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OBSTETRIC NURSING MENTORING

1. A nursing instructor notices a student nurse is lacking professionalism when the student:
A. Knocks on door before entering & says, “Hello, Mr. Smith. I am Bill Johnson & I’ll be your student nurse today.”
B. Shares personal information about their assigned client w/ other students not involves in client’s care.
C. Arrives on time and is clean and neat, wearing no perfumes or cologne
D. Accepts responsibility for an error he made in documentation.
2. A period at which menses begins is called:
A. Menstruation C. Menarche
B. Sexual development D. Sex maturation
3. The average age for menopause is:
A. 60 years B. 54 years C. 40 years D. 47 years
4. The nurse determines the usually constant duration of menstrual flow when it ranges:
A. 2-3 days B. 6-8 days C. 2-4 days D. 4-6 days
5. Which of the following hormones causes the Spinnbarkeit phenomenon and fern-like pattern occur:
A. human placental lactogen C. progesterone
B. glycogen D. estrogen
6. Prior to Leopold’s Maneuver, the client is requested to empty her bladder, primarily to:
A. Allow for easier palpitation because the abdomen is relaxed when the bladder is empty.
B. To prevent accidental voiding during the palpitation.
C. To facilitate accurate assessments
D. Provide comfort to the client
7. Which step in Leopold’s Maneuver will give the fetal lie?
A. first B. second C. thirdD. fourth
8. Which part of examining hand is used to determine fetal parts?
A. finger tips B. entire hand C. palm D. all of the above
9. Which finding is not derived from Leopold’s Maneuver?
A. Presentation B. Engagement C. Position D. Station
10. BSE is doen regularly and is recommended even during menopause. What is the schedule of BSE for
menopausal clients?
A. Same date every month C. Not necessary after menopause
B. Once a month for 5 years D. Same day of the week or month
11. Best position for breast inspection:
1. Both arms relaxed at the sides
2. Arms stretched above the head
3. Both hands on hips while leaning forward
4. Arms across the chest
A. 1 & 2 B. 2 &3 C. 1,2,& 3 D. 2, 3 & 4
12. A nurse is preparing a client for pap smear, which nursing instruction is incorrect regarding the procedure?
A. Do not douch at least 24 hours before the test
B. Avoid intercourse
C. Do not use spermicidal gels
D. Avoid genital washing before the specimen is obtained
13. The nurse is preparing a client for pelvic examination. After compelling all the necessary equipments for the
procedure, what should the nurse do next?
A. Ask the client to remove her clothing from below the waist
B. Encourage her to empty her bladder
C. Gather all supplies at the bedside table
D. Adjust the room temperature
14. Which assessment of the breast should be reported immediately to the physician?
A. Montgomery tubercle are prominent C. Slight difference in size
B. Occasional veins noted near the areola D. Nipple retraction
15. When is the schedule of the first Papaniculao smear?
A. Three years after the first sexual activity
B. All the girls who are 18 years old and over
C. During pregnancy
D. When symptoms like vaginal itchiness, discharge or bleeding are noted by the client
16. The draping techique used for pelvic examination is:
A. Horizontal B. Diagonal C. Both a and b
Connie and her husband Lito have been trying to postpone pregnancy for a year because they are planning to
migrate to the US. They sought the help of the clinic nurse who provided them with some information that would
help them choose the method that would be safe. The following questions pertain to this.
17. Connie has a regular 30 days cyce. She wants to know how she can determine her fertile days for December. If
her LMP was Nov. 29-Dec. 3, which dates should they consider as “unsafe days”?
A. Dec. 9-17 B. Dec. 10-18 C. Dec 13-21 D. Dec 14-22
18. Realizing how long the abstinence is, Connie asked about BBT, which instruction will be incorrect regarding this
method?
A. Take your temperature at almost the same time every day.
B. Take your temperature after breakfast
C. Take your temperature as soon as you wake up
D. Start taking your temperature after your menstrual period.
19. Lito heard that some couples used the “withdrawal method” which reason will discourage the couple to choose
this method?
A. The pre-ejaculate fluid contains live, healthy sperms that can be deposited into the woman’s genitals
unknowingly.
B. It is never effective in preventing pregnancy
C. The husband should develop a sense of control to prevent accidental sperm leakage
D. It causes a great deal of stress to the male partner
20. In the cervical mucus method, the couple who wish to have a baby should be told to have sexual intercourse at
which time of the woman’s cycle?
A. During the dry period when the woman has no noticeable secretions
B. During the time when there is a noticeable change in the type of mucus
C. When the woman has slippery, stretchable mucus
D. When the woman has lumpy, whitish mucus
21. Connie described that in her last pregnancy they used the LAM method, but was not successful at preventing the
second pregnancy. Which event caused it to fail?
A. She breastfeed her baby “on demand”
B. Connie worked 3 months after giving birth and she was assigned on the night shift at the call center.
C. She did not feed her baby solid food until 6 months
D. She started doing exercise after discharge from the hospital
22. There were concerns regarding the use of the barrier method. Which of the following is included in this method of
birth control?
1. Condom
2. IUD
3. Contraceptive sponge
4. Vaginal spermicides
A. 1 & 3 B. 1 & 4 C. 1, 3, & 4 D. 1, 2, 3 & 4
OBSTETRIC NURSING MENTORING
LABOR AND DELIVERY
23. Which of the following observations would suggest that placental separation is occurring?
A. Uterus stop contracting altogether
B. Umbilical cord pulsations stop
C. Uterine shape changes from discoid to globular
D. Maternal blood pressure drops
24. When a client in labor fully dilated, which instruction would be most effective to assist in encouraging effective
pushing?
A. Hold your breath and push through entire contraction
B. Use chest breathing with the contraction
C. Pant and blow during each contraction
D. Push for 6-7 seconds several times during each contraction
25. During the fourth stage of labor, the nurse palpates the uterus on the right side and sees a saturated perineal pad.
What is the nurse’s first action?
A. Massage the uterus vigorously C. Notify the physician
B. Have the client void and reassess her D. Document as a normal finding
26. Which of the following maternal responses would be most common in the second stage of labor?
A. Active pushing C. Concerned about the progress of labor
B. Loss of control D. Excitement
27. In order to identify the duration of labor, the nurse would:
A. Start from beginning of one contraction to the completion of the same contraction
B. Time from the beginning of one contraction to the beginning of the next contraction
C. Palpate for the strength of the contraction at its peak
D. Time the beginning of the contraction to the peak of the same contraction
28. During the transition phase of the first stage of labor, which of the following occurs?
A. Irregular short contractions C. Onset of first contractions
B. Feeling the urge to push D. Cervical dilatation of 4 to 7 cm
29. Celeste is having long and hard uterine contractions. What length of contraction would you report as abnormal?
A. A contraction over 60 seconds in length
B. A contraction over 90 seconds in length
C. Contraction over 60 seconds with three minute intervals
D. A contraction shorter than 60 seconds
30. Another client Jonna asks you if she could use warm-water tub bathing during labor. Nurse Jenny’s best answer
would be:
A. No. No one is allowed to tub bath during labor.
B. Yes, as long as her membranes are not ruptured.
C. No, because warm water can diminish labor contractions
D. Yes, as long as the warm water doesn’t raise her temperature
31. When caring for a client during active phase of labor without continuous electronic fetal monitoring, the nurse
would intermittently assess FHR every:
A. 15 minutes B. 5 minutes C. 30 minutes D. 60 minutes
32. The nurse understands that post partal breast engorgement occurs 48 to 72 hours after giving birth as a result of
an increase in:
A. Blood and lymph supply C. Colostrums production
B. Estrogen and progesterone levels D. Fluid retention in the breasts
33. A client in labor has been pushing effectively for 1 hour. A nurse determines that the client’s primary physiological
need at this time is to:
A. Ambulate C. Change positions frequently
B. Rest between contractions D. Consume oral food
34. A nurse is caring for a client in labor. The nurse determines that the client is beginning the second stage of labor
when which of the following assessment is noted?
A. The contractions are regular C. The cervix is dilated completely
B. The membranes have ruptured D. The client begins to expel clear vaginal fluid
Helen is admitted to the labor and delivery area in beginning labor. She complains of regular uterine contractions
with 8 to 10minutes interval and states that her bag of water has been ruptured. The fetus in a left occiput
anterior position (LOA).
35. The nurse’s first action should be to:
A. Check the FHR C. call the physician
B. Start IV fluid as ordered D. place to lying position
36. The FHR should be most audible in which quadrant of Helen’s abdomen?
A. Left upper B. Left lower C. Right upper D. Right lower
37. Which procedure would best determine if Helen’s BOW has ruptured
A. A complete blood count C. Urinalysis
B. Lithmus paper test D. Vaginal examination
38. Initial assessment done and revealed the following FH= 30 cm, FHT 142bpm, BP= 110/70 mmHg. IE done by Dr.
Zeus and revealed 4 cm cervical dilatation. Helen asked for Demerol. The nurse’s best response is:
A. “Try to wait until you really need it.”
B. “It is too early in your labor, medication will retard progress of uterine contraction.”
C. “ I know you are in pain. I’ll just prepare the medication.”
D. “ Perhaps a change in position will make you more comfortable.”
39. Helen is now dilated 8 cm and is working hard to maintain control during her contractions. She performed deep,
rapid breathing. She reports that she feels light- headed and has a tingling sensation in her fingers. The nurse
should:
A. change the client’s position C. have a client breathe into a paper bag
B. assess fetal heart tone D. administer oxygen
40. Helen begins to tremble, becomes very tense with contractions and is quite irritable. She frequently states, “I
cannot stand this a minute longer.” This kind of behavior may be indicative of the fact that the client:
A. needs immediate administration of an analgesic or anesthetic
B. is entering the transition phase of labor
C. has been very poorly prepared for labor in the patient’s classes
D. is developing some abnormality in terms of uterine contractions
41. During the transition phase of the first stage of labor, which of the following occurs?
A. Irregular short contractions C. Onset of first contractions
B. Feeling the urge to push D. Cervical dilatation of 4 to 7 cm
42. Which of the following measurements indicates that the fetal presenting part is engaged?
A. -2 B. 0 C. +2 D. +4
43. Which of the following descriptions best fits Braxton Hick’s contractions?
A. Contractions beginning irregularly, becoming regular and predictable
B. Contractions causing cervical effacement and dilatation.
C. Contractions felt initially in the lower back and radiating to the abdomen in a wavelike motion.
D. Contractions that begin and remain irregular
44. Which of the following descriptions best fits the term effacement?
A. Enlargement of the cervical canal
B. Expulsion of the mucus plug.
C. Shortening and thinning of the cervical canal
D. Downward movement of the fetal head
OBSTETRIC NURSING MENTORING
45. Which type of contractions signal true labor?
A. Contractions that achieve cervical dilatation
B. Contractions that are felt abdominally
C. Contractions that may be irregular
D. Contractions that may disappear with ambulation
46. Fetal presentation refers to which of the following descriptions?
A. Fetal body part that enters the maternal pelvis first
B. Relationships of the presenting part to the maternal pelvis
C. Relationship of the long axis of the fetus to the long axis of the mother
D. Classification according to the fetal part
47. Cleo explains the purpose of effleurage to a client in early labor. She tells Anna that effleurage is:
A. The applications of pressure to the sacrum to relieve backache
B. A form of feedback to enhance bearing-down efforts during delivery
C. Light stroking of the abdomen to facilitate relaxation during labor & provide tactile stimulation to fetus
D. Performed to stimulate uterine activity by contracting specific muscle group while other parts of the body rest.
48. Because of the high-discomfort level during the transition phase of labor, nursing care should be directed toward:
A. Administering medication
B. Helping the client maintain control
C. Decreasing the rate of intravenous fluid
D. Having the client breathe in uniform patterns
Situation: In the Delivery Unit, another nurse Flory was busy attending to Mrs. Pamatian who is being prepared
for her delivery. This is her first baby.
49. While preparing for the delivery of Mrs. Pamatian, nurse Flory positioned the client’s legs on the stirrups and
adjusted the height of the stirrups primarily to:
A. Allow the better pushing during delivery
B. Promote client’s comfort
C. Allow the baby to descend through the birth canal
D. Facilitate the work of the birth attendant.
50. Nurse Flory prepares to assist Dr. Cruzano who will perform a mediolateral episiotomy on her client. This
procedure is necessary to:
A. Shorten labor
B. Allow the fetal head to extend
C. Prevent perineal laceration
D. Decrease trauma to the baby’s head as it extends
51. A pudendal block was used prior to episiotomy. Which effect will nurse Flory expect?
A. It will allow the client to sleep all throughout the delivery
B. It will not allow the patient’s to push effectively since he will not feel the pressure of the baby’s head as
it “crowns”
C. It will prolong the duration of perineal heading during the postpartum period.
D. It will result in spinal headache if the client does not maintain a flat position 6-8 hours after delivery.
52. Ritgen’s maneuver is necessary when the:
A. Head extends to prevent rapid expulsion
B. Baby’s body is expelled to prevent vaginal laceration
C. Cord is cut
D. Placenta emerges
Situation: Mrs. Sioson, 35 years old, delivered her baby 4 hours ago. She had a midline episiotomy. This is her
second pregnancy she experienced difficult labor because of hypotonic dysfunction.
53. When Mrs. Sioson was voiding, she noted pain on the area where her incision was. You would:
A. Call her doctor C. Inspect the perineum
B. Administer the prescribed analgesic D. Prepare the periheat lamp
54. You noted discoloration and swelling on the site, which is the best form of therapy for the hematoma?
A.ice compress C. Warm compress
B. Periheat D. Sitz bath
55. On the second postpartum day you elicited Homan’s sign. A positive finding means:
A. Thrombophlebitis C. Mastitis
B. Puerperal sepsis D. Pelvic cellulitis
56. Her breast is unusually painful and feels “heavy” even after breast feeding. Upon inspection, the area appears
discolored and feels warm to touch, you would do all the following except:
A. Apply warm compress
B. Refer to the doctor
C. Encourage complete emptying of the breast by frequent breastfeeding
D. Check for other signs of infection
57. Which statement is true of post partum blues?
A. It is transitory depression
B. It is associated with traumatic childbirth experience
C. It is abnormal and should be treated
D. It is associated with pre-psychotic behavior prior to childbirth
58. Uterine involution begins immediately after delivery and continues until the uterus is as close to its prepregnant
size as possible. Immediate after delivery, the uterus should be at which level?
A. Above the symphysis pubis
B. At the umbilicus
C. Midway between the symphysis pubis and umbilicus
D. Two or three fingerbreadths above the umbilicus
59. In taking- in maternal role phase described by Rubin, the nurse would expect the woman’s behavior to be
characterized as which of the following?
A. Gaining self-confidence C. Being passive and dependent
B. Adjusting to her new relationships D. Resuming control over her life
60. Which of the following statements best describes lochia rubra?
A. It contains a mixture of mucus, tissues debris and blood
B. It contains placental fragments and blood
C. It contains mucus, placental fragments and blood
D. It contains tissue debris and blood
Situation: The following questions pertain to your role as a nurse assigned in the postpartum unit.
61. You observe Joan holding her newborn. Which position would best reassure you that she is relating well to her
newborn?
A. She looks directly at her infant’s face and talks to him
B. She holds the infant over her to burp him
C. She sits in a rocking chair and rocks the new infant
D. She lies in bed and places the infant on her stomach
62. Which statement by Siony is most suggestive of a woman developing postpartum pscyhosis?
A. “I wish my baby had more hair.”
B. “ My baby has the devil’s eyes.”
C. “ I feel exhausted since birth.”
D. “ Breast feeding is harder than I thought.”
OBSTETRIC NURSING MENTORING
63. Which of the following actions would alert you that a new mother is entering a postpartum taking- hold phase?
A. She tells you she was in a lot of pain all during labor
B. She sleeps as if exhausted from the effort of labor.
C. She urges the baby to stay awake so that she can breast feed him or her.
D. She says that she has not selected a name for the baby as yet.
64. When caring for a postpartum family, the nurse should foster attachment to their newborn. In order to fulfill this
goal the nurse should:
A. Limit visiting hours so the mother can rest
B. Use videos to teach parents about newborn care
C. Insist that parent participate in the rooming-in with the newborn option offered by the hospital
D. Introduce parents and family members to the newborn, teaching them about typical newborn
characteristics, behaviors, and sensory capabilities
65. Perineal care is an important control measure for infection. When evaluating a postpartum woman’s perineal care
techniques, the nurse would recognize that the client needs further teaching when the client:
A. Use soap and water to wash the vulva and perineum.
B. Washes the vulva and perineum from symphysis pubis to the episiotomy, then over the anus to the
episiotomy.
C. Changes her perineal pad every 2-3 hours interval
D. Washes her hands before perineal care
66. Post partum women experience an increased risk for urinary tract infection. A prevention the nurse could teach
the postpartum would be:
A. Acidify the urine by drinking 3 glasses of orange juice each day.
B. Maintain a fluid intake of 6-8 glasses each day
C. Perform perineal care on a regular basis
67. Postpartum client exhibited positive Homan’s sign: indicating thrombophlebitis. This sign is ellicited by:
A. Plantar extension C. Pointing the toes
B. Plantar flexion D. Extending the knees
68. Pre discharge instructions of postpartum mothers include all of the following EXCEPT:
A. return visit with the baby to the clinic a month later.
B. Proper care of the umbilical stump
C. Personal hygiene and nutritional guidance
D. Sexual activity that can be resumed in two weeks with appropriate use of birth control
PREGNANCY
Mrs. Garcia a 25 year old primigravida came to the prenatal clinic for the first time. She complained of frequency
of urination, nausea and vomiting and a missed menstrual period. The first day of her last menstrual period was
on May 24 2006.
69. To relieve nausea and vomiting, you would instruct her to do the following EXCEPT:
A. Eat dry toast crackers 30 minutes before arising
B. Drink a glass of lukewarm milk
C. Eat three full meals a day
D. Avoid fatty foods
70. You would tell Mrs. Garcia that frequency in urination normally occurs during early & late pregnancy. Due to:
A. Decreased activity during pregnancy
B. Increased weight gain
C. Hypermotility of the urinary bladder
D. Pressure extended by the uterus on the bladder
71. Changes in the cervix normally occur during pregnancy. Which of the following change contribute to the formation
of the mucus plug?
A. Increased vascularity of the cervical tissue
B. Development of the edema in the cervical tissue
C. Softening of the cervical tissue
D. Hyperplasia of the mucous glands
72. Changes in the motility of the alimentary tract and the pressure of the growing uterus both can lead to constipation
in pregnant women. To relieve their constipation safely, these women could be instructed to:
A. Increase fluid intake C. Use mineral oil
B. Reduce intake of raw vegetables D. Increase exercise
73. Which of the following factor contributes to the frequent occurrence of hemorrhoids among pregnant women?
A. Obstruction of venous return in the anus and rectum
B. Increase blood flow to the anus and rectum
C. Hyperplasia of mucous glands in the anus and rectum
D. Increased fluid retention during the last trimester
74. Which of the following is usually most effective in helping pregnant women maintain good posture?
A. modified sit ups C. Leg raising exercises
B. Pelvic rocking D. Sitting tailor fashion
75. Nurse Leda is providing instructions to a pregnant client regarding measures that will assist in alleviating
heartburn. Which statement of the client indicates understanding of these measures?
A. “I should lie down for an hour after eating.”
B. “I should avoid between meal snacks”
C. “I should substitute spices for cooking rather than using salt.”
D. “I should avoid eating gas-forming foods and fatty foods.”
76. Clinic nurse Madel is instructing a pregnant client regarding dietary measures to promote a healthy pregnancy.
She instructs the client to have an adequate intake of fluid daily. Which statement of the mother indicates an
understanding of the fluid requirements?
A. “I should drink at least 8-10 glasses of fluid each day, of which 4-6 glasses are water.”
B. “I should drink 8-10 glasses of fluid a day and I can count all of the diet soft drinks that I consumed.”
C. “I should drink 12 glasses of fluid a day and I can include the coffee or tea that I drink in the count.”
77. Mrs. Reyes asks the nurse about the types of exercises that are allowable during the pregnancy. The nurse would
instruct her that the safest exercise to engage in is which of the following?
A. Bicycling with legs in the air C. Scuba diving
B. Swimming D. Low-weight gymnastics
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78. After the birth of her 4 child, a 30 year old client asks about Natural Family Planning. Which of the following
statements is correct?
A. If menstrual cycle is irregular; the rhythm method can be used to predict the days the egg can be fertilized.
B. Vaginal douching after intercourse washes away the sperm and prevents fertilization
C. Combining body temperature assessment and cervical mucus changes is reliable method of birth
control
D. Breast feeding prevents ovulation and can be used as a method of birth control
79. Woman with UTIs should avoid which type of birth control method.
A. Oral contraceptives C. Injectable contraceptive
B. Male condom D. Diaphragms
Mrs. Cruz is 32 weeks pregnant and she has developed gestational diabetes. Because of this, her doctor
ordered for a Non Stress test.
80. What will you prepare prior to this procedure?
A. Consent for her to sign. C. An external fetal monitor
B. An ultrasound machine D. A BP apparatus
OBSTETRIC NURSING MENTORING
81. What will you do immediately before the procedure?
A. Ask Mrs. Cruz to void.
B. Explain the procedure, detailing the highlights of the test.
C. Position Mrs. Cruz on left lateral
D. Perform Leopold’s Maneuver
82. When the results were written on the patient’s record it revealed a positive finding. What is the meaning of this
test result?
A. Reactive fetus C. A need for further testing
B. Non-reactive fetus D. A need to terminate pregnancy
83. Which of the following is not true of a reactive response to NST?
A. Fetal movements of 3 or more in 20 minutes
B. Fetal heart rate accelerations of 15 bpm
C. Fetal heart rate decelerations for 15 seconds after movements have stopped.
D. No fetal movements during fetal sleep cycle.
84. An OCT was ordered after NST, what is the purpose of this test?
A. To establish fetal age of viability
B. To determine if the fetus can withstand the stress of uterine contractions
C. To confirm the findings of NST
D. It is a part of NST
85. A client in labor is placed on an internal fetal monitor. The nurse should tell the client that while she is on the
monitor, she:
A. Should detach the monitor leads when using the toilet
B. May feel free to assume any position that is comfortable for her.
C. Must maintain a side lying position to ensure more accurate monitoring
D. Must maintain a supine position to avoid dislodging the internal electrode.
86. When is contraction test ordered?
A. If a non stress test is negative C. If the non stress test result is positive
B. If the fetus is reactive D. If the fetus is non reactive
87. Angel, 23 y/o asked a student nurse about chromosomes. The clinical instructor needs to correct the student
nurse if she hears the student nurse say:
A. Chromosomes are composed of segments of DNA
B. Each sperm cell and ova contains the 46 chromosomes
C. Each cell is composed of 46 chromosomes
D. Each chromosomes in a sperm cell has an autosome in the ovum
Situation: Paula, a sophomore nursing student is studying her notes on maternity nursing. If you were her, what
will be your answer to the following test questions?
88. A patient made a remark that needs further information during a discussion of sexuality and reproduction. What is
the statement of the patient?
A. “With advancing age, sex can be very gratifying.”
B. “ Simultaneous orgasm isn’t essential for conception to occur.”
C. “The woman determines the sex of the offspring.”
D. “ Urination after intercourse won’t prevent pregnancy.”
89. When taking a sexual history, which of the following denotes the correct manner from which the nurse would
proceed?
A. Specific to general problem
B. Physical to psychological problems
C. Common to unusual problems
D. Simple to complex problems
Situation: Lorraine is a level II student having her RLE at OB-Gyne ward. Before exposing them to direct client
care, her clinical instructor reviewed them regarding the menstrual cycle and asked the following:
90. Menstruation consists of interrelated cycles, which of the following structures are involved in these cycles?
1. Uterus A. 2,3, 4
2. Ovaries B. 1, 2, 3
3. Hypothalamus C. 1, 2, 3, 4
4. Neurohypophysis D. 1, 3, 4
91. Her instructor asked her regarding the hormone responsible for the development of graafian follicle. Which of the
following would be the best answer?
A. FSH B. GnRH C. LH D. Progesterone
92. What are the two fetal membranes?
A. Chorion and amnion C. Chorion and endoderm
B. Ectoderm and mesoderm D. Amnion and mesoderm
93. Which structure is responsible for supplying the uterus nutrients and removing wastes?
A. Yolk sac B. Placenta C. Amniotic fluid D. Ductus arteriosus
94. Which factors affect placenta; function?
A. Oxygen consumption and maternal circulation
B. Oxygen consumption and fetal circulation
C. Amount of amniotic fluid
D. Position of the fetus
95. Which structures carries deoxygenated blood from the fetus to the placenta?
A. Foramen ovale C. Umbilical arteries
B. Umbilical veins D. Ductus arteriosus
96. Fetal development starts by the union of the ovum and spermatozoa. This process is called:
A. Fertilization B. Implantation C. Mitosis D. Fecundation
97. During which week of gestation is the product of conception prone to tetrogenic insults to the cardiovascular
system?
A. 4th week B. 8th week C. 12th week D. 16th week
98. The layer of non pregnant uterus that sloughs off during menstruation is the:
A. Myometrium B. Deciduas C. Endometrium D. Parametrium
99. What causes milk ejection post partum?
A. Prolactin B. Oxytocin C. Estrogen D. Progesterone
100.A couple comes to the health clinic interested in using a diaphragm or a cervical cap. The couple asks the nurse,
“What is the diference between these two methods?” The nurse’s correct response is:
A. “one is smaller than the other, but both should remain in place for 6 hours after intercourse.”
B. “ There is no difference between these two methods.”
C. “The cap may be inserted hours before intercourse and left in place longer than the diaphragm; use of
additional spermicide with repeated intercourse is optional.”
D. “The diaphragm may not be inserted hours before intercourse, and additional spermicide must be added each
time intercourse repeated.”
101.After vasectomy, Gerald asks the nurse if he’ll become sterile immediately. The best response is:
A. “If the procedure is done correctly, you’ll be sterile immediately.”
B. “ You’ll be sterile in 2 to 3 days.”
C. “It may take several weeks as many as 16-20 ejaculations to remove all the live sperm.”
D. “No, you’ll remain fertile. The procedure doesn’t make you infertile.”
102.A 30-year old primigravida at 8 weeks gestation tells that she’s a vegetarian. The nurse should instruct the patient
to increase her calcium intake by eating:
A. Pancake B. Bread C. Apples D. Wheat bread
OBSTETRIC NURSING MENTORING
103.A primigravida asks, “How can I increase my dietary intake of protein?” The best response by the nurse is to
instruct the patient to eat:
A. Peas B. Carrots C. Potatoes D. Broccoli
104.Nurse Aiza is collecting the data during an admission assessment of Alma, a client who is pregnant with twins.
Alma has a healthy 5 year old child that was delivered at 38 weeks and tells the nurse that she does not have a
history of any type of abortion or fetal demise. The nurse would document the GTPAL for this client as:
A. G=3, T=2, P= 0, A= 0 L=1
B. G=2, T=1, P=0, A=0, L=1
C. G=1, T=1, P=1, A=0, L=1
D. G=2, T=0, P=0, A=0, L=1
105.Regina, a home care nurse visits a pregnant client who has a diagnosis of mild pre eclampsia and who is being
monitored for pregnancy induced hypertension (PIH). Which assessment finding indicates a worsening of the
preeclampsia and the need to notify the physician?
A. Blood pressure reading is at prenatal baseline
B. Urinary output has decreased
C. The client complains of headache and blurred vision
D. Dependent edema has resolved
106.A stillborn infant was delivered in the lying in clinic a few hours ago. After the birth the family has remained
together, holding and touching the baby. Which statement by Nurse Lenie would further assist the family in their
initial period of grief?
A. “Don’t worry; there is nothing you could do to prevent this from happening.”
B. “We need to take the baby from you now so that you can get some sleep.”
C. “What have you named your lovely baby?”
D. “We will see to it that you have an early discharge so that you don’t have to be reminded of this experience.”
107.Nurse Shiela is caring for a pregnant client with preeclampsia. The nurse prepare a plan of care for the client and
documents in the plan that if the client progresses from preeclampsia, then Shiela’s first action is to:
A. Administer magnesium sulfate intravenously
B. Assess the blood pressure and fetal heart rate
C. Clear and maintain an open airway
D. Administer oxygen by face mask
108.Mrs. Campa has just had surgery to deliver a nonviable fetus resulting from abruptio placenta. As a result of
abruptio placenta, she develops disseminated intravascular coagulation (DIC) and told about the complication.
She begins to cry and screams, “God’ just let me die now!” Which nursing diagnosis should direct care for this
client?
A. Hopelessness related to loss of baby and personal health
B. Deficient knowledge related to disease process
C. Situational low esteem related to being ill
D. Grieving related to the loss of the baby
109.Nurse Rosanna is monitoring Mrs. Solis, who is in active labor and notes that the client is having contractions
every 3 minutes that lasts for 45 seconds. The nurse notes that the fetal heart rate between contractions is 100
beats per minute. Which of the following nursing action is most appropriate?
A. Encourage the client’s coach to continue to encourage breathing exercises
B. Encourage the client to continue pushing with each contraction
C. Continue to monitor for the fetal heart rate
D. Notify the physician
110.Nurse Merly is caring for a client in labor and is monitoring fetal heart rate patterns. The nurse notes the presence
of episode accelerations on the electronic fetal monitoring tracing. Which of the following actions is most
appropriate?
A. Document the findings and tell mother that the monitor indicates fetal well-being.
B. Take the mother’s vital signs and tell the mother that bed rest is required to conserve oxygen
C. Notify the physician
D. Reposition the mother and check the monitor for changes that bed rest is required to conserve oxygen
111.When caring for the mother with premature rupture of the membranes, the nurse monitors the mother and fetus
for indications of:
A. Chorioamnionitis C. Hemorrhage
B. Placenta previa D. Arrest of descent
112.The nurse should monitor for which of the following fetal-life threatening emergencies when the fetal head is not
engaged and the membranes rupture?
A.Uterine hyperstimulation C. Cord prolapsed
B. Placenta previa D. Abruptio placentae
113.When observing a mother receiving oxytocin (Pitocin) for induction of labor, which of the following should the
nurse asses for?
A. Maternal hypotension C. Maternal hyperthermia
B. Uterine hyperstimulation D. Placenta previa
114.After observing variable decelerations of the fetal heart rate on the fetal monitor tracing, the nurse should plan
care for a possible:
A. head compression C. Cord compression
B. Uteroplacental insufficiency D. Cardiac conduction defect
115.A mother in labor is admitted with profuse bright red vaginal bleeding and late decelerations on the fetal monitor.
Which of the following questions is a priority for the nurse to ask the client to determine whether the source of the
bleeding is placenta previa or abruptio placentae?
A. “Are you having pain?” C. “Is this your first baby?”
B. “Do you have a fever?” D. “Do you have a headache or blurred vision?”
116.The nurse is admitting a mother in labor who reports a small amount of dark red, mucoid vaginal discharge. The
nurse should:
A. Prepare for immediate cesarean delivery
B. Proceed with the admission
C. Obtain a specimen for coagulation studies.
D. Notify the physician.
117.After assessing a postpartum client’s breast, diagnosed with mastitis, the nurse notices a red streak and
tenderness around the areola. Which of the following is the most important nursing intervention?
A. Apply cold soak to the area.
B. Avoid administering pain medication
C. Instruct the client to empty the breast frequently
D. Instruct the client to avoid breast feeding due to pain
118.A client phones the nurse to express concern about having intercourse six weeks after delivery. She is
breastfeeding and reports that intercourse is uncomfortable. Which of the following is the appropriate response by
the nurse?
A. “Excess abdominal fat after delivery lead to painful intercourse.”
B. “Your estrogen levels are low and there is decreased mucous production and dryness.”
C. “Your vaginal walls are smooth and have not redeveloped rugae, making intercourse uncomfortable.”
D. “Intercourse is uncomfortable because of the distention of the vaginal canal.”
119.A client who had a vaginal delivery the previous day asks the nurse what it meant when she was informed that
she had a third degree laceration. The nurse’s response should be based on the understanding that a third
degree laceration is characterized by a tear
A. Through the skin and into the muscles.
B. That extends through the anal sphincter.
C. That involves the anterior rectal wall.
D. That extends through the perineal muscle layer.
OBSTETRIC NURSING MENTORING
120.A client who is postpartum is complaining of perineal pain. The nurse should implement which of the following
interventions?
A. Apply an ice pack to the perineal area.
B. Administer a pain medication.
C. Change position
D. Apply a warm pack to the perineal area
E. Administer a smooth muscle relaxant.
F. Increase fluids
121.A client delivered an infant 12 hours ago and has lots of questions regarding care, but shows little in caring for the
newborn. According to Rubin’s theory, the nurse identifies this as which stage the client is exhibiting?
A. Taking-in phase.
B. Taking- hold phase
C. Letting-go phase
D. Good bonding behavior.
122.A postprtum client’s complete blood counts reflects a white blood cell count immediately after delivery to be 1,
4000 per cubed mm. The nurse reports this as:
A. Abnormal and indicating an infection is present.
B. An atypical low fever.
C. Elevated but normal following delivery
D. Within the normal range.
123.A client after a vaginal delivery is at risk for postpartum hemorrhage. Nursing education to prevent postpartum
hemorrhage is based on the knowledge that priority explanation for the cause is:
A. Laceration of the perineal area.
B. Uterine rupture
C. High parity
D. Uterine atony
124.The nurse is caring for a client postoperatively following a cesarean section. It is priority for the nurse to monitor
the client for:
A. Postpartum depression
B. Infection
C. Dehydration
D. Blood clots
125.When performing discharge teaching for a postpartum client the nurse should inform her that:
A. The episiotomy suture will be removed at the first postpartum checkup.
B. She may not have any vowel movements for up to a weeek after the birth.
C. She has to schedule a postpartum check up as soon as her menses return.
D. The perineal tightening exercises started during pregnancy should be continued indefinitely.
126.The nurse should teach the client that breast feeding is always contraindicated with:
A. mastitis B. Hepatitis C C. Inverted nipples D. Herpes genitalis
127.During the prenatal visit, the nurse evaluates the fundal height of the uterus at the umbilicus. The nurse should
estimate the gestation at:
A. 16 weeks B. 20 weeks C. 24 weeks D. 28 weeks
128.A client receiving education about preterm labor during a prenatal visit. Which of the following is a priority for the
nurse to instruct the client to report?
A. Nausea and vomiting
B. Back pain that indicates down into the buttocks and legs.
C. Feeling that the baby is balling up and relaxing.
D. Vaginal spotting after a vaginal exam.
129.A client is 24 weeks pregnant and has just been told her prenatal visit that her amniotoc fluid volume has
decreased. She is confused and asks the nurse, “What does that mean for my baby?” Which of the following is
the appropriate response by the nurse?
A. “The amniotic fluid is important for the baby. You should ask your doctor about that.”
B. “The less amniotic fluid, the more your baby is sick for complications. The fluid protects the baby from
trauma and helps the baby develop.”
C. “Your membranes may have ruptured which heralds the beginning of labor. I think it would be a good idea to
notify your labor support person.”
D. “You need to ask the doctor that question. In the meantime, I will notify the hospital you will be coming.”
130.A pregnant client is admitted to the hospital for preterm labor. The nurses first intervention is to:
A. Obtain a complete history and update the physician.
B. Initiate IV hydration and begin tocolytic medication.
C. Obtain a fetal febronectin and CBC.
D. Monitor for contractions and fetal well-being.
131.After a routine screening ultrasound, a pregnant client in her third trimester asks the nurse to explain where all
the fluid comes from that surrounds the baby. The nurse’s response should be based on the understanding that
the amniotic fluid is:
A. Fluid from the maternal serum that diffuses passively across the membranes.
B. Primary fetal urine maintained by a balance of production and reabsorption.
C. Produced primarily by the placenta and remains static unless ROM has occurred
D. Fluid from fetal serum that diffuses activity across the membranes
132.Admitting a pregnant client to the hospital from the prenatal clinic for preterm premature rupture of membranes,
thte nurse includes in the client teaching which of the following treatment expectations?
A. Drugs will include antibiotic coverage.
B. Activity will be restricted to ambulating the hospital room.
C. Blood pressure will need to be continuously monitored.
D. Amniotic fluid volume will need to be continuously monitored.
133.A pregnant client asks the nurse about gestational diabetes mellitus. The nurse responds based on the
understanding that gestational diabetes in pregnancy is:
A. An impaired glucose tolerance
B. Beta cell failure in pregnancy
C. Type I DM undetected prior to pregnancy
D. Type 2 DM undetected prior to pregnancy
134.Which of the following is the appropriate pregnancy classification for a pregnant for the third time, whose first
pregnancy ended in a miscarriage at 9 weeks and second pregnancy was a vaginal delivery at 39 weeks of
gestation and the child is 3 years old now?
A. Gravida 3 para 1-0-1-1 C. Gravid 3 para 3-2-0-1-0
B. Gravida 2 para 2-1-1-0 D. Gravid 2 para 2-1-0-0
135.The nurse has implement education about HIV in pregnancy. Which statement illustrates that the pregnant HIV-
positive client understood the nurse’s teaching about HIV and pregnancy?
A. “My baby will not have AIDS”
B. “I will need to take drug throughout my pregnancy.”
C. “They will start giving me a drug for HIV when I come in to deliver.”
D. “I will need to continue taking the HIV drug the entire time I breast feed.”
136.During a prenatal visit, a client approaching term asks many questions about labor and delivery. The nurse’s
response should be based on the understanding of normal adaptation to pregnancy because:
A. Anger and confusion often follow initial ambivalence as the client nears term.
B. A client has fears for safe laboring and delivery as the end of pregnancy approaches.
C. It is typical for a client to only have questions as the end of the pregnancy approaches.
D. Pregnant clients will enter a phase of trust at term and ask questions only as they near term.
OBSTETRIC NURSING MENTORING
137.After delivering a newborn infant, a client asks about the appearance of the umbilical cord. Based on an
understanding of anatomy and physiology, which of the following responses by the nurse would be appropriate?
A. “There is protective tissue called chorionic villi, which surround the vessels in the cord.”
B. “The umbilical cord is normally coiled with three vessels evident from any side of the cord.”
C. “The umbilical cord normally develops one to two knots during pregnancy from fetal movement.”
D. “The vessels in the cord are surrounded by a connective tissue called Wharton’s jelly.”
138.Based on the understanding of the physiologic adaptations of pregnancy, the nurse understands the client may
have complications because of which of the following?
A. Blood volume increase 30 to 50% during pregnancy.
B. Thyroid function decrease 10 to 25% during pregnancy.
C. Respiratory rate increase by one - third during pregnancy.
D. FSH and LH production is stimulated and overproduced during pregnancy.
139.A pregnant client is hospitalized for vaginal bleeding from suspected abruption placentae. The nurse bases the
appropriate interventions on which understanding of the pathology?
A. Placenta tears away from the cervical os during dilation and results in fatal hemorrhage.
B. Placenta abruption in umbilical cord hemorrhage from trauma.
C. Placenta abruption is premature separation of the normally implanted from the uterine wall.
D. Abruption placentae is the rupturing or membranes along the uterine wall and the resulting loss of fetal blood
and amniotic fluid.
140.A pregnant client asks the nurse when the stretch marks will disappear. The most appropriate response by the
nurse is:
A. “They will disappear with the birth of the infant.”
B. “They will disappear take up to six months to disappear.”
C. “They will fade but not totally.”
D. “They will disappear with a nutritionally balanced diet and exercise.”
141.The nurse should monitor for complications of disseminated intravascular coagulation (DIC) after observing which
of the following decelerations of the fetal heart rate on the fetal monitor tracing? Deceleration that are:
A. Uniform in shape and timing.
B. Variable in shape and timing.
C. Uniform in shape and variable in timing.
D. Variable in shape and consistent in timing.
142.After noting early decelerations on the fetal monitor tracing, the nurse should.
A. Prepare for emergency cesarean section
B. Administer an IV fluid bolus.
C. Administer oxygen to the mother.
D. Continue to observe the tracing.
143.The nurse is caring for a mother at 32 weeks gestation who thinks her “water broke” about one hour prior to
arrival at the hospital. The nurse should prepare the client for which procedure to evaluate the status of the
membranes?
A. Digital vaginal exam
B. Ultrasounds
C. Fern test
D. Group B beta strep culture.
144.The nurse is reviewing the laboratory results of a mother in labor. Which of the following nursing actions should
the nurse implement with a white blood cell count of 14,000?
A. Notify the physician.
B. Repeat the test in two hours.
C. Continue to monitor the client.
D. Prepare the client for a cesarean delivery.
145.The nurse is caring for a mother in labor whose amniotic fluid is wine - colored. The appropriate action to:
A. Continue to observe the mother and fetus.
B. Test the fluid with Nitrazine.
C. Notify the physician and review the fetal monitor tracing.
D. Obtain a group B beta strep culture.
146.After a mother received and epidural anesthesia for labor and vaginal delivery, the nurse should evaluate the
expected outcome of:
A. A decrease in sensation and motor control of lower extremities, bladder and vasomotor tone.
B. A heaviness in the legs and numb feet bilaterally.
C. A postdural epidural headache and a decrease in blood pressure.
D. Sedation and a decrease in the mother’s ability to push.
147.The nurse should prepare for a forceps and vacuum delivery after determining which of the following pelvis types
to be present?
A. Gynecoid B. Android C. Platypelloid D. Anthropoid
148.Which of the following is priority for the nurse to assess in a mother receiving magnesium sulfate?
A. Loss of patellar reflex
B. Diaphoresis
C. Respiratory rate less than 16
D. Flushing
149.A client who is pre - eclamptic complaints of blurred vision and scotomata to the nurse. The nurse should report
this as indicating which of the following?
A. Glaucoma
B. cerebral edema
C. Spinal cord injury
D. Hydrocephalus
150.The registered nurse is preparing clinical assignments for maternity unit. Which of the following assignments
should the nurse delegate to a licensed practical nurse?
A. Administer oxytocin (Pitocin) IV to a woman in labor.
B. Instruct a mother on the clinical manifestations of eclampsia.
C. Initiate prescribed magnesium sulfate to a mother experiencing toxemia.
D. Walk a woman in labor to the delivery room.
151.Twelve hours after delivery, the nurse assesses a client’s vital signs. Which of the following findings should be
reported?
A. temperature of 37.80C or 100.20F
B. Respiratory rate of 18 bpm.
C. Blood pressure of 120/80
D. Pulse of 96
152.During the 25 - hour postpartum assessment, the nurse anticipates the uterine fundus to be which of the following
positions?
A. U /3
B. U/4
C. Unable to palpate, too low in the pelvic cavity.
D. U/U
153.The nurse is giving a client who is postpartum the discharge instructions from the hospital. The nurse should
instruct the client to return immediately for evaluation if which of the following occurs?
A. Temperature 37.20F, or 990 F
B. Slight swelling in the lower legs without pain or tenderness
C. Bleeding becomes heavier than a heavy period
D. Small hemorrhoids
OBSTETRIC NURSING MENTORING
154.A client who had breast augmentation one year ago asks the nurse after delivery if she will be able to breastfeed.
Based on knowledge of breastfeeding, the nurse responds:
A. “Yes, you will be able to breastfeed without any problems.”
B. No, you will be unable to breastfeed because the milk ducts were severed.”
C. “No, you will be unable to breastfeed because the implants will chemically alter milk.”
D. “No, you will be unable to breastfeed due to the risk of infection.”
155.The nurse caring for a client who delivered ago assesses the uterine fundus to be displaced to the right. Which of
the following is the priority intervention the nurse should implement?
A. Take the client’s vital signs.
B. Check the client’s perineal area.
C. Reevaluate the client after assisting to the bathroom to void.
D. Check the client’s legs for swelling.
156.The nurse informs a graduate nurse on a postpartum unit that the human chorionic gonadotropin (HCG) would no
longer be detected in the client’s blood at:
A. One week postpartum
B. Two days postpartum.
C. Four weeks postpartum.
D. One hour postpartum.
157.Which of the following is the most appropriate consideration to include in the plan of care for an Asian postpartum
client who delivered three days ago and refuses to drink ice cream water or use ice packs on her perineum?
A. The client does not like water.
B. It is an important cultural belief.
C. The ice feels uncomfortable.
D. The client is in too much pain.
158.When preparing a client who is not pregnant for an oral glucose tolerance test (OCTT or GTT), it is essential for
the nurse to explain that the client must drink what amount of glucose?
A. 25 grams
B. 50 grams
C. 75 grams
D. 100 grams
159.While assessing a client who just delivered a 9lb oz baby, the nurse assesses a firm fundus that is midline at U/U.
There is also a constant trickle of blood from the vaginal area. Which of the following is the priority nursing
intervention?
A. Suspect postpartum hemorrhage and massage the uterus.
B. Question the client regarding a history of hemorrhoids.
C. Notify the physician of a possible laceration.
D. Document this as a normal finding.
160.A client with a history of hypertension had an oxytocin drug ordered due to increased bleeding after delivery. The
nurse appropriately administers which of the following drugs?
A. Oxytocin (Pitocin)
B. Methylergonovine maleate (Methergine)
C. Ergonovine (Ergotrate)
D. Acetylsalicylic acid (Aspirin)
161.Following giving birth, a client complains of excruciating, the nurse observes a bluish, bulging area just under the
skin on the left labia majora.
A. A hemorrhage.
B. An indicator of infection.
C. A hematoma
D. A laceration
162.The registered nurse is delegating nursing tasks on a postpartum maternity unit. Which of the following task
should the nurse delegate to a licensed practical nurse?
A. Assess the fundus post delivery.
B. Administer oxytocin (Pitocin) IV after delivery of the placenta.
C. Maintain an accurate intake and output.
D. Report lochia rubra ten days after delivery.
163.With today’s shorter postpartum hospitalizations (24 to 72 hours), the focus of nursing revolves around which of
the following essential concepts?
A. Promotion of comfort and recovery through physical care measures and pain relief therapies.
B. Exploration of the emotional aspects of care of the high - risk newborn and the family.
C. Parental assistance to care for themselves and their newborn safely and effectively.
D. Client and family assistance to deal with anxiety effectively and completely.
164.During the postpartum period after a cesarean birth, the nurse examines the client and indentifies the presence of
lochia serosa and feels the fundus four fingerbreadths below the umbilicus. This indicates that the time elapsed is:
A. 1 to 3 days postpartum
B. 4 to 5 days postpartum
C. 6 to 7 days postpartum
D. 8 to 9 days postpartum
165.The pituitary hormone that stimulates the secretion of milk from the mammary gland is:
A. Prolactin B. Oxytocin C. Estrogen D. Progesterone
166.The nurse is aware that one of the factors influencing the availability of milk in the lactating woman is the:
A. Amount of erectile tissue present in the nipple.
B. Age of the woman at the time of delivery
C. Attitude of the woman’s family toward breastfeeding
D. Amount of milk and milk products consumed during pregnancy.
167.When caring for the client with episiotomy during the postpartum period, the nurse encourages sitz bath three
times a day every 15 minutes. Sitz bath primarily aids the haling process of:
A. Promoting vasodilation
B. Softening of incision site
C. Cleansing the perineal area
D. Tightening the rectal sphincter
168.The nurse working on the postpartum unit should encourage client to ambulate early to:
A. Promote respiration.
B. Increase the tone of the bladder.
C. Maintain tone of the abdominal muscle.
D. Increase peripheral vasomotor activity.
169.While teaching a prenatal class about infant feeding, the nurse asked a question about the relationship between
the size of breast and breastfeeding. The nurse’s best response would be:
A. “Everybody can be successful at breastfeeding”
B. “You seem to have some concern about breastfeeding.”
C. “The size of your breast has nothing to do with the production of milk.”
D. “The amount of fat and grandular tissue in the breast determines the amount of milk produced.”
170.A woman learning about infant feeding asks how anyone who is breastfeeding gets anything done with a baby on
demand feedings. The nurse’s best response would be:
A. “Most mother finds that feeding the baby whenever the baby cries works out fine.”
B. “Perhaps a schedule might be better because the baby is already accustomed to the hospital routine.”
C. “Most mothers find babies on do better on demand feeling because the amount of milk ingested varies at each
feeding.”
D. “Although the baby is on demand feedings, the baby will eventually set a schedule, so there will be
time for you to do other things.”
OBSTETRIC NURSING MENTORING
171.A client asks the difference between cow’s milk and the milk from her breast. The nurse should respond that
cow’s milk differs human milk in that it contains:
A. More protein, less calcium, and less carbohydrate
B. Less protein, less calcium and more carbohydrates
C. More protein, more calcium and less carbohydrate
D. Less protein, more calcium and more carbohydrates
172.The client that indicates correct understanding of teaching regarding breast care in the mother who is
breastfeeding would be, “I will:
A. Use a mild soap for washing.”
B. Remove my brassiere at night.”
C. Air dry my nipple after feeding.”
D. Line my breast pads with plastic.”
173.A client who is breastfeeding is being discharged. The client tells the nurse that she is worried because her
neighbor’s breast dried up when she got home and she had to discontinue breastfeeding. The nurse should best
reply:
A. “This is not true; once lactation is established, this rarely happens.”
B. “You have little to worry about because you already have a good milk supply.”
C. “This is commonly happens with excitement of going home. Putting the baby to breast more frequently
will reestablished lactation.”
D. “This commonly happens; however, we will give you a formula to go home so the baby won’t go hungry until
your milk supply returns.”
174.When teaching breast feeding, the nurse should recognize the client’s needs further instructions when she states,
“I will:
A. Use an alternate breast at each feeding.”
B. Try to empty my breast at each feeding.”
C. Wash my breast with water with each feeding.”
D. Wash my breast with soap and water with each feeding.”
175.They should plan to teach a recently delivered client who is formula - feeding her infant to minimize breast
discomfort by:
A. Gently apply cocoa butter.
B. Manually expressing colostrums.
C. Applying ice packs to the breast.
D. Placing warm, wet washed clothes on her nipples.
176.Since having a baby by cesarean birth, a client has walked to the nursery numerous times to see her baby each
day. Two days postpartum, the client complains of pain in the right leg. The nurse’s initial response should be to:
A. Apply hot soaks.
B. Massage the affected area.
C. Encourage ambulation and exercise.
D. Maintain bed rest and notify the physician.
177.A nurse, planning an initial home care visit to a mother who just given birth, recognizes that the visit will be more
productive if scheduled when the:
A. Mother is feeding the infant.
B. Husband is out of the home.
C. Time is convenient for the family.
D. Nurse has time to spend with the family.
178.During postpartum visit, a client whose infant is now 4 weeks old complains of leg cramps. The nurse suspects:
A. Hypercalcemia and tells her to increase her activity.
B. Hypocalcemia and tells her to increase her milk intake.
C. Hyperkalemia and tells her to see a physician immediately.
D. Hypokalemia and tells her to increase her intake of green, leafy vegetables.
179.During the postpartum period, a client tells the nurse she is having a leg cramps. The nurse should suggest that
the client increase her intake of:
A. Eggs and bacon
B. Liver and onion
C. Juice and water
D. Cheese and broccoli
180.The nurse teaches a multipara who has just delivered a large baby what to do to maintain a contacted uterus.
The nurse recognizes that the teaching has been effective when the client states:
A. “If a start to bleed, I will call for help.”
B. “I will gently massage my uterus.”
C. “If I urinate frequently, my uterus will stay contracted.
D. “I will call you every 15 mins to massage.”
181.During prenatal development, fetal weight gain is greatest in the:
A. First trimester C. Second trimester
B. Third trimester D. Implantation period
182.Physiologic anemia during pregnancy is a result of:
A. Decreased dietary intake of iron
B. Increased of plasma volume of the mother
C. Decreased erythropoiesis after the first trimester
D. Increased detoxification demands on the mother’s liver
183.On a first prenatal visit, a client asks the nurse, “Is it true that the doctor will do an internal examination today?”
The nurse should respond:
A. “Yes, an internal exam is done at the mother’s first visit.”
B. “Are you fearful of having an internal examination done?”
C. “Have you ever had an internal examination done before?”
D. “Yes, an internal will be done now, but it is just slightly uncomfortable.”
184.A primigravida in her 10th week gestation is concerned because she has read that nutrition during pregnancy is
important for the growth and development of the fetus. She wants to know something about the foods she should
eat. The nurse should:
A. Instruct her to continue eating a normal diet
B. Assess what she eats by taking a diet history
C. Give her a list of foods to help her better plan her meals
D. Emphasize the importance of limiting salt and highly seasoned food
185.A client who is 10 weeks pregnant calls the clinic and complains of morning sickness. To promote relief, the nurse
should suggest:
A. eating dry crackers before arising
B. increasing her fat intake before bedtime
C. having two small meals daily and a snack at noon
D. drinking more high - carbohydrate fluids with her meals
186.A client is in her fourth month of pregnancy. When she comes for her monthly examination, the nurse asks
whether she would like to listen the baby’s heartbeat. The woman, commenting on how rapid it is, appears
frightened and asks whether this is normal. The nurse should response:
A. ‘The baby’s heart rate is usually twice the mother’s pulse rate.”
B. “The baby’s heart beat is rapid to accommodate the nutritional needs.”
C. “A baby’s heart rate is usually rapid and your baby’s is within normal range.”
D. “It is far better that the heart rate is rapid; when it is slow, there is a need to worry.”
OBSTETRIC NURSING MENTORING
187.A 21-year-old client who is 6 months into her second pregnancy is experiencing increasing edema in the lower
extremities. Besides advising rest with the legs elevated, the nurse discusses and gives instructions concerning
the diet. In this instance:
A. The nutritionist should be brought in to plan a diet.
B. The foods selected should have a normal salt content
C. Dietary preferences must influence the food that is eaten
D. The client should be advised to see the physician at the prenatal clinic
188.A 36-year-old multigravida is 14 weeks pregnant and is scheduled for an alpha - fetoprotein test. She asks the
nurse, “What does the alpha - fetoprotein test indicate?” The nurse bases a response on the knowledge that this
test can detect:
A. Kidney defects C. Neural tube defects
B. Cardiacthdefects D. Urinary tract defects
189.In the 37 weeks of gestation, a client is scheduled for a nonstress test. The nurse, after explaining the
procedure, evaluates that the client understands the teaching when she says:
A. “I hope this test does not cause my labor to begin early.”
B. “I hope the baby doesn’t get too restless after this procedure.”
C. “I hate having needles in my arm, but now I understand why it is necessary.”
D. “If my baby’s heart reacts normally during the test, he should do okay during delivery.”
190.A nurse has provided discharge instructions to a client who delivered a healthy newborn infant by cesarean
delivery. Which statement, if made by the client, indicates a need for further instructions?
A. “I will begin abdominal exercises immediately.”
B. “I will notify the physician if I develop a fever.”
C. “I will turn on my side and push up with my arms to get out of bed.”
D. “I will lift nothing heavier than the newborn infant for at least 2 weeks.”
191.A nurse is caring for a client in labor and prepares to auscultate the fetal heart rate using a Doppler ultrasound
device. The nurse accurately determines that the fetal heart sounds are heard by:
A. Noting whether the heart rate is greater than 140 beats/min
B. Placing the diaphragm of the Doppler on the mother’s abdomen
C. Palpating the maternal radial pulse while listening to the fetal heart rate.
D. Performing Leopold’s maneuver first to determine the location of the fetal heart
192.After a client has spontaneous abortion, the nurse should observe the client for:
A. Hemorrhage C. Hypertension
B. Dehydration D. Subinvolution
193.Most spontaneous abortions are caused by:
A. Physical trauma C. Congenital defects
B. Unresolved stress D. Germ plasm defects
194.A client whose husband is overseas in the military is admitted to the hospital with vaginal staining but no pain.
The client’s history reveals amenorrhea for the last 2 months and pregnancy confirmation by her physician after
her first missed period. She is admitted for observation with a possible diagnosis of:
A. Missed abortion C. Inevitable abortion
B. Ectopic pregnancy D. Threatened abortion
195.A few hours after being admitted with a diagnosis of investable abortion, s client begins to experience bearing -
down sensations and suddenly expels the products of conception in bed. To give safe nursing care, the nurse
should first:
A. Give her the sedation ordered
B. Check the fundus for firmness
C. Immediately notify the physician
D. Take her immediately to the delivery room
196.After an incomplete abortion, a client tells the nurse that although her doctor explained what an incomplete
abortion was, she did not understand. The nurse could best respond:
A. “I really don’ think you should focus on what happened right now.”
B. “This is when the fetus dies but is retained in the uterus for 8 weeks or more.”
C. “I think it would be best if you asked your doctor for the answer to that question.”
D. “An incomplete abortion is when the fetus is expelled but part of the placenta and membranes are not.”
197.A client, at 41 weeks gestation, comes to the birthing suite with a bloody show and no contractions. A vaginal
examination reveals that the fetus’ head is at +1 station. To induce labor, the nurse should expect an order for:
A. A tap - water enema C. Artificial rupture of membranes
B. An IM injection of oxytocin D. Administration of prostaglandins
198.A client is admitted to the hospital in active labor. After an amniotomy the nurse would expect:
A. Increased fetal heart rate
B. Diminished bloody show
C. Less discomfort with contractions
D. Progressive dilation and effacement
199.A primigravida, at 40 weeks’ gestation, arrives at the birthing center with abdominal cramping and a bloody show.
Her membranes ruptured 30 minutes before arrival. A vaginal examination reveals 1cm dilation and presenting
part at -1 station. After obtaining the fetal heart rate and maternal vital signs, the nurse should:
A. Teach the client how to push
B. Review Lamaze breathing techniques with the client.
C. Provide the client with comfort measures used for women in labor.
D. Prepare to type and cross - match the client’s blood for a possible transfusion
200.Which occurs in response to the large amount of progesterone secreted during the secretory phase of the
menstrual cycle:
A. Onset of the ovulation
B. Regulation of menstruation
C. Incidence of capillary fragility
D. Maintenance of the thick endometrium of the uterus