D. 9.

"It will hurt, but we have medicine to help you feel better."

MATERNAL AND CHILD NURSING TOPIC EXAM 1 1. The mother of a child with flat feet asks the nurse why her child needs to wear corrective shoes. When responding to the mother, which of the following would the nurse include as the reason for the shoes? A. Keeping the legs in proper alignment. B. Delaying the development of femoral anteversion. C. Preventing the development of internal tibial torsion. D. Strengthening the arches of the feet. Which of the following describes a preterm neonate? A. A neonate weighing less than 2,500 g (5 lb, 8 oz) B. A low-birth-weight neonate C. A neonate born at less than 37 weeks' gestation regardless of weight D. A neonate diagnosed with intrauterine growth retardation A neonate is delivered at 29 weeks gestation and weighs 1619 g (3 lb 9 oz ). Based on the weight and gestational age, this neonate would be classified as: A. Preterm B. Immature C. Nonviable D. Low-birth-weight infant The nurse carefully documents the premature neonate's response to oxygen therapy, delivering only as much oxygen as is necessary to prevent the development of which of the following? A. Cataracts. B. Glaucoma. C. Ophthalmia neonatorum. D. Retinopathy of prematurity. When preparing to obtain a blood sample to screen the neonate for phenylketonuria (PKU), from which of the following areas would the nurse anticipate obtaining the sample? A. Heel. B. Radial artery. C. Scalp vein. D. Brachial artery. To restrain a three-year-old child in preparation for a lumbar puncture, the nurse should A. use soft arm restraints on both hands and legs to stabilize the child. B. apply a jacket restraint to prevent sudden movements. C. place the child in a flexed side-lying position. D. place the child in a supine position on a papoose board. As part of the respiratory assessment, the nurse observes the neonate's nares for patency and mucus. The information obtained from this assessment is important because: A. neonates are obligate nose breathers. B. nasal patency is required for adequate feeding. C. problems with nasal patency may cause flaring. D. a deviated septum will interfere with breathing. A 4-year-old child asks the nurse if it will hurt to have the tonsils and adenoids taken out. Which of the following responses by the nurse would be best? A. "It won't hurt because we put you to sleep." B. "It won't hurt because you're such a big boy." C. "It will hurt because of the incisions made in the throat."

Which of the following statements, if voiced by the parents of a female child receiving cotrimoxazole (Septra/Bactrim) for a urinary tract infection, would indicate the need for additional teaching? A. "We'll make arrangements to have her WBC count checked routinely." B. "We'll continue to give her the medication until the drug is finished." C. "We'll try to make sure that she doesn't go outside in the sun." D. "We'll call the physician immediately if a rash occurs."

2.

10. A parent group is discussing different types of punishment. The parents ask the nurse to discuss corporeal punishment. The nurse tells the group that corporeal punishment: A. Does not physically harm the child. B. Can result in children becoming accustomed to spanking. C. Reinforces the idea that violence is not acceptable. D. Can be beneficial in teaching children what they should do. 11. A mother expresses concern that picking up the infant whenever he cries will spoil him. Which of the following would be the nurse's best response? A. "Allow him to cry for no longer than 45 minutes, then pick him up." B. "Babies need comforting and cuddling; meeting these needs will not spoil him." C. "Babies this young cry when they're hungry; try feeding him when he cries." D. "If it seems as if nothing is wrong, don't pick him up; the crying will stop eventually." 12. The parents of teenagers express concerns about the types and large quantities of food their children eat and their refusal to eat foods served at family meals. Which of the following suggestions would be most helpful for the parents? A. Carefully evaluate the adolescents nutritional intake. B. Inform the adolescents about the adverse effects of fad diets. C. Give the adolescents responsibility for grocery shopping for 1 month. D. Incorporate the adolescents preferences into meal planning. 13. The nurse has an order to administer scopolamine 0.3mg IM. The medication is available in a vial that contains 0.4mg/ml. How many mL should the nurse prepare for administration? A. 0.35 mL. B. 5.5 mL. C. 0.75 mL. D. 1.25 mL. 14. Just before an 8-year-old has a physical examination by the physician, the nurse can best meet the child's developmental needs by: A. Allowing the child to handle the examination equipment B. Explaining exactly what will happen during the examination C. Having the child talk to a child who has recently had an examination D. Arranging to have one of the child's parents present during the examination 15. When developing a plan of care with the mother who expresses concern that her 10-year-old son is overweight, the nurse would expect to include which of the following? A. Eliminating the child's between-meal snacks. B. Eliminating the intake of fat from the diet. C. Including the child in meal planning and preparation. D. Allowing the child a daily intake of 1200 calories. 1

3.

4.

5.

6.

7.

8.

16. When caring for a 3-day-old neonate who is receiving phototherapy to treat jaundice, the nurse would expect to do which of the following? A. Turn the neonate every 6 hours. B. Encourage the mother to discontinue breast-feeding. C. Notify the physician if the skin becomes bronze in color. D. Check the vital signs every 2 to 4 hours. 17. A male neonate with a 3 cm-by-5 cm sac in the lumbar region of his back is diagnosed with myelomeningocele. Which of the following would the nurse expect to find when inspecting this sac? A. Serosanguineous fluid and fatty tissue. B. Bits of hair covered by skin. C. Spinal fluid and meninges. D. Spinal fluid, nerve tissue, and spinal bony defect. 18. What is the best advice for a nurse to give to the parents of a 2-year-old child who frequently throws temper tantrums? A. Move the toddler to a different setting. B. Allow the toddler more choices. C. Ignore the behavior when it happens. D. Give in to the toddler's demands. 19. When evaluating growth and development of a 6-monthold infant, the nurse would expect the infant to be able to: A. Sit alone, display pincer grasp, wave bye-bye B. Crawl, transfer toy from one hand to the other, display fear of strangers C. Pull self to a standing position, release a toy by choice, play peek-a-boo D. Turn completely over, sit momentarily without support, reach to be picked up 20. A 14-year-old girl with Type 1 diabetes is monitoring her blood glucose level at home. Which of the following actions indicates that she understands appropriate care management strategies for a blood glucose level of 250 mg/dL? She will: A. Skip the next dose of insulin and drink fruit juice. B. Take insulin and drink water. C. Eat a high-carbohydrate meal and exercise. D. Inject glucagon and rest. 21. A client with a high-risk pregnancy is to undergo a contraction stress test (CST). The nurse understands that this test would not be done if the client had: A. B. C. D. Blurred vision Vaginal bleeding Sickling of the red cells Increasing hypertension

Instructing her to increase milk and cheese intake to 8 to 10 servings per day 25. 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 would 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. 26. A predisposing factor to postpartal hemorrhage is: A. A short duration of labor B. A previous cesarean delivery C. The presence of a multifetal pregnancy D. A mother who is 40 years of age or more 27. A nonstress test is scheduled for a client with pregnancyinduced hypertension. During the nonstress test the nurse should be aware that if nonperiodic accelerations of the fetal heart rate occur with fetal movement, it most likely indicates: A. Fetal well-being B. Head compression C. Uteroplacental insufficiency D. Umbilical cord compression 28. The nurse is aware that a client could be at increased risk for postpartum hemorrhage if the client: A. Breastfed in the delivery room B. Received a pudendal block for delivery C. Delivered a baby who weighed 9 lb, 8 oz D. Had a third stage of labor that lasted 10 minutes 29. Which assessment would the nurse perform to validate that the membranes are ruptured? A. Observe for a pink, mucus vaginal discharge. B. Test the leaking fluid with nitrazine paper. C. Assess the client's temperature, pulse, and blood pressure. D. Send a urine specimen from the client to be cultured. 30. The nurse recognizes that a client who, although ambivalent, is seriously considering an abortion because of financial difficulties, is in crisis. The nurse should intervene to alleviate the crisis by: A. Understanding the family interaction B. Helping the mother express her feelings C. Involving the father in preparation classes D. Involving the mother in preparation classes 31. A client asks the nurse about the use of an intrauterine device (IUD) for contraception. When discussing this method with the client, the nurse includes that a common problem with IUDs is: A. Expulsion of the device B. Occasional dyspareunia C. Perforation of the uterus D. Frequent vaginal infections 32. The nurse cares for an 18-year-old woman in the labor unit. During the transitional phase of labor the umbilical cord becomes prolapsed. The nurse should place the patient in which of the following positions? A. Lithotomy. B. Side-lying. C. Semi-Fowler's. D. Trendelenburg. 33. A primipara on the postpartum unit 2 hours after a vaginal delivery tells the nurse that she was in labor for 16 hours and pushed for 2 hours before delivery of a viable female neonate. She tells the nurse that she is "thirsty and very happy it is over." A priority nursing diagnosis for this client is: A. Deficient Fluid Volume related to decreased fluid intake during labor. B. Potential for Impaired Parenting related to lack of experience as a mother. C. Potential for Urinary Retention related to lengthy labor process. D. Anxiety related to inexperience in the new role of parenting. 2

D.

22. Which assessment finding would lead the nurse to suspect dehydration in a preterm neonate? A. B. C. D. Bulging fontanels Excessive weight gain Urine specific gravity below 1.012 Urine output below 1 ml/hour

23. 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.

24. A client who is 7 months pregnant reports severe leg

cramps at night. Which nursing action would be most effective in helping her cope with these cramps? A. Suggesting that she walk for 1 hour twice per day B. Advising her to take over-the-counter calcium supplements twice per day C. Teaching her to dorsiflex her foot during the cramp

34. Which of the following describes the rationale for administering vitamin K to every neonate? A. Neonates don't receive the clotting factor in utero. B. The neonate lacks intestinal flora to make the vitamin. C. It boosts the minimal level of vitamin K found in the neonate. D. The drug prevents the development of phenylketonuria (PKU). 35. A primigravida and her husband, currently about 8 weeks pregnant and interested in childbirth preparation classes offered in the community, have their physician's support for delivery in a birthing center. The couple asks when they should begin the preparation for childbirth classes that discuss maternal and newborn nutrition during pregnancy. Which of the following times would be most appropriate for the nurse to suggest that they begin the classes? A. As soon as the client experiences lightening. B. After scheduling a visit with the dietitian. C. Now during the first trimester of pregnancy. D. Toward the end of the second trimester. 36. Uterine atony, a condition in which the uterus is unable to maintain a state of firmness, is a common cause of hemorrhage in the postpartum period. In providing client care, the nurse is aware that uterine atony can result from: A. hypertension. B. cervical and vaginal tears. C. urine retention. D. endometritis. 37. A client arrives at a prenatal clinic for the first prenatal assessment. The client tells a nurse that the first day of her last menstrual period was September 19, 2005. Using Nagele's rule, the nurse determines the estimated date of confinement as A. July 26, 2006. B. June 12, 2007. C. June 26, 2006. D. July 12, 2007. 38. Which of the following describes how the nurse interprets a neonate's Apgar score of 8 at 5 minutes? A. A neonate who is in good condition B. A neonate who is mildly depressed C. A neonate who is moderately depressed D. A neonate who needs additional oxygen to improve the Apgar score 39. The nurse should tell new mothers who are breast-feeding that breast milk is produced when: A. the placenta is delivered, causing the secretion of prolactin. B. the neonate begins to suckle and stimulates the anterior pituitary to produce prolactin. C. oxytocin is released from the posterior pituitary gland. D. relaxin is released from the ovary. 40. Lochia normally progresses in which pattern? A. Rubra, serosa, alba B. Serosa, rubra, alba C. Serosa, alba, rubra D. Rubra, alba, serosa 41. If a woman with an untreated chlamydial infection is allowed to deliver vaginally, the infant is in danger of being born with: A. Thrush B. Congenital syphilis C. Ophthalmia neonatorum D. Neurologic complications 42. Thirty hours after delivery, the nurse plans discharge teaching for the client about infant care. By this time, the nurse expects that the phase of postpartal psychological adaptation that the client would be in would be termed which of the following? A. Taking in.

B. C. D.

Letting go. Taking hold. Resolution.

43. In the maternal attachment process, which of the following best describes the anticipated actions in the taking-hold phase? A. Making sure the mother's needs are met first B. Looking at the infant C. Kissing, embracing, and caring for the infant D. Talking about the infant 44. 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. 45. 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." 46. A few hours after being admitted in active labor, a primigravida becomes very restless, flushed, and irritable and perspires profusely. The client states that she is going to vomit. The nurse suspects that these symptoms are indicative of: A. Late stage B. Third stage C. Second stage D. Transition stage 47. The nurse is instructing a mother about the nutritional needs of her full-term, breast-feeding infant, age 2 months. Which response shows that the mother understands the infant's dietary needs? A. "We won't start any new foods now." B. "We'll start the baby on skim milk." C. "We'll introduce cereal into the diet now." D. "We should add new fruits to the diet one at a time." 48. During the postpartum period, the nurse should assess for signs of normal involution. Which of the following would indicate that the client is progressing normally? A. The uterus is descending at the rate of one fingerbreadth per day. B. Blood pressure drops as a result of the birth and changed circulatory load. C. Urine output remains about the same as in the client's prenatal period. D. Pad usage remains at 10 to 15 per day. 49. On the second postpartum day after a cesarean delivery, the client complains of gas pains. The nurse should instruct the client to do which of the following? A. Ask the physician for simethicone (Mylicon). B. Chew on some ice chips. C. Drink some hot coffee. D. Ambulate more often. 50. A client in labor received an epidural anesthetic when her dilation reached 5 cm. Which of the following nursing diagnoses would have the highest priority for her at this time? A. Impaired urinary elimination related to the effects of the epidural B. Deficient knowledge related to lack of information about regional anesthesia C. Risk for injury related to hypotension secondary to vasodilation and pooling in extremities D. Impaired skin integrity related to inability to move lower extremities 3

51. A 35-week antepartal patient was involve4 in a two-car motor vehicle crash. The nurse should assess this patient for which of the following complications that would most likely cause both maternal and fetal mortality? A. Placenta previa B. Premature labor C. Spontaneous abortion D. Uterine rupture 52. After determining that a pregnant client is Rh-negative, the physician orders an indirect Coombs' test. What's the purpose of performing this test on a pregnant client? A. To determine the fetal blood Rh factor B. To determine the maternal blood Rh factor C. To detect maternal antibodies against fetal Rhnegative factor D. To detect maternal antibodies against fetal Rh-positive factor 53. 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. 54. The nurse plans to instruct the postpartum client in methods to prevent breast engorgement. Which of the following measures would the nurse include in the teaching plan? A. Feeding the neonate a maximum of 5 minutes per side on the first day. B. Wearing a supportive brassiere with nipple shields. C. Breastfeeding the neonate at frequent intervals. D. Decreasing fluid intake for the first 24 to 48 hours. 55. A 39-year-old who is Rh negative is seen by the physician during the first trimester of pregnancy. She has just been told that Rh sensitization is suspected. The nurse explains that Rho (D) immunoglobin (RhIg) will be given to reduce sensitization. The nurse's teaching is effective if the client understands that she will receive RhIg at: A. 12 weeks gestation B. 28 weeks gestation C. 36 weeks gestation D. 40 weeks gestation 56. A client who has received a new prescription for oral contraceptives asks the nurse how to take them. Which of the following would the nurse instruct the client to report to her primary caregiver? A. Breast tenderness B. Breakthrough bleeding within first 3 months of use C. Decreased menstrual flow D. Blurred vision and headache 57. 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. 58. Following delivery a client is transferred to the postpartum unit. Of the postpartum mothers on the unit, the one the nurse should observe most closely is: A. A primipara who has delivered an 8 lb baby B. A grand multipara who experienced a labor of only 1 hour C. A primipara who received 100 mg of Demerol during her labor D. A multipara who experienced placental separation and delivered in 10 minutes

59. Which of the following clinical assessments would be included when caring for an infant with hydrocephalus? A. Increased head circumference B. Vomiting C. Papilledema D. Ataxia

60. A 32-year-old female client visits the family planning clinic

and requests an intrauterine device for contraception. When assessing the client, a history of which of the following would be most important to determine? A. Thrombophlebitis. B. Pelvic inflammatory disease. C. Previous liver disease. D. Coronary artery disease.

If you have no confidence in yourself, you are twice defeated in the race of life. With confidence, you have won even before you have started. Marcus Garvey