1. A nurse is collecting date from a pregnant client. The hold the growing baby.
ing baby. It contracts during labor to push the
client asks the nurse about the purpose of the fallopian
tubes. The nurse responds to the client, knowing that the
fallopian tubes:
a. Secrete estrogen and progesterone (The
ovaries maintain the health of the female reproductive
system. They secrete two main hormones—estrogen and
progesterone.)
b. Are the organ of copulation (female: The
vagina is the female organ for copulation (sexual
intercourse), Male: The penis. The penis, the male organ of
copulation, is partly inside and partly outside the body.)
C. Are where the fetus develops (uterus, the
blastocyst implants in the wall of the uterus, where it
develops into an embryo attached to a placenta and
surrounded by fluid-filled membranes.)
d. Are where the fertilization occurs
ANS. C (Each Fallopian tube is a hallow muscular tube that
transport a mature oocyte for final maturation and
fertilization. Fertilization typically occurs near the boundary
between the ampulla and the isthmus of the tube.)
2. A nursing instructor has given a lecture on the
reproductive cycle of the female asks a nursing student to
identify the anatomical structure that supports and protects
the internal reproductive organs. The student correctly
responds by identifying which structure?
a. Ovaries (produce and store ovum and make
hormones that control your menstrual cycle and pregnancy)
b. Pelvis
c. Vagina ( It's the pathway (the birth canal) through
which a baby leaves a woman's body during childbirth)
d. Fallopian tubes (where fertilization occurs)
ANS. B (supports and protects the internal reproductive
organs)
3. A nurse is providing information to a client on the female
reproductive system. While discussing the uterus and it's
different layers, the unique muscle fibers that make it
ideally suited for the birth process. The nurse would
describe this layer to the client as:
a. The inner layer of the muscle that is in the uterus
(Endometrium. This is the inner lining. It is shed during your
period.)
b. The middle layer of thick muscle in the uterus C.
The outer layer of muscle that covers most of the uterus
(Perimetrium is the outer serous layer of the uterus. The
serous layer secretes a lubricating fluid that helps to reduce
friction.
d. The functional layer that lies above the basal
layer of the uterus (The endometrium two layers: During the
menstrual cycle, stratum functionalis (expands and
vascularizes and is subsequently sloughed off and stratum
basalis (remains relatively constant)
ANS. B (Myometrium. This is the thick middle muscle layer
of the corpus or fundus. This expands during pregnancy to
baby out.)
4. When performing a pelvic examination, the nurse
observes red swollen area on the right side of the vaginal
orifice. The nurse would document this as enlargement of
which of the following?
a. Clitoris (The clitoris is female erectile tissue
found in the perineal area above the urethra)
b. Parotid gland (parotid glands are open into the
mouth)
c. Skene's gland (Skene’s glands open into the
posterior wall of the female urinary meatus)
d. Bartholin's gland
ANS. D (D. Bartholin’s glands are the glands on either side
of the vaginal orifice)
5. A nursing student is assigned to care for an adolescent
female client in the health care clinic. The instructor reviews
the menstrual cycle with the student. The instructor
determines that the student understands the process of
secretion of the follicle stimulating hormone (FSH) and the
leuteinizing hormone (LH)bif the student states:
a. FSH and LH are released from the anterior
pituitary gland b. FSH and LH are secreted by the corpus
luteum of the ovary (secretes estrogens and progesterone
c. FSH and LH are secreted by the adrenal glands
(secretes steroid hormones such as cortisol and
aldosterone.
d. FSH and LH stimulate the formation of milk
during pregnancy (Suckling stimulates an increase in
prolactin levels, important for initiation of milk production,
maintenance of milk production)
ANS. A (six major hormones: (1) prolactin (PRL), (2) growth
hormone (GH), (3) adrenocorticotropic hormone (ACTH),
(4) luteinizing hormone (LH), (5) follicle-stimulating
hormone (FSH), and (6) thyroid-stimulating hormone (TSH)
(Table 401e-1).
6. A couple trying to conceive asks the nurse when
ovulation occurs. The woman reports a regular 32 day
cycle. Which response by the nurse is correct?
a. Days 7-10
b. Days 10-13
c. Days 14-16
d. Days 17-19
ANS. B (10 - 16 days before period starts)
7. When teaching a group of pregnant teens about
reproduction and conception, the nurse is correct when
stating that fertilization occurs:
a. In the uterus
b. When the ovum is released
c. Near the fimbriated end
d. In the first thir of the fallopian tube
ANS. D (In the first third of the fallopian tube.
Fertilization occurs in the first third of the fallopian tube.
After ovulation, an ovum is released by the ovary into the
abdominopelvic cavity. It enters the fallopian tube at the
fimbriated end and moves through the tube on the way to
the uterus. Sperm cells "swim up" the tube and meet the
ovum in the first third of the fallopian tube. The fertilized
ovum then travels to the uterus and implants. Nurses must
know where fertilization occurs because of the risk of an
ectopic pregnancy.)
8. When teaching a group of adolescents about variations
in the length of the menstrual cycle, the nurse understands
that the underlying mechanism is due to variations in which
of the following phases?
a. Menstrual phase (The menstrual, secretory and
ischemic phases do not contribute to this variation)
b. Proliferative phase (The first phase of the
menstrual cycle, occurs from day one to day 14 of the
menstrual cycle, based on the average duration of 28
days.)
c. Secretory phase
d. Ischemic phase
ANS. B. (Variations in the length of the menstrual cycle are
due to variations in the proliferative phase)
9. Spinnbarkeit is an indicator of ovulation which is
characterized as:
a. Thin watery mucus which can be stretched into a
long strand about 10 cm
b. Thick mucus that is detached from the cervix
during ovulation (cervical mucus)
c. Thin mucus that is yellowish in color with fishy
odor (Trichomoniasis Frothy, yellow discharge may be a
sign of trichomoniasis, a type of sexually transmitted
infection (STI).)
d. Thick mcus vaginal discharge influence by high
level of estrogen (When levels are high (estrogen,
stimulates cervix) vaginal discharge can result from
normal changes in estrogen levels.
ANS. A (Similar to raw egg white
consistency. Stretchable. At the time of ovulation,
you have 2 or 3 days of egg white cervical mucus and
then temperature will take a little dip)
10. When teaching a group of adolescents about male
hormone production, which of the following would the nurse
include as being produced by the Leydig's cells?
a. Follicle-stimulating hormone
b. Testosterone
c. Leutineizing hormone
d. Estrogen
ANS. B (testosterone and androgens)
11. A client scheduled for amniocentesis. When preparing
her for the procedure, the nurse should do which of the
following?
a. Ask her to void
b. Instruct her to drink 1L of fluid
c. Prepare her for 1.V. anesthesia
d. Place her on her left side
12. A postartum client admits to alcohol use throughout the
pregnancy. Which of the following newborn assessments
suggests to the nurse that the infant has fetal alcohol
syndrome?
a. Growth retardation is evident
b. Mlultiple anomalies are identified
c. Cranial facial abnormalities are noted
d. Prune belly syndrome is suspected
13. The nurse uses nitrazine paper to determine whether a
pregnant client's membranes have ruptured. If the
membranes have ruptures, the paper will turn which color?
a. Pink
b. Blue
c. Yellow
d. Green
14. The nurse is obtaining a prenatal history from a client
who's 8 weeks pregnant. To help determine whether the
client who's 8 weeks pregnant. To help determine whether
the client is at risk for a TORCH infection, the nurse should
ask: a. Have you ever had osteomyelitis? b. Do you have
any cats at home? Do you have any birds at home C. d.
Have you recently had a rubeola vaccination 15. Which of
the ff. refers to the single cell that reproduces itself after
conception? a. Chromosome c. Zygote b. Blastocyst 16. A
nurse is providing instructions to a pregnant client who is
scheduled for an amniocentesis. The d. Trophoblast nurse
tells the client that: a. Strict bed rest is required ff the
procedure b. An informed consent will need to be signed
before the procedure c. Hospitalization is necessary for 14
hours ff the procedure d. A fever is expected ff the
procedure because of the trauma to the abdomen 17. A
pregnant client in the first trimester calls a nurse at a health
care clinic and reports that she has a thin, colorless, vaginal
drainage. The nurse should make which statement to the
client? a. Come to the clinic immediately b. Report to the
emergency room at the maternity center immediately c. The
vaginal discharge may be bothersome but is a normal
occurrence d. Use tampons if the discharge is bothersome
but to be sure to change the tampons every 2 hours 18. A
nurse is conducting a prenatal class on the female
reproductive system. When a client in the class asks why
the fertilized ovum stays in the fallopian tube for 3 days, the
nurse responds that the reason for this is that it: a.
Promotes the fertilized ovum's chances of survival b.
Promotes the fertilized ovum's exposure to estrogen and
progesterone c. Promotes the fertilized ovum's normal
implantation in the top portion of the uterus d. Promotes the
fertilized ovum;s exposure to luteinizing hormone (LH) and
follicle stimulating hormone (FSH) 19. A nurse explains
some of the purposes of the placenta to a client during a
prenatal visit. The nurse determines that the client
understands some of these purposes when she states that
the placenta: a. Cushions and protects the baby b.
Maintains the temperature of the baby c. Is the way the
baby gets food and oxygen d. Prevents all antibodies and
viruses from passing to the baby 20. A pregnant client tells
the clinic nurse that she wants to know the sex of the baby
as soon as it can be determined. The nurse knows that the
client should be able to find at 12 weeks gestation because
by the end of the twelfth week: a. The sex of the baby can
be determined by the appearance of the external genitalia
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b. The sex of the baby can be determined because the
external genitalia begin to differentiate c. The sex of the
baby can be determined because the testes are descended
into the scrotal sac d. The sex of the baby can be
determined because the internal differences in males and
females become apparent 21. A nurse is providing
instructions to a pregnant client with genital herpes about
the measures that are needed to protect the fetus. The
nurse tells the client that: a. Total abstinence from sexual
intercourse is necessary during the entire pregnancy b. A
caesarean section will be necessary if vaginal lesions are
present at the time of labor c. Sitz baths need to be taken
every 4 hours while awake if vaginal lesions are present d.
Daily administration of acyclovir (Zovirax) is necessary
during the entire pregnancy 22. A nurse is performing an
assessment on a client who is at 38 weeks gestation and
notes that the fetal heart rate (FHR) is 174 beats/min. On
the basis of this finding, the appropriate nursing action is to;
a. Notify the physician b. Document the finding c. Check the
mother's heart rate d. Tell the client that the fetal heart rate
is normal 23. To differentiate as a female, the hormonal
stimulation of the embryo that must occur involves which of
the ff? a. Increase in maternal estrogen secretion b.
Decrease in maternal androgen secretion c. Secretion of
androgen by the fetal gonad d. Secretion of estrogen by the
fetal gonad 24. When preparing to listen to the fetal heart
rate at 12 weeks gestation, the nurse would use which of
the ff? a. Stethoscope placed midline at the umbilicus b.
Doppler placed midline at the suprapubic region c.
Fetoscope placed midway between the umbilicus and the
xiphoid process d. External electronic fetal monitor plaed at
the umbilicus 25. The pregnant client who is anemic tells
the nurse that she is concerned about her baby's condition
ff delivery. The nurse makes which statement that will best
address the client's concern? a. You will not have any
problems if you follow all the advice the doctor has given
you b. Your baby will need to spend a few days in the
neonatal intensive care unit following delivery c. Don't worry
about your baby, complications are rare d. The effects of
anemia on your baby are difficult to predict, but let's review
your plan of care to assure you are providing the best
nutrition and growth potential 26. A nurse is gathering data
from the pregnant client about potential maternal
physiological risk factors. The nurse would be sure to
obtain data about which of the ff at this time? a. Self-care
needs c. Support systems
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b. Weight d. Life-stress 27. When questioned, a pregnant
client admits she sometimes has several glasses of wine
with dinner. Her alcohol consumption puts her fetus at risak
of which condition? a. Alcohol addiction c. Down syndrome
d. Learning disability 28. At what gestational age would a
primigravida expect to feel quickening? b. Anencephaly a.
12 weeks c. 20-22 weeks b. 16-18 weeks d. By the end of
the 26th week 29. A woman in her third trimester complains
of severe heartburn. What is appropriate teaching by the
nurse to help the woman alleviate these symptoms? a.
Drinks small amounts of liquids frequently b. Eat the
evening meal just before retiring c. Take sodium
bicarbonate after each meal d. Sleep with head popped on
several pillows 30. A woman whose 10 weeks pregnant
tells the nurse that she's worried about her fatigue and
frequent urination. The nurse should: a. Recognize these
as normal early pregnancy signs and symptoms b.
Question her further about theses sign and symptoms c.
Tell her that she'll need blood work and urinalysis d. Tell
her that she may excessively worried 31. Which of the ff
instructions should the nurse give to a client who's 26
weeks pregnant and complains of constipation? a.
Encourage her to increase her intake of roughage and to
drink at least 6 glasses of water per day b. Tell her to ask
her caregiver for a mild laxative c. Suggest the use of a
over-the-counter stool softener d. Tell her to do the
evaluation unit because constipation may cause
contractions 32. A newly pregnant woman tells the nurse
that she hasn't been taking her prenatal vitamins because
they make her nauseated. In addition to telling the client
how important taking the vitamins are, the nurse should
advice her to: a. Switch brands b. Take the vitamin on a full
stomach c. Take the vitamin with orange juice for better
absorption d. Take the vitamin first thing in the morning 33.
The nurse is caring for a client in the first 4 weeks of
pregnancy. The nurse should expect to collect which
assessment findings? a. Presence of menses b. Uterine
enlargement c. Breast sensitivity d. Fetal heart tones 34. A
pregnant client in her third trimester asks why she needs to
urinate frequently again, as she did during the first
trimester. What should the nurse tell her? infection a. This
symptom is abnormal during the third trimester and may
indicate a urinary tract
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b. This symptom is a normal variation and is easily
managed by limiting fluid intake This symptom is normal
and results from the fetus exerting pressure on the bladder
d. This symptom is abnormal and should subside after the
present 35. A pregnant other asks the nurse whether she
can take castor oil for her constipation. How should the
nurse respond? a. Yes, it produces an adverse effects b.
No it can initiate premature uterine contractions c. No it can
promote sodium retention d. No it can lead to increased
absorption of fat-soluble vitamins 36. A woman whose 10
weeks pregnant tells the nurse that she's worried about her
fatigue and frequent urination. The nurse should:
Recognize these as normal early pregnancy signs and
symptoms Question her further about theses sign and
symptoms c. Tell her that she'll need blood work and
urinalysis d. Tell her that she may excessively worried 37. A
client 11 weeks pregnant is admitted to the facility with
hyperemesis gravidarum. She tells the nurse she has never
known anyone who had such severe morning sickness. The
nurse understands that hyperemesis gravidarum results
from; a. A neurologic disorder b. Inadequate nutrition An
unknown cause d. Hemolysis of fetal red blood cells
(RBCs) 38. A pregnant client asks how she can best
(prepare her 3-year-old son for the upcoming birth of a
sibling. The nurse should make which suggestions? Tell
your son about 1 month before your due date b. Reassure
your son that nothing is going to change Reprimand your
son that nothing is going to change d. Involve your son if he
displays immature behaviour 39. When auscultating the
heart sounds of a client who's 34 weeks pregnant, the
nurse detects a systolic ejection murmur, which action
should the nurse take? Document the finding which is
normal during pregnancy b. Consult with a cardiologist
Contact the client's primary health care provider d. Explain
that this finding may indicate a cardiac disorder 40. A
pregnant client comes to the facility for her first prenatal
visit. After obtaining her heakth history and performing a
physical examination the nurse reviews the client's
laboratory test results. Which findings suggest iron
deficiency anemia? Heb 15 g/L (HCT) 33% b. Heb 13 g
(HCT) 32% Heb10 g/L: (HCT) 35% d. Heb 9 g/: (HCT) 30%
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41. The nurse is caring for a 16 year old pregnant client.
The client is taking an iron supplement What should this
client drink to increase the absorption of iron? a. A glass of
drink c. Liquid antacid d. A glass of orange juice b. A cup of
hot tea 42. While caring for a pregnant adolescent, the
nurse should develop a plan of care that incorporates which
health concern? a. Age of menarche b. Family and home
life c. Healthy eating habits d. Level of emotional maturity
43. A pregnant client is seen in the health care clinic for a
regular prenatal visit. The client tells the nurse that she is
experiencing irregular contractions. The nurse determines
that the client is experiencing Braxton Hicks contractions.
Based on this finding, which nursing action is appropriate?
a. Instruct the client to maintain bed rest for the remainder
of the pregnancy b. Instruct the client that these are
common and may occur throughout the pregnancy C.
Contact the physician d. Call the maternity unit and inform
them that the client will be admitted in a prelabor condition
44. A nursing instructor asks a nursing student to describe
the process of quickening. Which of the following
statements, if made by the student, indicates an
understanding of this term? a. It is irregular, painless
contractions that occur throughout pregnancy b. It is soft
blowing sound that can be heard when the uterus is
auscultated It is the fetal movement that is felt by the
mother d. It is the thinning of the lower uterine segment 45.
A client arrives at the clinic for the first prenatal
assessment. The client tells a nurse that the first day of her
menstrual period was Octoer 19, 2008. Using Nagele's rule,
the nurse determines the estimated date of confinement as:
a. July 12, 2008 b. July 26, 2009 c. August 12, 2009 d.
August 26, 2009 46. During her first prenatal visit, a client
expresses concern about gaining weight. Which of the
following would be the nurse's best action? a. Ask the client
how she feels about gaining weight and provide instructions
about expected weight gain and diet b. Be alert for a
possible eating problem and do a further in-depth
assessment c. Report the client's concerns to her caregiver
d. Ask her to come back to the clinic every 2 weeks for a
weight check 47. A nurse is preparing to perform a fundal
assessment on a postpartum client. The initial nursing
action in performing this assessment is which of the
following? a. Ask the client to turn on her side b. Ask the
client to urinate and empty her bladder c. Massage the
fundus gently before determining the level of fundus
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d. Ask the client to lie on her back with the knees and legs
flat and straight 48. A woman visits her obstetrician for a
pregnancy test that is positive. In taking her history, she
reports that she has been pregnant four times before. She
has two children a home, one of which was born at 32
weeks gestation. She lost a set of twins at 14 weeks and
another baby at 12 weeks, what is her para, gravid and
TPAL? AGS, P4 (F1, P1, A2, 12) b. 65, P2 (T1, P1, A3, 12)
CG3, P2 (T1, P2, A2, L1) d. G3, P4 (T2, P3, A3, L2) 49.
The obstetrician asks the nurse to determine the due date
for a pregnant client on her fist due date for a pregnant
client on her first prenatal visit. The client reports that her
last menstral period began on February 5, 2010 and ended
on February 10, 2010. What is her due date? a. November
5, 2010 b. November 12, 2010 c. November 10, 2010 d.
November 17, 2010 50. A pregnant client is seen in the
health care clinic for a regular prenatal visit. The client tells
the nurse that she is experiencing irregular contractions,
and the nurse determines that the client is experiencing
Braxton Hicks contractions. Which of the following nursing
actions should be appropriate? Instruct the client to
maintain bed rest for the remainder of the pregnancy b.
Instruct the client that these contractions are common and
may occur throughout the c. Contact the physician d. Call
the maternity unit and inform them that the client will be
admitted in a prelabor condition 51. The nurse is assisting
in developing a teaching plan for a client who's about to
enter the third trimester of pregnancy. The teaching plan
should include identification of which danger sign that must
be reported immediately? a. Haemorrhoids b. Blurred vision
c. Dyspnea on exertion d. Increased vaginal mucus 52. A
client, 8 weeks pregnant, has a history of lactose
intolerance. To prevent a nutritional deficiency as a result of
lactose intolerance, the nurse teaches her about lactase
replacement. a. Which teaching point is appropriate? b. Ask
the physician for a lactase prescription that allows unlimited
refills c. Add lactase replacement drops to milk at least 24
hours before drinking it d. Warm milk to room temperature
before adding lactase replacement tablets 53. A nurse
explains the purpose of effleurage to a client in early labor.
The nurse tells the client that effleurage is: a. The
application of pressure to the sacrum to relive a backache
b. A form of biofeedback to enhance bearing down efforts
during delivery
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c. Light stroking of the abdomen to facilitate relaxation
during labor and provide tactile stimulation to the fetus d.
Performed to stimulate uterine activity by contracting a
specific muscle group while other parts of the body rest 54.
Assessment of a pregnant client reveals that she feels very
anxious because of lack of knowledge about giving birth.
The client is in her second trimester. Which intervention by
the nurse is appropriate for this client? a. Provide her with
the information and teach her the skills she'll need to
understand and cope during birth. b. Provide her with
written information about the birthing process. c. Have more
experienced pregnant woman assist her. d. Do nothing in
hopes that she'll begin coping as the pregnancy
progresses. Winner's Blueprint for Achievement: BELIEVE
while others are doubting. PLAN while others are playing
STUDY while others are sleeping. DECIDE while others are
delaying. PREPARE while others are daydreaming. BEGIN
while others are procrastinating WORK while others are
wishing SAVE while other are wasting. LISTEN while others
are talking. SMILE while others are frowning. COMMEND
while others are criticizing. Bar 55. The nurse has been
teaching an apprehensive primipara who has difficulty in
initial nursing of the newborn. What observation at the time
of discharge suggest that initial breast feeding is effective?
a. The mother feels calmer and talks the baby while
nursing. b. The mother awaken the newborn to feed
whenever it falls asleep c. The newborn fall asleep after 3
minutes at the breast d. The newborn refuses the
supplemental bottle of glucose water 56. The nurse is
monitoring the contractions of a woman in labor. A
contraction is recorded as beginning at 10:00 AM and
ending at 10:01 A.M. another begins at 10:15 AM what is
the frequency of the contractions? a. 14 minutes b. 10
minutes c. 15 minutes d. 9 minutes 57. A client is brought to
the labor unit and as the nurse is attaching the fetal heart
monitor, the client's membranes rupture spontaneously.
The nurse immediately.
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a. Monitors the contraction pattern b. Checks the fetal heart
rate (FHR) c Notes the amount, color, and odor of the
amniotic fluid d. Prepares the client for immediate delivery
58. A client, age 19, has an episiotomy to widen her birth
canal. Delivery extends the incision into the anal sphincter.
This complication is called: a. A first degree laceration b. A
second degree laceration CA third degree laceration d. A
fourth degree laceration 59. A nurse is reading the
physician's documentation regarding a pregnant client and
notes that the physician has documented that the client has
a platypelloid pelvic shape. The nurse understands that this
pelvic shape is: a. Rounded and most favorable for a
vaginal birth b. Narrow and oval and not the most favorable
for a vaginal birth Wedge shape and narrow and
nonfavorable for a vaginal birth d. Flat and nonfavorable for
a vaginal birth 60. A maternity nurse inspects the amniotic
fluid from a client following an amniotomy. The nurse.
documents that the amniotic fluid is normal if which of the
following is noted? a. It is light green with no odor b. It is
thick white with no odor c. It is clear and dark amber d. It is
pale with flecks of vernix 61. A nurse is caring for a woman
in labor. The nurse is monitoring the baseline fetal heart
rate (FHR) and would document that the FHR is normal it
which of the following were noted? a. 105 BPM b 150 8PM
e. 170 BPM d. 180 BPM 62. A client has had a midline
episiotomy. In relation to clients with other types of
episiotomies, the nurse anticipates that the client will
generally experience: a. Greater blood loss b. No blood
loss c. greater pain d. less pain 63. A nurse observes a
client following childbirth for normal maternal physiological
changes that are anticipated. The nurse would document
which expected changes in vital sign? a. Altered respiration
b. Increased pulse rate c. Altered level of consciousness d.
Slowed pulse rate
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64. A nurse assisting in the care of a woman in labor should
focus primary attention on which of the following at the
same time of delivery? a. Mother b. Primary health care
provider c. Infant d. Support person Complications of Labor
and delivery 65. The nurse is caring for a client who's on
ritodrine therapy to half premature labor. What condition
indicates an adverse reaction to ritodine therapy? a.
Hypoglycemia c. bradycardia b. Crackles d. hyperkalemia
66. Methylergonovine (Methergine) is prescribed for a client
with postpartum hemorrhage. Before administering the
medication, a nurse contacts the health care provider who
prescribed the medication if which of the following
conditions is documented in the client's medical history? a.
Hypotension c. DM b. Hypothyroidism d. peripheral
Vascular Disease 67. A nurse performs a vaginal
assessment on a pregnant client in labor and notes the
presence of the umbilical cord protruding from the vagina.
The nurse immediately: a. Places a gloved hand into the
vagina and holds the presenting part off of the umbilical
cord b. Transports the client to the delivery room c. Gently
pushes the cord into the vagina d. Summons for help other
staff members 68. A client experiences postpartum
hemorrhage eight hours after the birth of twins. Following
administration of IV fluids and 500 ml of whole blood, her
hemoglobin and hematocrit are within normal limits. She
asks the nurse whether she should continue to breast feed
the infants. Which of the following is based on sound
rationale? a. "Nursing will help contract the uterus and
reduce your risk of bleeding." b. "Breast feeding twins will
take too much energy after the hemorrhage." C. "The blood
transfusion may increase the risks to you and the babies."
d. "Lactation should be delayed until the "real milk" is
secreted." 69. While caring for the client during the first
hour after delivery, the nurse determines that the uterus is
boggy and there is vaginal bleeding. What should be the
nurse's first action? a. check vital sign c. offer a bedpan b.
massage the fundus d. check for perineal lacerations
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70. The clinic nurse is counselling a substance abusing
postpartum client on the risks of continued cocaine use. In
order to provide continuity of care, which nursing diagnosis
is priority? a. Social isolation c. Altered parenting d. Sexual
dysfunction b. Ineffective coping 71. A nurse in the
postpartum unit is assigned to care for a client who
delivered a full term healthy baby. The nurse receives
report and is told that the mother has lost 500 ml of blood
during the delivery. When checking the vital signs, the
nurse notes that the woman's pulse is 90 beats per minute
(BPM) and is weak and thready. This finding would indicate
which of the following to the nurse? a. A normal pulse rate
following delivery b. A normal pulse rate following a loss of
500 ml of blood The mother is very excited about the
delivery of the baby d. This may be a sign of hemorrhage or
shock 72. A nurse is reinforcing instructions to a client who
had an episiotomy during the birthing process. Which
statement by the client would indicate a need for further
instructions? Ca. "I can apply a local anesthetic spray to the
area." b. "I can apply ice to the area." c. "I should tighten
the perineum before I sit and then relax it slowly after being
seated." d. "I should take sitz bath three or four times a day
and test the water temperature to be sure that it is at 115 F.
73. The nurse should anticipate that hemorrhage related to
uterine atony may occur postpartally if this condition was
present during the delivery: a. Excessive analgesia was
given to the mother b. Placental delivery occurred within
thirty minutes after the baby was c. An episiotomy had to be
done to facilitate delivery of the head d. The labor and
delivery lasted for 12 hours 74. A nursing student is
preparing to perform a cardiovascular assessment on a
postpartum client. A nursing instruction asks the student
about the procedure to elicit Homan's sign. Which response
by the nursing student would indicate an understanding of
his assessment technique? a. "I will ask the client to raise
her legs up to her waist and then to lower her legs slowly."
b. "I will ask the client to raise he legs and to try to lower
them against pressure from my hand." c. "I will ask the
client to extend her legs flat on the bed, and I will grasp her
foot and gently dorsiflex it forward." d. "I will ask the client
to extend her legs flat on bed, and I will grasp her foot and
sharply extend it backward." 75. A nurse planning care for a
postpartum client who had a vaginal delivery 2 hours ago.
The client had a midline episiotomy and has several
hemorrhoids. What is the priority nursing diagnosis for this
client? a. Acute pain
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b. Disturbed body image c. Impaired urinary elimination d.
Risk for imbalanced fluid volume 76. A nurse on a
postpartum unit is instructing a client regarding lochia and
the amount of expected lochia drainage. The nurse
instructs the client that the normal amount of lochia may
vary but should never exceed the need for: a. One peripad
a day b. Two peripads a day c. Eight peripads a day d.
Three peripads a day 77. A nurse is developing a plan of
care for a postpartum woman with a small vulvar
hematoma. The nurse indicates which specific intervention
in the plan during the first 12 hours following delivery? a.
Assess vital sign every 4 hours. b. Measure fundal height
every 4hours. c. Prepare an ice pack for application to the
area. d. Inform health care provider of assessment findings,
78. A nurse is providing instructions about measures to
prevent postpartum mastitis to a client who is breastfeeding
her newborn. Which of the following, if stated by the client,
would indicate a need for further instructions? a. "I should
breastfeed every 2-3 hours." b. "I should change the breast
pad frequently." c. "I should wash my hands well before
breast-feeding." d. "I should was my nipples daily with soap
and water." 79. A nurse performs an assessment on a client
who is 4 hours postpartum. The nurse notes that the client
has cool, clammy skin and is restless and excessively
thirsty. The nurse prepares immediately to: a. Begin hourly
pad counts and reassure the client. b. Begin fundal
massage and start oxygen by mask. c. Elevate the head of
the bed and assess vital signs. d. Assess for hypovolemia
and notify the health care provider. 80. In assessing a
postpartum client, the nurse palpates a firm fundus and
observes a constant trickle of bright red blood form the
vagina. What is the most likely cost of these findings? a.
Uterine atony b. Genital laceration c. retained placenta d.
clotting disorder for an a with the cretion of b t erior pituitar,
rum of the ds ong pregn tion Family Planning and
Contraception 81. A couple ask the nurse about risks of
several birth control methods. What is the most appropriate
response by the nurse? a. Norplant is safe and may be
removed easily
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b. Oral contraceptives should not be used by smokers c.
Depo-Provera is convenient with few side effects d. The
IUD gives protection from pregnancy and infection 82.
Vasectomy is a procedure done on a male for sterilization.
The organ involved in this procedure is a. Prostate gland b.
Seminal vesicle c. testes d. Vas deferens S 08 hurse ent
this. d. Bartl ent fer at The le st High Risk Pregnancy 83.
When evaluating a client's knowledge of symptoms to
report during her pregnancy, which statement would
indicate to the nurse that the client understands the
information given to her? a. "I'll report increased frequency
in urination." b. "if I have blurred or double vision, I should
call the clinic immediately." c. "if I feel tired after resting, I
should report it immediately." d. "Nausea should be
reported immediately." 84. A client 12 weeks' pregnant
come to the emergency with abdominal cramping and
moderate vaginal bleeding. Speculum examination reveals
2 to 3 cms cervical dilation. The nurse would document
these findings as which of the following? a. Threatened
abortion b. Imminent abortion c. complete abortion d.
missed abortion 85. A client makes a routine visit to the
prenatal clinic. Although she's 14 weeks pregnant, the size
of the uterus approximates that in an 18 to 20, week
pregnancy. The physician diagnoses gestational
trophoblastic disease and orders ultrasonography. This
nurse expects ultrasonography to reveal: a. An empty
gestational sac b. Grapelike cluster c. A severely
malformed fetus d. Extra uterine pregnancy 86. A nurse is
caring for a client who had a cesarean section to deliver a
nonviable fetus due to abruption placenta. The client
develops signs of disseminated intravascular coagulopathy
(DIC). The spouse asks the nurse what is happening, and
the nurse explains the condition. The spouse becomes
upset and says to the nurse, "I lost my baby and now my
wife? What am I going to do?" which problem most
appropriately addresses the situation? a. Grieving related to
loss of the baby b. Deficient knowledge related to the
disease process C. Anxiety related to the reason the baby
died d. Hopelessness related to the loss of baby and illness
of the spouse 87. The nursing assessment a client for signs
and symptoms of ectopic pregnancy. What is the most
common finding associated with this antepartum
complication?
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a. Temperature elevation b. Vaginal bleeding c. nausea and
vomiting d. abdominal pain 88. A nurse planning care for a
client with placental abruption would plan to: a. Prepare the
client for cesarean birth b. Administer frequent enemas until
clear c. Prepare the client for a stress test d. Reposition the
client to the left side 89. The nurse is caring for a client after
evacuation of a hydatidiform molar pregnancy. The nurse
should tell the woman to: a. Wait 1 month before trying to
become pregnant again b. Make an appointment for follow
up human chorionic gonadotropin (HCG) level monitoring at
the end of 1 year. c. Discuss options for sterilization with
the physician d. Use birth control for at least 1 year 90.
What is the primary nursing diagnosis for a client with
ruptured ectopic pregnancy? a. Anxiety b. Pain c. fluid
volume deficit d. anticipatory grieving 91. A nurse
overhears that a prenatal client is at risk for placental
abruption. The nurse would expect to find which risk factor
documented in the client's record? a. Gestational diabetes
c. maternal hypertension d. oliguria b. Hyperemesis
gravidarum 92. The client calls the nurse hotline to ask for
advice. She states "I have had the worst headache for the
past 2 days. It pounds and by the middle of the afternoon
everything I look at looks wavy. Nothing I have taken
helps." What should the nurse do next? a. Advise the client
that the swings in her hormones may have that effect.
However, suggest for her to call her health care provider
within the next day. b. Advise the client to have someone
bring her to the emergency room as soon as possible c.
Ask the client to stay on the line, get the address and send
an ambulance to the home d. Ask what the client has
taken? How often? Ask about other specific complaints. 93.
A nurse assessing the newborn of a mother with diabetes
understand that hypoglycemia is related to what
pathophysiological process? a. Disruption of fetal glucose
supply b. Pancreatic insufficiency c. Maternal insulin
dependency d. Reduced glycogen reserves
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94. The nursing is teaching a client who's 28 weeks
pregnant and has gestational diabetes how to control her
blood glucose levels. Diet therapy alone has been
unsuccessful in controlling this client's blood glucose levels,
so she has started insulin therapy. The nurse should
consider the teaching effective when the client says: a. "I
won't use insulin if I'm sick b. "I need to use insulin each
day" c. "if I give myself an insulin injection, don't need to
watch what eat." d. "I'll monitor my blood glucose levels
twice a week." 95. a client has meconium-stained amniotic
fluid. Fetal scalp sampling indicates a blood pH of 7.12;
fetal bradycardia is present. Based take which action? a.
Administer amnioinfusion b. Prepare for caesarian delivery
c. Reposition the client d. Start I.V oxytocin infusion as
prescribed 96. A client in her 15th week of pregnancy has
presented with abdominal cramping and vaginal bleeding
for the past 8 hours. She has passed several clots. What is
the primary nursing diagnosis for his client? a. Knowledge
deficit b. Fluid volume deficit c. anticipatory grieving d. pain
97. A woman in her 34" week of pregnancy presents with
sudden onset of bright red vaginal bleeding. Her uterus is
soft, and she's experiencing no pain. Fetal heart rate is 120
beats/minute. Based on history above, the nurse should
suspect which of the following conditions? a. Abruption
placenta b. Preterm labor c. placenta previa d. threatened
abortion Infertility and Vital Statistics 98. A client comes to
the clinic for treatment of recurrent pelvic inflammatory
disease. The nurse recognizes that this condition most
frequently follows which type of infection? a.
Trichomoniasis b. Chlamydia c. staphylococcus d.
streptococcus 99. Infertility can be attributed to male
causes such as the following, EXCEPT: a. Cryptorchidism
b. Orchitis C. Sperm count of about 20 million per milliliter
d. Premature ejaculation 100. When describing dizygotic
twins to a couple, on which of the following would the nurse
base the explanation?

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a. Tow ova fertilized by separate sperm b. Sharing of a

common placenta c. Each ova with the same genotype d.
Sharing of a common chorion

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