measure commonly used to describe effacement is : a. decimal b. percentage

c. centimeter d. fingerbreadth 41. The nurse teaches that systematic abdominal palpation commonly called Leopolds maneuvers, is used primarily to ; a. determine fetal position b. turn the fetus in the uterus c. ease the fetus in the pelvis d. estimate the position of the placenta 42. The patient will be more comfortable and results more accurate when the patient is prepared for Leopolds maneuvers by having her : a. empty the bladder b. lie on her left side c. hyperventilate for a short time d. avoid eating immediately before the examination 43. Which of the following techniques should the nurse use to help prevent contractions of the patients abdominal muscles when the nurse begins utilizing Leopolds maneuvers? a. Have the patient extend her legs flat on the bed. b. Palpate with the hands flat on the patients abdomen c. Use her fingers to palpate an outline of the fetal body d. have the patient take quick breaths when beginning the procedure 44. The nurse explains the flexion of the the fetal head during labor is important because the more the head is flexed, the: a. straighter is the plane of delivery b. greater is the long axis of the fetus c. smaller is the diameter of the skull entering the pelvis d. more directly the fontanel is aligned with the cervical opening 45. The nurse discusses presentation which is best defined as : a. part of the cervix that first become dilated during pregnancy b. relationship of the head of the fetus to the maternal pelvis. c. Part of the fetal body that can be felt at the opening of the cervix d. relationship of the long axis of the mother and the long axis of the fetus 46. The nurse teaches that the fetus normally goes through a sequence of maneuvers during labor. When the head will be born first, the normal sequence is : a. descent, ,flexion, ,external rotation,, and extension b. engagement,, external rotation, flexion and expulsion c. internal rotation, descent, engagement restitution, and expulsion d. descent, flexion, internal rotation, extension and external rotation 47. As the head of the fetus approaches delivery, if the phrase station plus one is used, it means the head is 1 a. centimeter above the ischial spine b. centimeter below the ischial spine

c. fingerbreadth above the ischial spine d. fingerbreadth below the ischial spine 48. When the nurse describes approaching birth, she uses the term crowning, which is best described as the : a. accommodation of the fetal head to the pelvic shape b. elongation of the fetal head at the ischial spines c. first appearance of the fetal head at the vaginal opening d. encircling of the largest diameter of the fetal head by the vulvar ring 49. The amniotic fluid and sac serves all of the following functions except that : a. helping to dilate the cervix b. cleansing the birth canal c. protecting the fetus from injury d. providing the fetus with immune bodies . 50. A tap of water enema is ordered. What is the best position when administering enema> a. Lying on her back b. lying on either side c. Sitting on a bedpan or toilet. d. None of the above