Name: ________________________________ Date: _____________ Score: _____________

MATERNAL CHILD NURSING

EMOTIONAL NEEDS RELATED TO CHILDBEARING AND WOMEN’S HEALTH

1. Twenty-four hours after a cesarean delivery a client elects to sign herself and her baby out of the hospital
because of difficulty at home with her 2-year-old son. Staff members have been unable to contact her
physician. The client arrives at the nursery dressed and ready to leave and asks that her infant be given to
her to dress and take home. Appropriate nursing action would be:
Explain to the client that her infant must remain in the hospital until signed out by the physician and that
she must leave the baby in the nursery
A. Allow the client time with the baby to cuddle him before she leaves, but emphasize that the baby is a
minor and legally must remain until orders are received
B. Tell the client that under the circumstances hospital policy prevents the staff from releasing the infant
into her care, but she will be informed when the infant is discharged
C. Give the baby to the client to take home, making sure that she receives information regarding care
and feeding of a 2-day-old infant and any potential problems which may develop

2. A newly delivered mother, with three young children at home, comments to the nursery nurse that she cannot
hold the baby for feedings once she gets home. She has just too much to do, and anyhow, it spoils the baby.
The best response for the nurse to make is:
A. “You seem concerned about time. Let’s talk about it.”
B. “That’s entirely up to you; you have to do what works for you.”
C. “Holding the baby when feeding is important for development.”
D. “It is most unsafe to prop a bottle. The baby could aspirate the fluid.”

3. After a client has a spontaneous abortion, the nurse notes that the involved couple are visibly upset. The
husband has tears in his eyes and the wife has her face turned toward the wall and is sobbing quietly. The
nurse’s best approach would be to go over to the woman and say:
A. “I know that you are upset now, but hopefully you will become pregnant again very soon.”
B. “I see that both of you are very upset. I bought you a glass of juice and will be here if you want to
talk.”
C. “I know how you feel, but you should not be so upset now; it will make it more difficult for you to get
well quickly.”
D. “I can understand that you are upset but be glad it happened early in your pregnancy and not after
you carried the baby for the full time.”

4. A client with preeclampsia with two preschool children is prescribed bed rest at home. To help stimulate
compliance, plans for the client’s care should include:
A. A suggest to find a housekeeper
B. An explanation as to why Bedrest is necessary
C. A warning of the risks involved in noncompliance
D. A contract that 4 hours of nap time will meet the requirement

5. A client suspects that she is pregnant, but because she is the only wage earned in her family she is
ambivalent about continuing the pregnancy. The nurse recognizes that the client is in crisis and also
remembers that pregnancy and birth are called crises because:
A. There are mood changes during pregnancy
B. They are periods of change and adjustment to change
C. There are hormonal and physiologic changes in the mother
D. Narcissism in the mother affects the husband-wife relationship

6. A young couple attend the prenatal clinic. The wife is 8 weeks pregnant and asks the clinic nurse for
information about an abortion. The nurse expresses the opinion that abortion is immoral and that many
women have long-term guilt feelings after an abortion. The couple leave the clinic in a very disturbed state.
Legally, the:
A. Client had a right to correct, unbiased information
B. Nurse’s statements need not be based on scientific knowledge
C. Physician should have been called in, since the nurse cannot talk about it
D. Nurse had a right to state feelings as long as they were identified as the nurse’s own

7. An amniocentesis done on a client, 16 weeks gestation, reveals a Down Syndrome infant. The client and her
husband, RH-incompatible partners, elect to have the pregnancy terminated. The nursing giving care to a
client whose pregnancy us surgically terminated should be aware that:
A. The risk of postoperative infection is high
B. The client is emotionally unstable at this time
C. Contraceptive counseling should be deferred to a later time
D. The client needs to express her feelings of guilt, anger, and frustration
8. Research concerning the emotional factors of pregnancy indicates:
A. A rejected pregnancy will result un a rejected infant
B. Ambivalence and anxiety about mothering are common
C. Maternal love is fully developed within the first week after birth
D. A good mother experiences neither ambivalence nor anxiety about mothering

9. An obstetric client with a history of three spontaneous abortion is now 16 weeks pregnant and attending the
high-risk clinic. The client expresses concerns about remaining at home during her pregnancy. The nurse
should question the client to determine her knowledge of:
A. Causes of spontaneous abortion
B. Signs and symptoms of spontaneous abortion
C. Interrelationship among rest, normal delivery, and diet
D. Current status of pregnancy and availability of support system

10. A client with severe abdominal pain and heavy bleeding is prepared for delivery. Nursing care should include:
A. Teaching coughing and deep-breathing techniques
B. An abdominal prep and administration of a Fleet enema
C. Obtaining an informed consent and assessment for drug allergies
D. Inserting a Foley catheter and administration of a tap water enema

11. When caring for a client who is having a prolonged labor, the nurse must be aware that the client us very
concerned when her labor deviates from what she sees as the norm. a response conveying acceptance of the
client’s expressions of frustration and hostility would be:
A. “I’ll rub your back; tell me if it helps.”
B. “I’ll leave so you can talk to your husband.”
C. “All women get weary and frustrated during labor.”
D. “Would you like to talk about what’s bothering you?”

12. The husband of a client who is in the transitional phase of labor becomes very tense and nervous during this
period and asks the nurse, “Do you think is it best for me to leave, since I don’t seem to do my wife much
good?” The most appropriate response by the nurse would be:
A. “This is the time your wife needs you. Don’t run out on her now.”
B. “This is hard for you. Let me try to help you coach her during this difficult phase.”
C. “I know this is hard for you. Why don’t you go have a cup of coffee and relax and come back later if
you feel like it?”
D. “If you feel that way, you’d best go out and sit in the father’s waiting room for a while because you
may transmit your anxiety to your wife.”

13. After an 8-hour, eneventful labor a client delivers a baby boy spontaneously under epidural black anesthesia.
As the nurse places the baby in the mother’s arm immediately following delivery, the mother asks, “is it
normal?” The most appropriate response by the nurse would be:
A. “Most babies are normal; of course he is.”
B. “He must be all right, he has such a good strong cry.”
C. “Yes, because your pregnanc and labor wer so normal.”
D. “Shall we unwrap him so you can look him over for yourself.”

14. Supportive nursing care in the beginning mother-infant relationship should include:
A. Requiring the mother to assist with simple aspects of her infant’s care
B. Encouraging the mother to decide between breastfeeding and bottlefeeding
C. Allowing the mother ample time to undress and to carefully inspect her infant
D. Unobtrusive observation of the mother and her infant to pick up a disturbed relationship

15. While holding her baby, a primipara calls the nurse and worriedly comments the baby seems to sneeze a lot
and breathes very rapidly and irregular. She expresses fear that her baby may be sick like her neighbor’s
baby was and will have to be taken back to the hospital after being home for few days. The nurse should:
A. Pick up the baby and tell the mother that the nurses will watch the baby closely
B. Look the baby over and tell the mother that the baby is fine and nothing is wrong
C. Look the baby over and explain to the mother that sneezing is a normal and helps the baby to get rid
of mucus, and that a baby normally has rapid, shallow, irregular respirations
D. Assess the baby, take the baby to the nursery immediately and return to the mother to tell her that the
physician has been called since the baby is obviously in respiratory distress

16. During the taking-hold phase, the nurse would expect the new mother to:
A. Talk about the baby C. Touch the baby with her fingertips
B. Call the baby by name D. Be passively involved with the baby

17. Following delivery, while considering nursing measures to help parent-child relationships, the nurse should b
e aware that the most important factor at this time is the:
A. Anesthesia during labor C. Physical condition of the infant
B. Duration and difficulty of labor D. Health status during pregnancy
18. When caring for a family on a postpartum unit, the nurse must be aware that all the tasks, responsibilities, and
attitudes that make up child care can be called parenting and that either parent can exhibit these qualities. A
person is able to perform parenting because if:
A. A marriage with flexible roles
B. An inborn ability based on instinct
C. Positive childhood roles and concepts
D. A good education in growth and development

19. When planning care for the parents of a newborn with abnormalities, the nurse should be aware that the
parents are better able to cope with this problem I informed:
A. When bringing the baby to the mother for the first time
B. When the parents ask if something is wrong with their baby
C. Right after delivery while the mother is still in the delivery room
D. After the first 24 hours, when the mother’s strength has returned

20. A decision to withhold “extraordinary care” for a newborn with severe abnormalities is actually:
A. A decision to let the newborn due C. Presuming that the
B. The same as pediatric euthanasia D. Unethical and illegal medical and
nursing practice

21. It is important for the nurse to support the parents’ decision to abort a fetus with a birth defect because:
A. Supporting them will estimate feelings of guilt
B. It is essential for maintenance of family equilibrium
C. The parents are legally responsible for the decision
D. The nurse’s support will relive the pressure associated with decision making

DRUG-RELATED RESPONSES

22. In the 12th week of gestation a client completely expels the products of conception. Because the client is Rh
negative, the nurse must:
A. Administer RhoGAM within 72 hours
B. Make certain she receives RhoGAM on her first clinic visit
C. Not give RhoGAM, since it is not used with the birth of a stillborn
D. Make certain the client does not receive RhoGAM, since the gestation was only 12 weeks

23. A pregnant client develops thrombophlebitis of the left leg and admitted to the hospital for Bedrest and
anticoagulant therapy. The anticoagulant the nurse should expect to administer is:
A. Heparin C. Diphenadione
B. Dicumarol D. Warfarin (Coumadin sodium)

24. A client, undergoing treatment for infertility, is diagnosed as having endometrosis. The nurse is aware that
one of the drugs that may be used to treat this condition is:
A. Relaxin (Releasin) C. Ergonovine (Ergotrate)
B. Leuprolide (Lupron) D. Estrerified estrogen (Climestrone)

25. During labor a client who has been receiving epidural anesthesia has a sudden episode of severe nausea and
her skin becomes pale and clammy. The nurse’s immediate reaction is to:
A. Notify the physician C. Check for vaginal bleeding
B. Elevate the client’s legs D. Monitor the FHR every 3 minutes

26. A client at 6 weeks gestation is receiving antibiotic therapy for pyeloephritis. The nurse is aware that the
safest antibiotic for administration during pregnancy is:
A. Gantrisin C. Tetracycline
B. Ampicillin D. Nitrofurantoin

27. A client who was admitted in active labor has only progressed from 2 cm to 3 cm in 8 hours. She is diagnosed
as having hypotonic dystocia and is given oxytocin (Pitocin) to augment her contractions. The most important
aspect of nursing at this time is:
A. Monitoring the FHR
B. Checking perinuim for bulging
C. Timing and recording length of contractions
D. Preparing for an emergency cesarean delivery

28. A client 38 weeks gestation, is admitted for indection of labor. She has a history of ruptured membranes for
the past 12 hours. She has no other symptoms of labor. The nurse is aware that if the proper conditions exist
the physician will prescribe:
A. Progesterone C. Luturin (Letrexin)
B. Oxytocin D. Ergonovine maleate
29. At about 5 cm, a laboring client receives medication for pain. The nurse us aware that one of the medications
given to woman in labor that should cause respiratory depression of the newborn is:
A. Scopolamine C. Meperidine (Demerol)
B. Promazine (Sparine) D. Promethazine (Phenergen)

30. A client in the midphase of labor becomes very uncomfortable and asks for medication. Meperidine (Demerol)
50 mg and Phenergan 50 mg are ordered. These medications:
A. Acts to produce amnesia
B. Act as preliminary anesthesia
C. Induce sleep until the time of delivery
D. Increase the client’s pain threshold, resulting in relaxation
31. A client beings preterm labor and the physician orders terbutaline sulfate (Brethine). After its administration,
the nurse assesses the client for the therapeutic effect of:
A. Reduction of pain in the perineal area
B. Decrease in blood pressure from 120/80 to 90/60
C. Decrease in frequency and duration con contractions
D. Dilation of the cervix from 1 to 1.5 cm for every hour of labor

32. A client is on magnesium sulfate therapy for severe preeclampsia. The nurse must be alert for the first sign of
an excessive boold magnesium level, which is:
A. Disturbance in sensoruim C. Development of cardiac dysrhythmi
B. Increase in respiratory rate D. Disappearance of the nee-jerk reflex

REPRODUCTIVE CHOICES

33. Following delivery a cardiac client with type 2 diabetes ask the nurse, “Which prevent pregnancy in the near
future?” The nurse’s best response would be:
A. “You may use oral contraceptives. They are almost 100% effective in preventing a pregnancy
B. “You may want to use a foam and a condom to prevent pregnancy until you consult with your doctor
at your postpartum visit”
C. “The intrauterine device is best for you because it does not allow a fertilized ovum to become
implanted into the uterine lining”
D. “You do not need to worry about becoming pregnant in the near future. Clients with cardiac conditions
usually become infertile

34. The nurse teaches that the most frequent side effect associated with the use of IUDs is:
A. Ectopic pregnancy C. Rupture of the uterus
B. Expulsion of the IUD D. Excessive menstrual flow

35. The nurse should explain that a common problem that has been associated with IUDs when they are used is:
A. Perforation of the uterus C. Development of vaginal infections
B. Discomfort associated with coitus D. Spontaneous expulsion of the device

36. A client seeking advice about contraception asks the nurse about an IUD. The nurse explains that the IUD
provides contraception by:
A. Blocking the cervical os
B. Increasing the mobility of the uterus
C. Preventing the sperm from reaching the fallopian tube
D. Setting up a nonspecific inflammatory cell reaction in the endometruim

37. In a lecture on sexual functioning the nurse plans to include the fact that ovulation occurs when the:
A. Oxytocin level is high C. Progesterone level is high
B. Blood level of LH is high D. Endometrial wall is sloughed off

38. After ovulation has occurred, the ovum is believed to remain viable for:
A. 1 to 6 hours C. 24 to 36 hours
B. 12 to 16 hours D. 48 to 72 hours

39. The time of ovulation can be determined by taking the basal temperature:
A. Drops markedly C. Rises suddenly and then falls
B. Drops slightly and then rises D. Rises markedly and remains high

40. When oral contraceptives are prescribed for a client the nurse should teach the client about the potential of
developing:
A. Cervisitis C. Fibrocystic disease
B. Ovarian Cysts D. Breakthrough bleeding
41. A young couple have been using oral contraceptives to delay pregnancy. When the wife misses her regular
menstrual period, she decides to find out if she is pregnant. She tells the nurse that pregnancy may have
occurred because she missed taking her contraceptive pills for 1 week because of the flu. The nurse’s best
response would be:
A. “Contraceptive pills are very unpredictable anyhow. You probably would have become pregnant even
if you had taken them regularly as prescribed”
B. “Don’t think about that now. It’s too late to worry anyhow. First find out whether you really are
pregnant. If you are, you may want to consider having an abortion”
C. “You may well be correct one of the reasons for prescribing an exact schedule is that the effect of
contraceptive drugs depends on the regularity with which they are taken”
D. “That’s the trouble with using contraceptive pills. People become too careless and don’t use proper
restraint. If you had used the rhythm method, this probably would not have happened”

42. The nurse explains that the efficiency of the basal body temperature (BBT) method of contraception depends
on fluctuation of the basal body temperature. A factor that will alter its effectiveness is:
A. Presence of stress C. Age of those involved
B. Length of abstinence D. Frequency of intercourse

43. A biphasic antivulatory medication of combined progestin and estrogen is prescribed for a female client. The
nurse, instructing the client about the medication, should include the need to:
A. Have bimonthly Pap smears C. Temporarily restrict sexual activity
B. Increase her intake of calcium D. Report any irregular vaginal bleeding

44. During the salinization method of elective abortion, the nurse should be alert for side effects of hypernatremia
such as:
A. Edema C. Headache
B. Oliguria D. Bradycardia

45. Following a salinization procedure for an elective abortion of a 20-week pregnancy, the client is told that labor
will probably begin within:
A. Two hours after the procedure C. Eight to 24 hours after the procedure
B. Four hours following the procedure D. Several minutes following the procedure

46. In the dilation and suction evacuation method of elective abortion, Laminaria is used in the dilation stage of
the procedure because:
A. Dilation occurs within 2 hours
B. They are hygroscopic and expand
C. They are stronger in action than instruments
D. Less anesthesia is necessary with this method

REPRODUCTIVE PROBLES

47. One of the responsibilities of a nurse is a fertility specialist’s office is to provide health teaching to the client in
relation to timing of intercourse. Instructions to the client would include the information that the best time to
achieve a pregnancy would be:
A. Midway between periods
B. Immediately after menses end
C. Fourteen days before the next period is expected
D. Fourteen days after the beginning the last period

48. A factor in infertility may be related to the pH of the vaginal canal. A medication that is ordered to alter the
vaginal pH is:
A. Estrogen therapy C. Lactic acid douches
B. Sulfur insufflations D. Sodium bicarbonate douches

49. A diagnosis test used to evaluate fertility is the postcoital test. It is best timed:
A. 1 week after ovulation
B. Immediately after menses
C. Just before the next menstrual period
D. Within 1 to 2 days of presumed ovulation

50. a tubal insufflation test is done to determine whether there is a tuba obstruction. Infertility caused by a defect
in the tube is most often related to a:
A. Past infection C. Congenital anomaly
B. Fibriod tumor D. Previous injury to a tube

51. In dealing with a couple who have been identified as having an infertility problem, the nurse should know that:
A. Infertility is usually psychologic in origin
B. Infertility and sterility are essentially same problem
C. The couple has been unable to have a child after trying for a year
D. One partner has a problem that makes that person unable to have children
52. A high concentration of estrogen in the blood:
A. Causes ovulation C. Inhibits secretion of FSH
B. Stimulates lactation D. Is one cause of osteoporosis

53. A test commonly used to determine the number, motility, and activity of sperm is the:
A. Rubin test C. Friedman test
B. Huhner test D. Papanicolaou test

54. In the female, evaluation of the pelvic organs iof reproduction is accomplished by:
A. Biopsy C. Culdoscopy
B. Cystoscopy D. Hysterosalpinogogram

55. When assessing a client with a tentative diagnosis of hydatidiform mole, the nurse should be alert for:
A. Hypotension C. Unusual uterine enlargement
B. Decreased FHR D. Painless, heavy vaginal bleeding

56. When obtaining the nursing history from a client with a diagnosis of a ruptured tubal pregnancy, the nurse
should expect the client to indicate that her symptoms of pain in the lower abdomen and vaginal bleeding
started:
A. About the sixth week of pregnancy
B. At the beginning of the last trimester
C. Midway through the second trimester
D. Immediately after implantation occurred
57. The nurse would suspect an Ectopic pregnancy if the client complained of:
A. An adherent painful ovarian mass
B. Lower abdominal cramping for a long period of time
C. Leukorrhea and dysuria a few days after the first missed period
D. Sharp lower right or left abdominal pain radiating to the shoulder

58. The most common type of Ectopic pregnancy is tubal. Within a few weeks after conception the tube may
rupture suddenly, causing:
A. Painless vaginal bleeding
B. Intermittent abdominal contractions
C. Continuous dull, upper-quadrant abdominal pain
D. Sudden knifelike, lower-quadrant abdominal pain

59. A client who has missed two menstrual periods comes to the prenatal clinic complaining of vaginal bleeding
and one-sided lower-quadrant pain. The nurse suspects that this client has:
A. Abruptio placentae C. An incompatible abortion
B. An Ectopic pregnancy D. A rupture of a graafian follicle

60. A client is admitted to the emergency department with vaginal bleeding. When taking a history, the nurse
learns that the client has had five missed periods. Later the nurse reads the chart, which states “stillborn
delivered at 8 pm.” The nurse understands this to mean that the fetus and other products of conception:
A. Were previable C. Were completely expelled
B. Weighed over 600 g D. Measured 13.4 cm in length

61. after a spontaneous abortion the nurse should observe the client for:
A. Hemorrhage and infection
B. Dehydration and hemorrhage
C. Subinvolution and dehydration
D. Signs of pregnancy-induced hypertension

62. Most spontaneous abortions are caused by:

A. Physical trauma C. Congenital defects
B. Unresolved stress D. Germ plasm defects

63. A client, whose husband is overseas in the military, is admitted to the hospital with vaginal staining but not
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. Ectopic pregnancy
B. Inevitable abortion D. Threatened abortion

64. A few hours after being admitted with a diagnosis of inevitable abortion, a client beings to experience bearing-
down sensations and suddenly expels the products of conception in bed. To give safe nursing care, the nurse
should first:
A. Check the fundus for firmness
B. Giver her the sedation ordered
C. Immediately notify the physician
 D. Take her immediately to the delivery room

65. 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’t 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.’

HEALTHY CHILDBREAING

66. The inner membranes that encloses the fluid medium for the embryo is the:
A. Funis C. Chorion
B. Amnion D. Yolk sac

67. The chief function of progesterone is the:

A. Stimulation of follicles for ovulation to occur
B. Development of female reproductive organs
C. Preparation of the uterus to receive a fertilized ovum
D. Establishment of the secondary male sex characteristics

68. During the process of gametogensis, the male and female sex cells divide, and each mature sex cell contains:
A. Twenty-two pairs of autosomes in their nuclei
B. Forty-six pairs of chromosomes in their nuclei
C. A diploid number of chromosomes in their nuclei
D. A haploid number of chromosomes in their nuclei

69. The placenta does not produce:

A. Somatotropin C. Follicle-stimulating hormone
B. Chorionic gonadotropin D. Progesterone precursor substances

70. The developing cells are called a fetus from the:

A. Time the fetal is heard
B. Eight week to the time of birth
C. Implantation of the fertilized ovum
D. End of the second week to the onset of labor

71. During pregnancy the volume of tidal air increases because there is:
A. An increase in total blood volume
B. Increased expansion of the lower ribs
C. Upward displacement of the diaphragm
D. A relative increase in the height of the rib cage

72. The uterus rises out of the pelvis and becomes an abdominal organ at about the:
A. Tenth week of pregnancy C. Twelfth week of pregnancy
B. Eight week of pregnancy D. Eighteenth week of pregnancy

73. First fetal movement felt by the mother are known as:
A. Lightening C. Ballottement
B. Quickening D. Engagement

74. In prenatal development, fetal weight gain is greatest in the:

A. First trimester C. Second trimester
B. Third trimester D. Implantation trimester

75. After the first 3 months of pregnancy the chief source of estrogen and progesterone is the:
A. Placenta C. Corpus luteum
B. Adrenal cortex D. Anterior hypophysis

76. In fetal blood vessels the oxygen content is highest in the:

A. Umbilical artery C. Pulmonary artery
B. Ductus venosus D. Ductus Arteriosus

77. A client relates that the first day of her last menstrual period was July 22. the estimated date of birth would be:
A. May 5 C. April 15
B. May 14 D. April 29

78. Anticipatory guidance during the first trimester of pregnancy is primarily directed toward increasing the
pregnancy woman’s knowledge of:
A. Labor and delivery
 B. Signs of complications
C. Role transition into parenthood
D. Physical changes resulting from pregnancy

79. The anterior/posterior diameter of the pelvic inlet is an important measurement of the pelvic and is known as
the:
A. Conjugate vera C. Transverse diameter
B. Diagonal conjugate D. Transverse conjugate

80. During pregnancy, the uterine musculature hypertrophies and is, greatly stretched as the fetus grows. This
stretching:
A. By itself inhibits uterine contraction until oxytocin stimulates the birth process
B. Is prevented from stimulating uterine contraction by high levels of estrogen during late pregnancy
C. Inhibits uterine contraction along with the combined inhibitory effects of estrogen and progesterone
D. Would ordinarily stimulate uterine contraction but is prevented by high levels of progesterone during
pregnancy
81. The nurse recognizes that a normal, expected change in the hematologic system that occurs during the
second trimester of pregnancy is:
A. A decrease in WBCs C. An increase in blood volume
B. An increase in hematocrit D. A decrease in sedimentation rate

82. The nurse is aware that a normal adaptation of pregnancy is an increased blood supply to the pelvic region
that results in a purplish discoloration of the vaginal musoca, which is known as:
A. Ladin’s sign C. Goodell’s sign
B. Hegar’s sign D. Chadwick’s sign

83. Physiologic anemia during pregnancy is a result of:

A. Decreased dietary intake of iron
B. Increased plasma volume of the mother
C. Decreased erythropoiesis after the first trimester
D. Increased detoxification demands on the mother’s liver

84. On a first prenatal visit, a client asks the nurse, “Is it true the doctor will do an internal examination today?”
The nurse should respond:
A. “Yes, an internal is done on all mothers on the first visit.”
B. “Are you fearful of having on internal examination done?”
C. “Yes. Have you ever had an internal examination done before?”
D. “Yes, an internal is done on all mothers, but it is only slightly uncomfortable.”
85. A normal cardiopulmonary symptom experienced by most pregnant women is:
A. Tachycardia C. Progressive dependent edema
B. Dyspnea at rest D. Shortness of breath on exertion

86. A client asks the nurse why menstruation ceases once pregnancy occurs. The nurse’s best response would
be that this occurs because of the:
A. “Reduction in the secretion of hormones by the ovaries.”
B. “Production of estrogen and progesterone by the ovaries.”
C. “Secretion of luteinizing hormone produced by the pituitary.”
D. “Secretion of follicle-stimulating hormone produced by the pituitary.”

87. The nurse is aware that the nausea and vomiting commonly experienced by many women during the first
trimester of pregnancy is an adaptation to the increase level of:
A. Estrogen C. Luteinizing hormone
B. Progesterone D. Chorionic gonadotropin

88. A pregnant client works as a keypunch operator. This would necessarily have implications for her plan of care
during pregnancy. The nurse should recommend that the client:
A. Try to talk about every few hours during the workday
B. Ask for time in the morning and afternoon to elevate her legs
C. Tell her employer she cannot work beyond the second trimester
D. Ask for time in the morning and afternoon to obtain nourishment

89. The nurse in the prenatal clinic should provide nutritional counseling to all newly pregnant women because:
A. Most weight gain during pregnancy is fluid retention
B. Dietary allowances should not increase during pregnancy
C. Pregnant women must adhere to a specific pregnancy diet
D. Different sources of essential nutrients are favored by different cultural groups

90. A primigravida in her tenth week of gestation is concerned because she has read that nutrition during
pregnancy is important for proper growth and development of the baby. 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 so she can better plan her meals
D. Emphasize the importance of limiting salt and highly seasoned food
91. A client, in her eight week of pregnancy, complains of having to go to the bathroom often to urinate. The
nurse explains to the client that urinary frequency often occurs because the capacity of the bladder during
pregnancy is diminished by:
A. Atony of the detrusor muscle
B. Compressionjby the enlarging uterus
C. Compromise of the automatic reflexes
D. Constriction of the ureteral entrance at the trigone

92. A client who is 10 weeks pregnant calls the clinic and complaints 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-carbohydrates

93. When attending the prenatal clinic, a newly pregnant client, having her first child, expresses concern about
her “dark nipples” and a “dark line” from her navel to the pubis. The nurse explains that these adaptations are
due to hyperactivity of the:
A. Ovaries C. Adrenal gland
B. Thyroid gland D. Pituitary gland

94. The nurse can try to help a pregnant client overcome first-trimester morning sickness by suggesting that the
client:
A. Eat protein before sleep
B. Take an antacid before bedtime
C. Eat nothing until the nausea subsides
D. Request her care provider to prescribe an antiemetic

95. Nutritional planning for a newly pregnant woman of average height weighing 130 pounds should include:
A. A decrease to 1000 calories per day
B. A decrease in fat and protein consumption
C. An increase to 1800 to 2000 calories per day
D. An increase in caloric intake to 2800 calories per day

96. A client is concerned about gaining weight during pregnancy. The nurse explains that the largest part of
weight gain during pregnancy is because of:
A. The fetus C. Metabolic alterations
B. Fluid retention D. Increased blood volume

97. A client who is pregnant for the first time attends the prenatal clinic. She tells the nurse, “I’m worried about
gaining too much weight because I have heard that it is bad for me.” The nurse’s best response would be:
A. “Yes, weight gain causes compilations during pregnancy.”
B. “If you gain over 15 pounds, you’ll have to follow a low-calorie diet.”
C. “We are more concerned if you don’t gain enough weight to ensure proper growth of your baby.”
D. “A 25-pound weight gain is recommended; however, the pattern of your weight gain will be of more
importance that the total amount.”

98. A client, 7 weeks pregnant, confides to the nurse in the prenatal clinic that she is very sick every morning with
nausea and vomiting and is sure that she is being punished for having initially thought of aborting pregnancy.
The nurse assures her that this is not punishment but a common occurrence in early pregnancy and will
probably disappear by the end of the:
A. 5th month B. 4th month C. 3rd month D. 2nd month
99. A client who is pregnant is being prepared for a pelvic examination. The client complains of feeling very tired
and sick to her stomach, especially in the morning. The best response for the nurse to make is:
A. “This is common. There is no need to worry.”
B. “Can you tell me how you feel in the morning?”
C. “Perhaps you might ask the nurse midwife about it.”
D. “Let’s discuss some ways to deal with these common problems.”

100. During a prenatal examination the nurse draws blood from a young client and explains that the
determination of Rh is routinely performed on expectant mothers to predict whether the fetus is at risk for
developing:
A. Acute hemolytic anemia C. Physiologic hyperbilirubinemia
B. Protein metabolism deficiency D. Respiratory distress syndrome