Midterm Practice Exam PDF

1\. For the client who is using oral contraceptives, the nurse informs the client about the need to take the pill at the same time each day to accomplish which of the following? A. Decrease the incidence of nausea B. Maintain hormonal levels C. Reduce side effects D. Prevent drug interactions 2\. When teaching a client about contraception. Which of the following would the nurse include as the most effective method for preventing sexually transmitted infections? A. Spermicides B. Diaphragm C. Condoms D. Vasectomy 3\. When preparing a woman who is 2 days postpartum for discharge, recommendations for which of the following contraceptive methods would be avoided? A. Diaphragm B. Female condom C. Oral contraceptives D. Rhythm method 4\. For which of the following clients would the nurse expect that an intrauterine device would not be recommended? A. Woman over age 35 B. Nulliparous woman C. Promiscuous young adult D. Postpartum client 5\. A client in her third trimester tells the nurse, "I'm constipated all the time!" Which of the following should the nurse recommend? A. Daily enemas B. Laxatives C. Increased fiber intake D. Decreased fluid intake 6\. Which of the following would the nurse use as the basis for the teaching plan when caring for a pregnant teenager concerned about gaining too much weight during pregnancy? A. 10 pounds per trimester B. 1 pound per week for 40 weeks C. ½ pound per week for 40 weeks D. A total gain of 25 to 30 pounds 7\. The client tells the nurse that her last menstrual period started on January 14 and ended on January 20. Using Nagele's rule, the nurse determines her EDD to be which of the following? A. September 27 B. October 21 C. November 7 D. December 27 8\. When taking an obstetrical history on a pregnant client who states, "I had a son born at 38 weeks gestation, a daughter born at 30 weeks gestation and I lost a baby at about 8 weeks,"the nurse should record her obstetrical history as which of the following? A. G2 T2 P0 A0 L2 B. G3 T1 P1 A0 L2 C. G3 T2 P0 A0 L2 D. G4 T1 P1 A1 L2 9\. When preparing to listen to the fetal heart rate at 12 weeks' gestation, the nurse would use which of the following? 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 placed at the umbilicus 10\. When developing a plan of care for a client newly diagnosed with gestational diabetes, which of the following instructions would be the priority? A. Dietary intake B. Medication C. Exercise D. Glucose monitoring 11\. A client at 24 weeks gestation has gained 6 pounds in 4 weeks. Which of the following would be the priority when assessing the client? A. Glucosuria B. Depression C. Hand/face edema D. Dietary intake 12\. A client 12 weeks' pregnant come to the emergency department 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 13\. Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy? A. Risk for infection B. Pain C. Knowledge Deficit D. Anticipatory Grieving 14\. Before assessing the postpartum client's uterus for firmness and position in relation to the umbilicus and midline, which of the following shouldthe nurse do first? A. Assess the vital signs B. Administer analgesia C. Ambulate her in the hall D. Assist her to urinate 15\. Which of the following should the nurse do when a primipara who is lactating tells the nurse that she has sore nipples? A. Tell her to breast feed more frequently B. Administer a narcotic before breast feeding C. Encourage her to wear a nursing brassiere D. Use soap and water to clean the nipples 16\. The nurse assesses the vital signs of a client, 4 hours' postpartum that are as follows: BP 90/60; temperature 100.4ºF; pulse 100 weak, thready; R 20 per minute. Which of the following shouldthe nurse do first? A. Report the temperature to the physician B. Recheck the blood pressure with another cuff C. Assess the uterus for firmness and position D. Determine the amount of lochia 17\. The nurse assesses the postpartum vaginal discharge (lochia) on four clients. Which of the following assessments would warrant notification of the physician? A. A dark red discharge on a 2-day postpartum client B. A pink to brownish discharge on a client who is 5 days postpartum C. Almost colorless to creamy discharge on a client 2 weeks after delivery D. A bright red discharge 5 days after delivery 18\. A postpartum client has a temperature of 101.4ºF, with a uterus that is tender when palpated, remains unusually large, and not descending as normally expected. Which of the following shouldthe nurse assess next? A. Lochia B. Breasts C. Incision D. Urine 19\. Which of the following is the priority focus of nursing practice with the current early postpartum discharge? A. Promoting comfort and restoration of health B. Exploring the emotional status of the family C. Facilitating safe and effective self-and newborn care D. Teaching about the importance of family planning 20\. Which of the following actions would be least effective in maintaining a neutral thermal environment for the newborn? A. Placing infant under radiant warmer after bathing B. Covering the scale with a warmed blanket prior to weighing C. Placing crib close to nursery window for family viewing D. Covering the infant's head with a knit stockinette 21\. A newborn who has an asymmetrical Moro reflex response should be further assessed for which of the following? A. Talipes equinovarus B. Fractured clavicle C. Congenital hypothyroidism D. Increased intracranial pressure 22\. During the first 4 hours after a male circumcision, assessing for which of the following is the priority? A. Infection B. Hemorrhage C. Discomfort D. Dehydration 23\. The mother asks the nurse. "What's wrong with my son's breasts? Why are they so enlarged?" Whish of the following would be the best response by the nurse? A. "The breast tissue is inflamed from the trauma experienced with birth" B. "A decrease in material hormones present before birth causes enlargement," C. "You should discuss this with your doctor. It could be a malignancy" D. "The tissue has hypertrophied while the baby was in the uterus" 24\. Immediately after birth the nurse notes the following on a male newborn: respirations 78; apical hearth rate 160 BPM, nostril flaring; mild intercostal retractions; and grunting at the end of expiration. Which of the following shouldthe nurse do? A. Call the assessment data to the physician's attention B. Start oxygen per nasal cannula at 2 L/min. C. Suction the infant's mouth and nares D. Recognize this as normal first period of reactivity 25\. The nurse hears a mother telling a friend on the telephone about umbilical cord care. Which of the following statements by the mother indicates effective teaching? A. "Daily soap and water cleansing is best" B. 'Alcohol helps it dry and kills germs" C. "An antibiotic ointment applied daily prevents infection" D. "He can have a tub bath each day" 26\. A newborn weighing 3000 grams and feeding every 4 hours needs 120 calories/kg of body weight every 24 hours for proper growth and development. How many ounces of 20 cal/oz formula should this newborn receive at each feeding to meet nutritional needs? A. 2 ounces B. 3 ounces C. 4 ounces D. 6 ounces 27\. The postterm neonate with meconium-stained amniotic fluid needs care designed to especially monitor for which of the following? A. Respiratory problems B. Gastrointestinal problems C. Integumentary problems D. Elimination problems 28\. When measuring a client's fundal height, which of the following techniques denotes the correct method of measurement used by the nurse? A. From the xiphoid process to the umbilicus B. From the symphysis pubis to the xiphoid process C. From the symphysis pubis to the fundus D. From the fundus to the umbilicus 29\. A client with severe preeclampsia is admitted with of BP 160/110, proteinuria, and severe pitting edema. Which of the following would be most important to include in the client's plan of care? A. Daily weights B. Seizure precautions C. Right lateral positioning D. Stress reduction 30\. A postpartum primipara asks the nurse, "When can we have sexual intercourse again?" Which of the following would be the nurse's best response? A. "Anytime you both want to." B. "As soon as choose a contraceptive method." C. "When the discharge has stopped and the incision is healed." D. "After your 6 weeks examination." 31\. When preparing to administer the vitamin K injection to a neonate, the nurse would select which of the following sites as appropriate for the injection? A. Deltoid muscle B. Anterior femoris muscle C. Vastus lateralis muscle D. Gluteus maximus muscle 32\. When performing a pelvic examination, the nurse observes a 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 B. Parotid gland C. Skene's gland D. Bartholin's gland 33\. To differentiate as a female, the hormonal stimulation of the embryo that must occur involves which of the following? 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 34\. A client at 8 weeks' gestation calls complaining of slight nausea in the morning hours. Which of the following client interventions should the nurse question? A. Taking 1 teaspoon of bicarbonate of soda in an 8-ounce glass of water B. Eating a few low-sodium crackers before getting out of bed C. Avoiding the intake of liquids in the morning hours D. Eating six small meals a day instead of thee large meals 35\. The nurse documents positive ballottement in the client's prenatal record. The nurse understands that this indicates which of the following? A. Palpable contractions on the abdomen B. Passive movement of the unengaged fetus C. Fetal kicking felt by the client D. Enlargement and softening of the uterus 36\. During a pelvic exam the nurse notes a purple-blue tinge of the cervix. The nurse documents this as which of the following? A. Braxton-Hicks sign B. Chadwick's sign C. Goodell's sign D. McDonald's sign 37\. During a prenatal class, the nurse explains the rationale for breathing techniques during preparation for labor based on the understanding that breathing techniques are most important in achieving which of the following? A. Eliminate pain and give the expectant parents something to do B. Reduce the risk of fetal distress by increasing uteroplacental perfusion C. Facilitate relaxation, possibly reducing the perception of pain D. Eliminate pain so that less analgesia and anesthesia are needed 38\. After 4 hours of active labor, the nurse notes that the contractions of a primigravida client are not strong enough to dilate the cervix. Which of the following would the nurse anticipate doing? A. Obtaining an order to begin IV oxytocin infusion B. Administering a light sedative to allow the patient to rest for several hour C. Preparing for a cesarean section for failure to progress D. Increasing the encouragement to the patient when pushing begins 39\. A multigravida at 38 weeks' gestation is admitted with painless, bright red bleeding and mild contractions every 7 to 10 minutes. Which of the following assessments should be avoided? A. Maternal vital sign B. Fetal heart rate C. Contraction monitoring D. Cervical dilation 40\. Which of the following would be the nurse's most appropriate response to a client who asks why she must have a cesarean delivery if she has a complete placenta previa? A. "You will have to ask your physician when he returns." B. "You need a cesarean to prevent hemorrhage." C. "The placenta is covering most of your cervix." D. "The placenta is covering the opening of the uterus and blocking your baby." 41\. The nurse understands that the fetal head is in which of the following positions with a face presentation? A. Completely flexed B. Completely extended C. Partially extended D. Partially flexed 42\. With a fetus in the left-anterior breech presentation, the nurse would expect the fetal heart rate would be most audible in which of the following areas? A. Above the maternal umbilicus and to the right of midline B. In the lower-left maternal abdominal quadrant C. In the lower-right maternal abdominal quadrant D. Above the maternal umbilicus and to the left of midline 43\. The amniotic fluid of a client has a greenish tint. The nurse interprets this to be the result of which of the following? A. Lanugo B. Hydramnio C. Meconium D. Vernix 44\. A patient is in labor and has just been told she has a breech presentation. The nurse should be particularly alert for which of the following? A. Quickening B. Ophthalmia neonatorum C. Pica D. Prolapsed umbilical cord 45\. When describing dizygotic twins to a couple, on which of the following would the nurse base the explanation? A. Two ova fertilized by separate sperm B. Sharing of a common placenta C. Each ova with the same genotype D. Sharing of a common chorion 46\. Which of the following refers to the single cell that reproduces itself after conception? A. Chromosome B. Blastocyst C. Zygote D. Trophoblast 47\. In the late 1950s, consumers and health care professionals began challenging the routine use of analgesics and anesthetics during childbirth. Which of the following was an outgrowth of this concept? A. Labor, delivery, recovery, postpartum (LDRP) B. Nurse-midwifery C. Clinical nurse specialist D. Prepared childbirth 48\. A client has a midpelvic contracture from a previous pelvic injury due to a motor vehicle accident as a teenager. The nurse is aware that this could prevent a fetus from passing through or around which structure during childbirth? A. Symphysis pubis B. Sacral promontory C. Ischial spines D. Pubic arch 49\. 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 B. Proliferative phase C. Secretory phase D. Ischemic phase 50\. When teaching a group of adolescents about male hormone production, which of the following would the nurse include as being produced by the Leydig cells? A. Follicle-stimulating hormone B. Testosterone C. Leuteinizing hormone D. Gonadotropin releasing hormone \-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-\-- 1\. You performed the leopold's maneuver and found the following: breech presentation, fetal back at the right side of the mother. Based on these findings, you can hear the fetal heart beat (PMI) BEST in which location? A. Left lower quadrant B. Right lower quadrant C. Left upper quadrant D. Right upper quadrant 2\. In Leopold's maneuver step \#1, you palpated a soft broad mass that moves with the rest of the mass. The correct interpretation of this finding is: A. The mass palpated at the fundal part is the head part. B. The presentation is breech. C. The mass palpated is the back D. The mass palpated is the buttocks. 3\. In Leopold's maneuver step \# 3 you palpated a hard round movable mass at the supra pubic area. The correct interpretation is that the mass palpated is: A. The buttocks because the presentation is breech. B. The mass palpated is the head. C. The mass is the fetal back. D. The mass palpated is the fetal small part 4\. The hormone responsible for a positive pregnancy test is: A. Estrogen B. Progesterone C. Human Chorionic Gonadotropin D. Follicle Stimulating hormone 5\. The hormone responsible for the maturation of the graafian follicle is: A. Follicle stimulating hormone B. Progesterone C. Estrogen D. Luteinizing hormone 6\. The most common normal position of the fetus in utero is: A. Transverse position B. Vertical position C. Oblique position D. None of the above 7\. In the later part of the 3rd trimester, the mother may experience shortness of breath. This complaint maybe explained as: A. A normal occurrence in pregnancy because the fetus is using more oxygen B. The fundus of the uterus is high pushing the diaphragm upwards C. The woman is having allergic reaction to the pregnancy and its hormones D. The woman maybe experiencing complication of pregnancy 8\. Which of the following findings in a woman would be consistent with a pregnancy of two months duration? A. Weight gain of 6-10 lbs. and presence of striae gravidarum B. Fullness of the breast and urinary frequency C. Braxton Hicks contractions and quickening D. Increased respiratory rate and ballottement 9\. Which of the following is a positive sign of pregnancy? A. Fetal movement felt by mother B. Enlargement of the uterus C. (+) pregnancy test D. (+) ultrasound 10\. What event occurring in the second trimester helps the expectant mother to accept the pregnancy? A. Lightening B. Ballotment C. Pseudocyesis D. Quickening 11\. Shoes with low, broad heels, plus a good posture will prevent which prenatal discomfort? A. Backache B. Vertigo C. Leg cramps D. Nausea 12\. When a pregnant woman experiences leg cramps, the correct nursing intervention to relieve the muscle cramps is: A. Allow the woman to exercise B. Let the woman walk for a while C. Let the woman lie down and dorsiflex the foot towards the knees D. Ask the woman to raise her legs 13\. From the 33rd week of gestation till full term, a healthy mother should have prenatal check up every: A. 1 week B. 2 weeks C. 3 weeks D. 4 weeks 14\. The expected weight gain in a normal pregnancy during the 3rd trimester is A. 1 pound a week B. 2 pounds a week C. 10 lbs a month D. 10 lbs total weight gain in the 3rd trimester 15\. In the Batholonew's rule of 4, when the level of the fundus is midway between the umbilicus and xyphoid process the estimated age of gestation (AOG) is: A. 5th month B. 6th month C. 7th month D. 8th month 16\. The following are ways of determining expected date of delivery (EDD) when the LMP is unknown EXCEPT: A. Naegele's rule B. Quickening C. Mc Donald's rule D. Batholomew's rule of 4 17\. If the LMP is Jan. 30, the expected date of delivery (EDD) is A. Oct. 7 B. Oct. 24 C. Nov. 7 D. Nov. 8 18\. Kegel's exercise is done in pregnancy in order to: A. Strengthen perineal muscles B. Relieve backache C. Strengthen abdominal muscles D. Prevent leg varicosities and edema 19\. Pelvic rocking is an appropriate exercise in pregnancy to relieve which discomfort? A. Leg cramps B. Urinary frequency C. Orthostatic hypotension D. Backache 20\. The main reason for an expected increased need for iron in pregnancy is: A. The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal requires about 350-400 mg of iron to grow B. The mother may suffer anemia because of poor appetite C. The fetus has an increased need for RBC which the mother must supply D. The mother may have a problem of digestion because of pica 21\. The diet that is appropriate in normal pregnancy should be high in A. Protein, minerals and vitamins B. Carbohydrates and vitamins C. Proteins, carbohydrates and fats D. Fats and minerals 22\. Which of the following signs will require a mother to seek immediate medical attention? A. When the first fetal movement is felt B. No fetal movement is felt on the 6th month C. Mild uterine contraction D. Slight dyspnea on the last month of gestation 23\. You want to perform a pelvic examination on one of your pregnant clients. You prepare your client for the procedure by: A. Asking her to void B. Taking her vital signs and recording the readings C. Giving the client a perineal care D. Doing a vaginal prep 24\. When preparing the mother who is on her 4th month of pregnancy for abdominal ultrasound, the nurse should instruct her to: A. Observe NPO from midnight to avoid vomiting B. Do perineal flushing properly before the procedure C. Drink at least 2 liters of fluid 2 hours before the procedure and not void until the procedure is done D. Void immediately before the procedure for better visualization 25\. The nursing intervention to relieve "morning sickness" in a pregnant woman is by giving A. Dry carbohydrate food like crackers B. Low sodium diet C. Intravenous infusion D. Antacid 26\. The common normal site of nidation/implantation in the uterus is A. Upper uterine portion B. Mid-uterine area C. Lower uterine segment D. Lower cervical segment 27\. Mrs. Santos is on her 5th pregnancy and has a history of abortion in the 4th pregnancy and the first pregnancy was a twin. She is considered to be A. G 4 P 3 B. G 5 P 3 C. G 5 P 4 D. G 4 P 4 28\. The following are skin changes in pregnancy EXCEPT: A. Chloasma B. Striae gravidarum C. Linea negra D. Chadwick's sign 29\. Which of the following statements is TRUE of conception? A. Within 2-4 hours after intercourse conception is possible in a fertile woman B. Generally, fertilization is possible 4 days after ovulation C. Conception is possible during menstruation in a long menstrual cycle D. To avoid conception, intercourse must be avoided 5 days before and 3 days after menstruation 30\. Which of the following are the functions of amniotic fluid? 1.Cushions the fetus from abdominal trauma 2.Serves as the fluid for the fetus 3.Maintains the internal temperature 4.Facilitates fetal movement A. 1 & 3 B. 1, 3, 4 C. 1, 2, 3 D. All of the above 31\. You are performing abdominal exam on a 9th month pregnant woman. While lying supine, she felt breathless, had pallor, tachycardia, and cold clammy skin. The correct assessment of the woman's condition is that she is: A. Experiencing the beginning of labor B. Having supine hypotension C. Having sudden elevation of BP D. Going into shock 32\. Smoking is contraindicated in pregnancy because A. Nicotine causes vasodilation of the mother's blood vessels B. Carbon monoxide binds with the hemoglobin of the mother reducing available hemoglobin for the fetus C. The smoke will make the fetus and the mother feel dizzy D. Nicotine will cause vasoconstriction of the fetal blood vessels 33\. Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy? A. Large for gestational age (LGA) fetus B. Hemorrhage C. Small for gestational age (SGA) baby D. Erythroblastosis fetalis 34\. Which of the following signs and symptoms will most likely make the nurse suspect that the patient is having hydatidiform mole? A. Slight bleeding B. Passage of clear vesicular mass per vagina C. Absence of fetal heart beat D. Enlargement of the uterus 35\. Upon assessment the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP) 5 months ago, fetal heart beat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition? A. Hydatidiform mole B. Missed abortion C. Pelvic inflammatory disease D. Ectopic pregnancy 36\. When a pregnant woman goes into a convulsive seizure, the MOST immediate action of the nurse to ensure safety of the patient is: A. Apply restraint so that the patient will not fall out of bed B. Put a mouth gag so that the patient will not bite her tongue and the tongue will not fall back C. Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration D. Check if the woman is also having a precipitate labor 37\. A gravido-cardiac mother is advised to observe bedrest primarily to A. Allow the fetus to achieve normal intrauterine growth B. Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother C. Prevent perinatal infection D. Reduce incidence of premature labor 38\. A pregnant mother is admitted to the hospital with the chief complaint of profuse vaginal bleeding, AOG 36 wks, not in labor. The nurse must always consider which of the following precautions: A. The internal exam is done only at the delivery under strict asepsis with a double set-up B. The preferred manner of delivering the baby is vaginal C. An emergency delivery set for vaginal delivery must be made ready before examining the patient D. Internal exam must be done following routine procedure 39\. Which of the following signs will distinguish threatened abortion from imminent abortion? A. Severity of bleeding B. Dilation of the cervix C. Nature and location of pain D. Presence of uterine contraction 40\. The nursing measure to relieve fetal distress due to maternal supine hypotension is: A. Place the mother on semi-fowler's position B. Put the mother on left side lying position C. Place mother on a knee chest position D. Any of the above 41\. To prevent preterm labor from progressing, drugs are usually prescribed to halt the labor. The drugs commonly given are: A. Magnesium sulfate and terbutaline B. Prostaglandin and oxytocin C. Progesterone and estrogen D. Dexamethasone and prostaglandin 42\. In placenta praevia marginalis, the placenta is found at the: A. Internal cervical os partly covering the opening B. External cervical os slightly covering the opening C. Lower segment of the uterus with the edges near the internal cervical os D. Lower portion of the uterus completely covering the cervix 43\. In which of the following conditions can the causative agent pass through the placenta and affect the fetus in utero? A. Gonorrhea B. Rubella C. Candidiasis D. moniliasis 44\. Which of the following can lead to infertility in adult males? A. German measles B. Orchitis C. Chicken pox D. Rubella 45\. Papanicolaou smear is usually done to determine cancer of A. Cervix B. Ovaries C. Fallopian tubes D. Breast 46\. Which of the following causes of infertility in the female is primarily psychological in origin? A. Vaginismus B. Dyspareunia C. Endometriosis D. Impotence 47\. Before giving a repeat dose of magnesium sulfate to a pre-eclamptic patient, the nurse should assess the patient's condition. Which of the following conditions will require the nurse to temporarily suspend a repeat dose of magnesium sulfate? A. 100 cc. urine output in 4 hours B. Knee jerk reflex is (+)2 C. Serum magnesium level is 10mEg/L. D. Respiratory rate of 16/min 48\. Which of the following is TRUE in Rh incompatibility? A. The condition can occur if the mother is Rh(+) and the fetus is Rh(-) B. Every pregnancy of an Rh(-) mother will result to erythroblastosis fetalis C. On the first pregnancy of the Rh(-) mother, the fetus will not be affected D. RhoGam is given only during the first pregnancy to prevent incompatibility WEHO9UCWIECRHO8D7IYUQHO8RUADHOCAUIEFOIURFHeoIUO 1\. A nursing instructor is conducting lecture and is reviewing the functions of the female reproductive system. She asks Mark to describe the follicle-stimulating hormone (FSH) and the luteinizing hormone (LH). Mark accurately responds by stating that: A. FSH and LH are released from the anterior pituitary gland. B. FSH and LH are secreted by the corpus luteum of the ovary C. FSH and LH are secreted by the adrenal glands D. FSH and LH stimulate the formation of milk during pregnancy. 2\. A nurse is describing the process of fetal circulation to a client during a prenatal visit. The nurse accurately tells the client that fetal circulation consists of: A. Two umbilical veins and one umbilical artery B. Two umbilical arteries and one umbilical vein C. Arteries carrying oxygenated blood to the fetus D. Veins carrying deoxygenated blood to the fetus 3\. During a prenatal visit at 38 weeks, a nurse assesses the fetal heart rate. The nurse determines that the fetal heart rate is normal if which of the following is noted? A. 80 BPM B. 100 BPM C. 150 BPM D. 180 BPM 4\. A client arrives at a prenatal clinic for the first prenatal assessment. The client tells a nurse that the first day of her last menstrual period was September 19th, 2013. Using Naegele's rule, the nurse determines the estimated date of confinement as: A. July 26, 2013 B. June 12, 2014 C. June 26, 2014 D. July 12, 2014 5\. A nurse is collecting data during an admission assessment of a client who is pregnant with twins. The client has a healthy 5-year old child that was delivered at 37 weeks and tells the nurse that she doesn't have any history 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 = 0, P = 1, 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 6\. A nurse is performing an assessment of a primipara who is being evaluated in a clinic during her second trimester of pregnancy. Which of the following indicates an abnormal physical finding necessitating further testing? A. Consistent increase in fundal height B. Fetal heart rate of 180 BPM C. Braxton hicks contractions D. Quickening 7\. A nurse is reviewing the record of a client who has just been told that a pregnancy test is positive. The physician has documented the presence of a Goodell's sign. The nurse determines this sign indicates: A. A softening of the cervix B. A soft blowing sound that corresponds to the maternal pulse during auscultation of the uterus. C. The presence of hCG in the urine D. The presence of fetal movement 8\. A nursing instructor asks a nursing student who is preparing to assist with the assessment of a pregnant client 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 the irregular, painless contractions that occur throughout pregnancy." B. "It is the soft blowing sound that can be heard when the uterus is auscultated." C. "It is the fetal movement that is felt by the mother." D. "It is the thinning of the lower uterine segment." 9\. A nurse midwife is performing an assessment of a pregnant client and is assessing the client for the presence of ballottement. Which of the following would the nurse implement to test for the presence of ballottement? A. Auscultating for fetal heart sounds B. Palpating the abdomen for fetal movement C. Assessing the cervix for thinning D. Initiating a gentle upward tap on the cervix 10\. A nurse is assisting in performing an assessment on a client who suspects that she is pregnant and is checking the client for probable signs of pregnancy. Select all probable signs of pregnancy. A. Uterine enlargement B. Fetal heart rate detected by nonelectric device C. Outline of the fetus via radiography or ultrasound D. Chadwick's sign E. Braxton Hicks contractions F. Ballottement 11\. A pregnant client calls the clinic and tells a nurse that she is experiencing leg cramps and is awakened by the cramps at night. To provide relief from the leg cramps, the nurse tells the client to: A. Dorsiflex the foot while extending the knee when the cramps occur B. Dorsiflex the foot while flexing the knee when the cramps occur C. Plantar flex the foot while flexing the knee when the cramps occur D. Plantar flex the foot while extending the knee when the cramps occur. 12\. A nurse is providing instructions to a client in the first trimester of pregnancy regarding measures to assist in reducing breast tenderness. The nurse tells the client to: A. Avoid wearing a bra B. Wash the nipples and areola area daily with soap, and massage the breasts with lotion. C. Wear tight-fitting blouses or dresses to provide support D. Wash the breasts with warm water and keep them dry 13\. A pregnant client in the last trimester has been admitted to the hospital with a diagnosis of severe preeclampsia. A nurse monitors for complications associated with the diagnosis and assesses the client for: A. Any bleeding, such as in the gums, petechiae, and purpura. B. Enlargement of the breasts C. Periods of fetal movement followed by quiet periods D. Complaints of feeling hot when the room is cool 14\. A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement, if made by the client, indicates a need for further education? A. "I will maintain strict bedrest throughout the remainder of pregnancy." B. "I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding." C. "I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad." D. "I will watch for the evidence of the passage of tissue." 15\. A prenatal nurse is providing instructions to a group of pregnant client regarding measures to prevent toxoplasmosis. Which statement if made by one of the clients indicates a need for further instructions? A. "I need to cook meat thoroughly." B. "I need to avoid touching mucous membranes of the mouth or eyes while handling raw meat." C. "I need to drink unpasteurized milk only." D. "I need to avoid contact with materials that are possibly contaminated with cat feces." 16\. A homecare nurse visits a pregnant client who has a diagnosis of mild Preeclampsia 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 the prenatal baseline B. Urinary output has increased C. The client complains of a headache and blurred vision D. Dependent edema has resolved 17\. A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes. Which statement if made by the client indicates a need for further education? A. "I need to stay on the diabetic diet." B. "I will perform glucose monitoring at home." C. "I need to avoid exercise because of the negative effects of insulin production." D. "I need to be aware of any infections and report signs of infection immediately to my health care provider." 18\. A primigravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension (PIH). The nurse who is caring for the client is performing assessments every 30 minutes. Which assessment finding would be of most concern to the nurse? A. Urinary output of 20 ml since the previous assessment B. Deep tendon reflexes of 2+ C. Respiratory rate of 10 BPM D. Fetal heart rate of 120 BPM 19\. A nurse is caring for a pregnant client with Preeclampsia. The nurse prepares a plan of care for the client and documents in the plan that if the client progresses from Preeclampsia to eclampsia, the nurse's first action is to: A. Administer magnesium sulfate intravenously B. Assess the blood pressure and fetal heart rate C. Clean and maintain an open airway D. Administer oxygen by face mask 20\. A nurse is monitoring a pregnant client with pregnancy induced hypertension who is at risk for Preeclampsia. The nurse checks the client for which specific signs of Preeclampsia (select all that apply)? A. Elevated blood pressure B. Negative urinary protein C. Facial edema D. Increased respirations 21\. Rho (D) immune globulin (RhoGAM) is prescribed for a woman following delivery of a newborn infant and the nurse provides information to the woman about the purpose of the medication. The nurse determines that the woman understands the purpose of the medication if the woman states that it will protect her next baby from which of the following? A. Being affected by Rh incompatibility B. Having Rh positive blood C. Developing a rubella infection D. Developing physiological jaundice 22\. A pregnant client is receiving magnesium sulfate for the management of preeclampsia. A nurse determines the client is experiencing toxicity from the medication if which of the following is noted on assessment? A. Presence of deep tendon reflexes B. Serum magnesium level of 6 mEq/L C. Proteinuria of +3 D. Respirations of 10 per minute 23\. A woman with preeclampsia is receiving magnesium sulfate. The nurse assigned to care for the client determines that the magnesium therapy is effective if: A. Ankle clonus in noted B. The blood pressure decreases C. Seizures do not occur D. Scotomas are present 24\. A nurse is caring for a pregnant client with severe preeclampsia who is receiving IV magnesium sulfate. Select all nursing interventions that apply in the care for the client. A. Monitor maternal vital signs every 2 hours B. Notify the physician if respirations are less than 18 per minute. C. Monitor renal function and cardiac function closely D. Keep calcium gluconate on hand in case of a magnesium sulfate overdose E. Monitor deep tendon reflexes hourly F. Monitor I and O's hourly G. Notify the physician if urinary output is less than 30 ml per hour. 25\. 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 only lasted 12 weeks. 26\. In a lecture on sexual functioning, the nurse plans to include the fact that ovulation occurs when the: A. Oxytocin is too high B. Blood level of LH is too high C. Progesterone level is high D. Endometrial wall is sloughed off. 27\. The chief function of progesterone is the: A. Development of the female reproductive system B. Stimulation of the follicles for ovulation to occur C. Preparation of the uterus to receive a fertilized egg D. Establishment of secondary male sex characteristics 28\. The developing cells are called a fetus from the: A. Time the fetal heart is heard B. Eighth week to the time of birth C. Implantation of the fertilized ovum D. End of the send week to the onset of labor 29\. After the first four months of pregnancy, the chief source of estrogen and progesterone is the: A. Placenta B. Adrenal cortex C. Corpus luteum D. Anterior hypophysis 30\. The nurse recognizes that an expected change in the hematologic system that occurs during the 2nd trimester of pregnancy is: A. A decrease in WBC's B. In increase in hematocrit C. An increase in blood volume D. A decrease in sedimentation rate 31\. The nurse is aware than an adaptation of pregnancy is an increased blood supply to the pelvic region that results in a purplish discoloration of the vaginal mucosa, which is known as: A. Ladin's sign B. Hegar's sign C. Goodell's sign D. Chadwick's sign 32\. A pregnant client is making her first Antepartum visit. She has a two year old son born at 40 weeks, a 5 year old daughter born at 38 weeks, and 7 year old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. Using the GTPAL format, the nurse should identify that the client is: A. G4 T3 P2 A1 L4 B. G5 T2 P2 A1 L4 C. G5 T2 P1 A1 L4 D. G4 T3 P1 A1 L4 33\. An expected cardiopulmonary adaptation experienced by most pregnant women is: A. Tachycardia B. Dyspnea at rest C. Progression of dependent edema D. Shortness of breath on exertion 34\. Nutritional planning for a newly pregnant woman of average height and weighing 145 pounds should include: A. A decrease of 200 calories a day B. An increase of 300 calories a day C. An increase of 500 calories a day D. A maintenance of her present caloric intake per day 35\. During a prenatal examination, the nurse draws blood from a young Rh negative client and explain that an indirect Coombs test will be performed to predict whether the fetus is at risk for: A. Acute hemolytic disease B. Respiratory distress syndrome C. Protein metabolic deficiency D. Physiologic hyperbilirubinemia 36\. When involved in prenatal teaching, the nurse should advise the clients that an increase in vaginal secretions during pregnancy is called leukorrhea and is caused by increased: A. Metabolic rates B. Production of estrogen C. Functioning of the Bartholin glands D. Supply of sodium chloride to the cells of the vagina 37\. A 26-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 B. Cardiac defects C. Neural tube defects D. Urinary tract defects 38\. At a prenatal visit at 36 weeks' gestation, a client complains of discomfort with irregularly occurring contractions. The nurse instructs the client to: A. Lie down until they stop B. Walk around until they subside C. Time contraction for 30 minutes D. Take 10 grains of aspirin for the discomfort 39\. The nurse teaches a pregnant woman to avoid lying on her back. The nurse has based this statement on the knowledge that the supine position can: A. Unduly prolong labor B. Cause decreased placental perfusion C. Lead to transient episodes of hypotension D. Interfere with free movement of the coccyx 40\. The pituitary hormone that stimulates the secretion of milk from the mammary glands is: A. Prolactin B. Oxytocin C. Estrogen D. Progesterone 41\. Which of the following symptoms occurs with a hydatidiform mole? A. Heavy, bright red bleeding every 21 days B. Fetal cardiac motion after 6 weeks gestation C. Benign tumors found in the smooth muscle of the uterus D. "Snowstorm" pattern on ultrasound with no fetus or gestational sac 42\. Which of the following terms applies to the tiny, blanched, slightly raised end arterioles found on the face, neck, arms, and chest during pregnancy? A. Epulis B. Linea nigra C. Striae gravidarum D. Telangiectasias 43\. Which of the following conditions is common in pregnant women in the 2nd trimester of pregnancy? A. Mastitis B. Metabolic alkalosis C. Physiologic anemia D. Respiratory acidosis 44\. A 21-year old client, 6 weeks' pregnant is diagnosed with hyperemesis gravidarum. This excessive vomiting during pregnancy will often result in which of the following conditions? A. Bowel perforation B. Electrolyte imbalance C. Miscarriage D. Pregnancy induced hypertension (PIH) 45\. Clients with gestational diabetes are usually managed by which of the following therapies? A. Diet B. NPH insulin (long-acting) C. Oral hypoglycemic drugs D. Oral hypoglycemic drugs and insulin 46\. The antagonist for magnesium sulfate should be readily available to any client receiving IV magnesium. Which of the following drugs is the antidote for magnesium toxicity? A. Calcium gluconate B. Hydralazine (Apresoline) C. Narcan D. RhoGAM 47\. Which of the following answers best describes the stage of pregnancy in which maternal and fetal blood are exchanged? A. Conception B. 9 weeks' gestation, when the fetal heart is well developed C. 32-34 weeks gestation D. maternal and fetal blood are never exchanged 48\. Gravida refers to which of the following descriptions? A. A serious pregnancy B. Number of times a female has been pregnant C. Number of children a female has delivered D. Number of term pregnancies a female has had. 49\. A pregnant woman at 32 weeks' gestation complains of feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. The nurse's initial response would be A. Assess the woman's blood pressure and pulse B. Have the woman breathe into a paper bag C. Raise the woman's legs D. Turn the woman on her side. 50\. A pregnant woman's last menstrual period began on April 8, 2005, and ended on April 13. Using Naegele's rule her estimated date of birth would be: A. January 15, 2006 B. January 20, 2006 C. July 1, 2006 D. November 5, 2005 URYIVFBUGO8WUBECGUIBO8UOIUDHFOIUGFPIUIWUGOIGODIYGOisdugIDYSGCOUYDG 1\. A nurse is caring for a client in labor. The nurse determines that the client is beginning in the 2nd stage of labor when which of the following assessments is noted? A. The client begins to expel clear vaginal fluid B. The contractions are regular C. The membranes have ruptured D. The cervix is dilated completely 2\. A nurse in the labor room is caring for a client in the active phases of labor. The nurse is assessing the fetal patterns and notes a late deceleration on the monitor strip. The most appropriate nursing action is to: A. Place the mother in the supine position B. Document the findings and continue to monitor the fetal patterns C. Administer oxygen via face mask D. Increase the rate of pitocin IV infusion 3\. A nurse is performing an assessment of a client who is scheduled for a cesarean delivery. Which assessment finding would indicate a need to contact the physician? A. Fetal heart rate of 180 beats per minute B. White blood cell count of 12,000 C. Maternal pulse rate of 85 beats per minute D. Hemoglobin of 11.0 g/dL 4\. A client in labor is transported to the delivery room and is prepared for a cesarean delivery. The client is transferred to the delivery room table, and the nurse places the client in the: A. Trendelenburg's position with the legs in stirrups B. Semi-Fowler position with a pillow under the knees C. Prone position with the legs separated and elevated D. Supine position with a wedge under the right hip 5\. A nurse is caring for a client in labor and prepares to auscultate the fetal heart rate by using a Doppler ultrasound device. The nurse most accurately determines that the fetal heart sounds are heard by: A. Noting if the heart rate is greater than 140 BPM B. Placing the diaphragm of the Doppler on the mother abdomen C. Performing Leopold's maneuvers first to determine the location of the fetal heart D. Palpating the maternal radial pulse while listening to the fetal heart rate 6\. A nurse is caring for a client in labor who is receiving Pitocin by IV infusion to stimulate uterine contractions. Which assessment finding would indicate to the nurse that the infusion needs to be discontinued? A. Three contractions occurring within a 10-minute period B. A fetal heart rate of 90 beats per minute C. Adequate resting tone of the uterus palpated between contractions D. Increased urinary output 7\. A nurse is beginning to care for a client in labor. The physician has prescribed an IV infusion of Pitocin. The nurse ensures that which of the following is implemented before initiating the infusion? A. Placing the client on complete bed rest B. Continuous electronic fetal monitoring C. An IV infusion of antibiotics D. Placing a code cart at the client's bedside 8\. A nurse is monitoring a client in active labor and notes that the client is having contractions every 3 minutes that last 45 seconds. The nurse notes that the fetal heart rate between contractions is 100 BPM. Which of the following nursing actions 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 monitoring the fetal heart rate D. Notify the physician or nurse midwife 9\. A nurse is caring for a client in labor and is monitoring the fetal heart rate patterns. The nurse notes the presence of episodic accelerations on the electronic fetal monitor tracing. Which of the following actions is most appropriate? A. Document the findings and tell the 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 or nurse midwife of the findings. D. Reposition the mother and check the monitor for changes in the fetal tracing 10\. A nurse is admitting a pregnant client to the labor room and attaches an external electronic fetal monitor to the client's abdomen. After attachment of the monitor, the initial nursing assessment is which of the following? A. Identifying the types of accelerations B. Assessing the baseline fetal heart rate C. Determining the frequency of the contractions D. Determining the intensity of the contractions 11. A nurse is reviewing the record of a client in the labor room and notes that the nurse midwife has documented that the fetus is at (-1) station. The nurse determines that the fetal presenting part is: A. 1 cm above the ischial spine B. 1 fingerbreadth below the symphysis pubis C. 1 inch below the coccyx D. 1 inch below the iliac crest 12. A pregnant client is admitted to the labor room. An assessment is performed, and the nurse notes that the client's hemoglobin and hematocrit levels are low, indicating anemia. The nurse determines that the client is at risk for which of the following? A. A loud mouth B. Low self-esteem C. Hemorrhage D. Postpartum infections 13. A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse documents these observations as signs of: A. Hematoma B. Placenta previa C. Uterine atony D. Placental separation 14. A client arrives at a birthing center in active labor. Her membranes are still intact, and the nurse-midwife prepares to perform an amniotomy. A nurse who is assisting the nurse-midwife explains to the client that after this procedure, she will most likely have: A. Less pressure on her cervix B. Increased efficiency of contractions C. Decreased number of contractions D. The need for increased maternal blood pressure monitoring 15. A nurse is monitoring a client in labor. The nurse suspects umbilical cord compression if which of the following is noted on the external monitor tracing during a contraction? A. Early decelerations B. Variable decelerations C. Late decelerations D. Short-term variability 16. A nurse explains the purpose of effleurage to a client in early labor. The nurse tells the client that effleurage is: A. A form of biofeedback to enhance bearing down efforts during delivery B. Light stroking of the abdomen to facilitate relaxation during labor and provide tactile stimulation to the fetus C. The application of pressure to the sacrum to relieve a backache D. Performed to stimulate uterine activity by contracting a specific muscle group while other parts of the body rest 17. A nurse is caring for a client in the second stage of labor. The client is experiencing uterine contractions every 2 minutes and cries out in pain with each contraction. The nurse recognizes this behavior as: A. Exhaustion B. Fear of losing control C. Involuntary grunting D. Valsalva's maneuver 18. A nurse is monitoring a client in labor who is receiving Pitocin and notes that the client is experiencing hypertonic uterine contractions. List in order of priority the actions that the nurse takes. ANSWER: A, D, B, E, C A. Stop of Pitocin infusion B. Perform a vaginal examination C. Reposition the client D. Check the client's blood pressure and heart rate E. Administer oxygen by face mask at 8 to 10 L/min 19\. A nurse is assigned to care for a client with hypotonic uterine dysfunction and signs of a slowing labor. The nurse is reviewing the physician's orders and would expect to note which of the following prescribed treatments for this condition? A. Medication that will provide sedation B. Increased hydration C. Oxytocin (Pitocin) infusion D. Administration of a tocolytic medication 20. A nurse in the labor room is preparing to care for a client with hypertonic uterine dysfunction. The nurse is told that the client is experiencing uncoordinated contractions that are erratic in their frequency, duration, and intensity. The priority nursing intervention would be to: A. Monitor the Pitocin infusion closely B. Provide pain relief measures C. Prepare the client for an amniotomy D. Promote ambulation every 30 minutes 21. A nurse is developing a plan of care for a client experiencing dystocia and includes several nursing interventions in the plan of care. The nurse prioritizes the plan of care and selects which of the following nursing interventions as the highest priority? A. Keeping the significant other informed of the progress of the labor B. Providing comfort measures C. Monitoring fetal heart rate D. Changing the client's position frequently 22\. A maternity nurse is preparing to care for a pregnant client in labor who will be delivering twins. The nurse monitors the fetal heart rates by placing the external fetal monitor: A. Over the fetus that is most anterior to the mother's abdomen B. Over the fetus that is most posterior to the mother's abdomen C. So that each fetal heart rate is monitored separately D. So that one fetus is monitored for a 15-minute period followed by a 15 minute fetal monitoring period for the second fetus 23\. A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with placenta previa. The nurse reviews the plan of care and prepares to monitor the client for which of the following risks associated with placenta previa? A. Disseminated intravascular coagulation B. Chronic hypertension C. Infection D. Hemorrhage 24\. A nurse in the delivery room is assisting with the delivery of a newborn infant. After the delivery of the newborn, the nurse assists in delivering the placenta. Which observation would indicate that the placenta has separated from the uterine wall and is ready for delivery? A. The umbilical cord shortens in length and changes in color B. A soft and boggy uterus C. Maternal complaints of severe uterine cramping D. Changes in the shape of the uterus 25\. A nurse in the labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. Which of the following would be the initial nursing action? A. Place the client in Trendelenburg's position B. Call the delivery room to notify the staff that the client will be transported immediately C. Gently push the cord into the vagina D. Find the closest telephone and stat page the physician 26\. A maternity nurse is caring for a client with abruptio placenta and is monitoring the client for disseminated intravascular coagulopathy. Which assessment finding is least likely to be associated with disseminated intravascular coagulation? A. Swelling of the calf in one leg B. Prolonged clotting times C. Decreased platelet count D. Petechiae, oozing from injection sites, and hematuria 27\. A nurse is assessing a pregnant client in the 2nd trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which of the following assessment findings would the nurse expect to note if this condition is present? A. Absence of abdominal pain B. A soft abdomen C. Uterine tenderness/pain D. Painless, bright red vaginal bleeding 28\. A maternity nurse is preparing for the admission of a client in the 3rd trimester of pregnancy that is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the physician's orders and would question which order? A. Prepare the client for an ultrasound B. Obtain equipment for external electronic fetal heart monitoring C. Obtain equipment for a manual pelvic examination D. Prepare to draw a Hgb and Hct blood sample 29\. An ultrasound is performed on a client at term gestation that is experiencing moderate vaginal bleeding. The results of the ultrasound indicate that an abruptio placenta is present. Based on these findings, the nurse would prepare the client for: A. Complete bed rest for the remainder of the pregnancy B. Delivery of the fetus C. Strict monitoring of intake and output D. The need for weekly monitoring of coagulation studies until the time of delivery 30\. A nurse in a labor room is assisting with the vaginal delivery of a newborn infant. The nurse would monitor the client closely for the risk of uterine rupture if which of the following occurred? A. Hypotonic contractions B. Forceps delivery C. Schultz delivery D. Weak bearing down efforts 31\. A client is admitted to the birthing suite in early active labor. The priority nursing intervention on admission of this client would be: A. Auscultating the fetal heart B. Taking an obstetric history C. Asking the client when she last ate D. Ascertaining whether the membranes were ruptured 32\. A client who is gravida 1, para 0 is admitted in labor. Her cervix is 100% effaced, and she is dilated to 3 cm. Her fetus is at +1 station. The nurse is aware that the fetus' head is: A. Not yet engaged B. Entering the pelvic inlet C. Below the ischial spines D. Visible at the vaginal opening 33\. After doing Leopold's maneuvers, the nurse determines that the fetus is in the ROP position. To best auscultate the fetal heart tones, the Doppler is placed: A. Above the umbilicus at the midline B. Above the umbilicus on the left side C. Below the umbilicus on the right side D. Below the umbilicus near the left groin 34\. The physician asks the nurse the frequency of a laboring client's contractions. The nurse assesses the client's contractions by timing from the beginning of one contraction: A. Until the time it is completely over B. To the end of a second contraction C. To the beginning of the next contraction D. Until the time that the uterus becomes very firm 35\. The nurse observes the client's amniotic fluid and decides that it appears normal, because it is: A. Clear and dark amber in color B. Milky, greenish yellow, containing shreds of mucus C. Clear, almost colorless, and containing little white specks D. Cloudy, greenish-yellow, and containing little white specks 36\. At 38 weeks gestation, a client is having late decelerations. The fetal pulse oximeter shows 75% to 85%. The nurse should: A. Discontinue the catheter, if the reading is not above 80% B. Discontinue the catheter, if the reading does not go below 30% C. Advance the catheter until the reading is above 90% and continue monitoring D. Reposition the catheter, recheck the reading, and if it is 55%, keep monitoring 37\. When examining the fetal monitor strip after rupture of the membranes in a laboring client, the nurse notes variable decelerations in the fetal heart rate. The nurse should: A. Stop the oxytocin infusion B. Change the client's position C. Prepare for immediate delivery D. Take the client's blood pressure 38\. When monitoring the fetal heart rate of a client in labor, the nurse identifies an elevation of 15 beats above the baseline rate of 135 beats per minute lasting for 15 seconds. This should be documented as: A. An acceleration B. An early elevation C. A sonographic motion D. A tachycardic heart rate 39. A laboring client complains of low back pain. The nurse replies that this pain occurs most when the position of the fetus is: A. Breech B. Transverse C. Occiput anterior D. Occiput posterior 40\. The breathing technique that the mother should be instructed to use as the fetus' head is crowning is: A. Blowing B. Slow chest C. Shallow D. Accelerated-decelerated 41\. During the period of induction of labor, a client should be observed carefully for signs of: A. Severe pain B. Uterine tetany C. Hypoglycemia D. Umbilical cord prolapse 42\. A client arrives at the hospital in the second stage of labor. The fetus' head is crowning, the client is bearing down, and the birth appears imminent. The nurse should: A. Transfer her immediately by stretcher to the birthing unit B. Tell her to breathe through her mouth and not to bear down C. Instruct the client to pant during contractions and to breathe through her mouth D. Support the perineum with the hand to prevent tearing and tell the client to pant 43\. A laboring client is to have a pudendal block. The nurse plans to tell the client that once the block is working she: A. Will not feel the episiotomy B. May lose bladder sensation C. May lose the ability to push D. Will no longer feel contractions 44\. Which of the following observations indicates fetal distress? A. Fetal scalp pH of 7.14 B. Fetal heart rate of 144 beats/minute C. Acceleration of fetal heart rate with contractions D. Presence of long term variability 45\. Which of the following fetal positions is most favorable for birth? A. Vertex presentation B. Transverse lie C. Frank breech presentation D. Posterior position of the fetal head 46. A laboring client has external electronic fetal monitoring in place. Which of the following assessment data can be determined by examining the fetal heart rate strip produced by the external electronic fetal monitor? A. Gender of the fetus B. Fetal position C. Labor progress D. Oxygenation 47\. A laboring client is in the first stage of labor and has progressed from 4 to 7 cm in cervical dilation. In which of the following phases of the first stage does cervical dilation occur most rapidly? A. Preparatory phase B. Latent phase C. Active phase D. Transition phase 48\. A multiparous client who has been in labor for 2 hours states that she feels the urge to move her bowels. How should the nurse respond? A. Let the client get up to use the potty B. Allow the client to use a bedpan C. Perform a pelvic examination D. Check the fetal heart rate 49\. Labor is a series of events affected by the coordination of the five essential factors. One of these is the passenger (fetus). Which are the other four factors? A. Contractions, passageway, placental position and function, pattern of care B. Contractions, maternal response, placental position, psychological response C. Passageway, contractions, placental position and function, psychological response D. Passageway, placental position and function, paternal response, psychological response 50\. Fetal presentation refers to which of the following descriptions? A. Fetal body part that enters the maternal pelvis first B. Relationship 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. A classification according to the fetal part 51\. A client is admitted to the L & D suite at 36 weeks' gestation. She has a history of C-section and complains of severe abdominal pain that started less than 1 hour earlier. When the nurse palpates tetanic contractions, the client again complains of severe pain. After the client vomits, she states that the pain is better and then passes out. Which is the probable cause of her signs and symptoms? A. Hysteria compounded by the flu B. Placental abruption C. Uterine rupture D. Dysfunctional labor 52\. Upon completion of a vaginal examination on a laboring woman, the nurse records: 50%, 6 cm, -1. Which of the following is a correct interpretation of the data? A. Fetal presenting part is 1 cm above the ischial spines B. Effacement is 4 cm from completion C. Dilation is 50% completed D. Fetus has achieved passage through the ischial spines 53. Which of the following findings meets the criteria of a reassuring FHR pattern? A. FHR does not change as a result of fetal activity B. Average baseline rate ranges between 100 -- 140 BPM C. Mild late deceleration patterns occur with some contractions D. Variability averages between 6 -- 10 BPM 54. Late deceleration patterns are noted when assessing the monitor tracing of a woman whose labor is being induced with an infusion of Pitocin. The woman is in a side-lying position, and her vital signs are stable and fall within a normal range. Contractions are intense, last 90 seconds, and occur every 1 1/2 to 2 minutes. The nurse's immediate action would be to: A. Change the woman's position B. Stop the Pitocin C. Elevate the woman's legs D. Administer oxygen via a tight mask at 8 to 10 liters/minute 55. The nurse should realize that the most common and potentially harmful maternal complication of epidural anesthesia would be: A. Severe postpartum headache B. Limited perception of bladder fullness C. Increase in respiratory rate D. Hypotension 56\. Perineal care is an important infection control measure. When evaluating a postpartum woman's perineal care technique, the nurse would recognize the need for further instruction if the woman: A. Uses soap and warm water to wash the vulva and perineum B. Washes from symphysis pubis back to episiotomy C. Changes her perineal pad every 2 -- 3 hours D. Uses the peribottle to rinse upward into her vagina 57\. Which measure would be least effective in preventing postpartum hemorrhage? A. Administer Methergine 0.2 mg every 6 hours for 4 doses as ordered B. Encourage the woman to void every 2 hours C. Massage the fundus every hour for the first 24 hours following birth D. Teach the woman the importance of rest and nutrition to enhance healing 58\. When making a visit to the home of a postpartum woman one week after birth, the nurse should recognize that the woman would characteristically: A. Express a strong need to review events and her behavior during the process of labor and birth B. Exhibit a reduced attention span, limiting readiness to learn C. Vacillate between the desire to have her own nurturing needs met and the need to take charge of her own care and that of her newborn D. Have reestablished her role as a spouse/partner 59\. Four hours after a difficult labor and birth, a primiparous woman refuses to feed her baby, stating that she is too tired and just wants to sleep. The nurse should: A. Tell the woman she can rest after she feeds her baby B. Recognize this as a behavior of the taking-hold stage C. Record the behavior as ineffective maternal-newborn attachment D. Take the baby back to the nursery, reassuring the woman that her rest is a priority at this time 60\. Parents can facilitate the adjustment of their other children to a new baby by: A. Having the children choose or make a gift to give to the new baby upon its arrival home B. Emphasizing activities that keep the new baby and other children together C. Having the mother carry the new baby into the home so she can show the other children the new baby D. Reducing stress on other children by limiting their involvement in the care of the new baby UHRIUDKJHCGVUFVHJKCLIAUGFYHCBJKSAOAIDUYGFSCDHBJNKFOIDUOSIUDLUSF 1\. Which of the following conditions will lead to a small-for-gestational age fetus due to less blood supply to the fetus? A. Diabetes in the mother B. Maternal cardiac condition C. Premature labor D. Abruptio placenta 2\. The lower limit of viability for infants in terms of age of gestation is: A. 21-24 weeks B. 25-27 weeks C. 28-30 weeks D. 38-40 weeks 3\. Which provision of our 1987 constitution guarantees the right of the unborn child to life from conception is A. Article II section 12 B. Article II section 15 C. Article XIII section 11 D. Article XIII section 15 4\. In the Philippines, if a nurse performs abortion on the mother who wants it done and she gets paid for doing it, she will be held liable because A. Abortion is immoral and is prohibited by the church B. Abortion is both immoral and illegal in our country C. Abortion is considered illegal because you got paid for doing it D. Abortion is illegal because majority in our country are catholics and it is prohibited by the church 5\. The preferred manner of delivering the baby in a gravido-cardiac is vaginal delivery assisted by forceps under epidural anesthesia. The main rationale for this is: A. To allow atraumatic delivery of the baby B. To allow a gradual shifting of the blood into the maternal circulation C. To make the delivery effort free and the mother does not need to push with contractions D. To prevent perineal laceration with the expulsion of the fetal head 6\. When giving narcotic analgesics to mother in labor, the special consideration to follow is: A. The progress of labor is well established reaching the transitional stage B. Uterine contraction is progressing well and delivery of the baby is imminent C. Cervical dilatation has already reached at least 8 cm. and the station is at least (+)2 D. Uterine contractions are strong and the baby will not be delivered yet within the next 3 hours. 7\. The cervical dilatation taken at 8:00 A.M. in a G1P0 patient was 6 cm. A repeat I.E. done at 10 A.M. showed that cervical dilation was 7 cm. The correct interpretation of this result is: A. Labor is progressing as expected B. The latent phase of Stage 1 is prolonged C. The active phase of Stage 1 is protracted D. The duration of labor is normal 8\. Which of the following techniques during labor and delivery can lead to uterine inversion? A. Fundal pressure applied to assist the mother in bearing down during delivery of the fetal head B. Strongly tugging on the umbilical cord to deliver the placenta and hasten placental separation C. Massaging the fundus to encourage the uterus to contract D. Applying light traction when delivering the placenta that has already detached from the uterine wall 9\. The fetal heart rate is checked following rupture of the bag of waters in order to: A. Check if the fetus is suffering from head compression B. Determine if cord compression followed the rupture C. Determine if there is utero-placental insufficiency D. Check if fetal presenting part has adequately descended following the rupture 10\. Upon assessment, the nurse got the following findings: 2 perineal pads highly saturated with blood within 2 hours post partum, PR= 80 bpm, fundus soft and boundaries not well defined. The appropriate nursing diagnosis is: A. Normal blood loss B. Blood volume deficiency C. Inadequate tissue perfusion related to hemorrhage D. Hemorrhage secondary to uterine atony 11\. The following are signs and symptoms of fetal distress EXCEPT: A. Fetal heart rate (FHR) decreased during a contraction and persists even after the uterine contraction ends B. The FHR is less than 120 bpm or over 160 bpm C. The pre-contraction FHR is 130 bpm, FHR during contraction is 118 bpm and FHR after uterine contraction is 126 bpm D. FHR is 160 bpm, weak and irregular 12\. If the labor period lasts only for 3 hours, the nurse should suspect that the following conditions may occur: 1. Laceration of cervix 2. Laceration of perineum 3. Cranial hematoma in the fetus 4. Fetal anoxia A. 1 & 2 B. 2 & 4 C. 2,3,4 D. 1,2,3,4 13\. The primary power involved in labor and delivery is A. Bearing down ability of mother B. Cervical effacement and dilatation C. Uterine contraction D. Valsalva technique 14\. The proper technique to monitor the intensity of a uterine contraction is A. Place the palm of the hands on the abdomen and time the contraction B. Place the finger tips lightly on the suprapubic area and time the contraction C. Put the tip of the fingers lightly on the fundal area and try to indent the abdominal wall at the height of the contraction D. Put the palm of the hands on the fundal area and feel the contraction at the fundal area 15\. To monitor the frequency of the uterine contraction during labor, the right technique is to time the contraction A. From the beginning of one contraction to the end of the same contraction B. From the beginning of one contraction to the beginning of the next contraction C. From the end of one contraction to the beginning of the next contraction D. From the deceleration of one contraction to the acme of the next contraction 16\. The peak point of a uterine contraction is called the A. Acceleration B. Acme C. Deceleration D. Axiom 17\. When determining the duration of a uterine contraction the right technique is to time it from A. The beginning of one contraction to the end of the same contraction B. The end of one contraction to the beginning of another contraction C. The acme point of one contraction to the acme point of another contraction D. The beginning of one contraction to the end of another contraction 18\. When the bag of waters ruptures, the nurse should check the characteristic of the amniotic fluid. The normal color of amniotic fluid is A. Clear as water B. Bluish C. Greenish D. Yellowish 19\. When the bag of waters ruptures spontaneously, the nurse should inspect the vaginal introitus for possible cord prolapse. If there is part of the cord that has prolapsed into the vaginal opening the correct nursing intervention is: A. Push back the prolapse cord into the vaginal canal B. Place the mother on semifowler's position to improve circulation C. Cover the prolapse cord with sterile gauze wet with sterile NSS and place the woman on trendellenberg position D. Push back the cord into the vagina and place the woman on sims position 20\. The fetal heart beat should be monitored every 15 minutes during the 2nd stage of labor. The characteristic of a normal fetal heart rate is A. The heart rate will decelerate during a contraction and then go back to its pre-contraction rate after the contraction B. The heart rate will accelerate during a contraction and remain slightly above the pre-contraction rate at the end of the contraction C. The rate should not be affected by the uterine contraction. D. The heart rate will decelerate at the middle of a contraction and remain so for about a minute after the contraction 21\. The mechanisms involved in fetal delivery is A. Descent, extension, flexion, external rotation B. Descent, flexion, internal rotation, extension, external rotation C. Flexion, internal rotation, external rotation, extension D. Internal rotation, extension, external rotation, flexion 22\. The first thing that a nurse must ensure when the baby's head comes out is A. The cord is intact B. No part of the cord is encircling the baby's neck C. The cord is still attached to the placenta D. The cord is still pulsating 23\. To ensure that the baby will breath as soon as the head is delivered, the nurse's priority action is to A. Suction the nose and mouth to remove mucous secretions B. Slap the baby's buttocks to make the baby cry C. Clamp the cord about 6 inches from the base D. Check the baby's color to make sure it is not cyanotic 24\. When doing perineal care in preparation for delivery, the nurse should observe the following EXCEPT A. Use up-down technique with one stroke B. Clean from the mons veneris to the anus C. Use mild soap and warm water D. Paint the inner thighs going towards the perineal area 25\. What are the important considerations that the nurse must remember after the placenta is delivered? 1. Check if the placenta is complete including the membranes 2. Check if the cord is long enough for the baby 3. Check if the umbilical cord has 3 blood vessels 4. Check if the cord has a meaty portion and a shiny portion A. 1 and 3 B. 2 and 4 C. 1, 3, and 4 D. 2 and 3 26\. The following are correct statements about false labor EXCEPT A. The pain is irregular in intensity and frequency. B. The duration of contraction progressively lengthens over time C. There is no vaginal bloody discharge D. The cervix is still closed. 27\. The passageway in labor and deliver of the fetus include the following EXCEPT A. Distensibility of lower uterine segment B. Cervical dilatation and effacement C. Distensibility of vaginal canal and introitus D. Flexibility of the pelvis 28\. The normal umbilical cord is composed of: A. 2 arteries and 1 vein B. 2 veins and 1 artery C. 2 arteries and 2 veins D. none of the above 29\. At what stage of labor and delivery does a primigravida differ mainly from a multigravida? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4 30\. The second stage of labor begins with \_\_\_ and ends with \_\_? A. Begins with full dilatation of cervix and ends with delivery of placenta B. Begins with true labor pains and ends with delivery of baby C. Begins with complete dilatation and effacement of cervix and ends with delivery of baby D. Begins with passage of show and ends with full dilatation and effacement of cervix 31\. The following are signs that the placenta has detached EXCEPT: A. Lengthening of the cord B. Uterus becomes more globular C. Sudden gush of blood D. Mother feels like bearing down 32\. When the shiny portion of the placenta comes out first, this is called the \_\_\_ mechanism. A. Schultze B. Ritgens C. Duncan D. Marmets 33\. When the baby's head is out, the immediate action of the nurse is A. Cut the umbilical cord B. Wipe the baby's face and suction mouth first C. Check if there is cord coiled around the neck D. Deliver the anterior shoulder 34\. When delivering the baby's head the nurse supports the mother's perineum to prevent tear. This technique is called A. Marmet's technique B. Ritgen's technique C. Duncan maneuver D. Schultze maneuver 35\. The basic delivery set for normal vaginal delivery includes the following instruments/articles EXCEPT: A. 2 clamps B. Pair of scissors C. Kidney basin D. Retractor 36\. As soon as the placenta is delivered, the nurse must do which of the following actions? A. Inspect the placenta for completeness including the membranes B. Place the placenta in a receptacle for disposal C. Label the placenta properly D. Leave the placenta in the kidney basin for the nursing aide to dispose properly 37\. In vaginal delivery done in the hospital setting, the doctor routinely orders an oxytocin to be given to the mother parenterally. The oxytocin is usually given after the placenta has been delivered and not before because: A. Oxytocin will prevent bleeding B. Oxytocin can make the cervix close and thus trap the placenta inside C. Oxytocin will facilitate placental delivery D. Giving oxytocin will ensure complete delivery of the placenta 38\. In a gravido-cardiac mother, the first 2 hours postpartum (4th stage of labor and delivery) particularly in a cesarean section is a critical period because at this stage A. There is a fluid shift from the placental circulation to the maternal circulation which can overload the compromised heart. B. The maternal heart is already weak and the mother can die C. The delivery process is strenuous to the mother D. The mother is tired and weak which can distress the heart 39\. The drug usually given parentally to enhance uterine contraction is: A. Terbutalline B. Pitocin C. Magnesium sulfate D. Lidocaine 40\. The partograph is a tool used to monitor labor. The maternal parameters measured/monitored are the following EXCEPT: A. Vital signs B. Fluid intake and output C. Uterine contraction D. Cervical dilatation 41\. The following are natural childbirth procedures EXCEPT: A. Lamaze method B. Dick-Read method C. Ritgen's maneuver D. Psychoprophylactic method 42\. The following are common causes of dysfunctional labor. Which of these can a nurse, on her own manage? A. Pelvic bone contraction B. Full bladder C. Extension rather than flexion of the head D. Cervical rigidity 43\. At what stage of labor is the mother is advised to bear down? A. When the mother feels the pressure at the rectal area B. During a uterine contraction C. In between uterine contraction to prevent uterine rupture D. Anytime the mother feels like bearing down 44\. The normal dilatation of the cervix during the first stage of labor in a nullipara is A. 1.2 cm./hr B. 1.5 cm./hr. C. 1.8 cm./hr D. 2.0 cm./hr 45\. When the fetal head is at the level of the ischial spine, it is said that the station of the head is A. Station --1 B. Station "0" C. Station +1 D. Station +2 46\. During an internal examination, the nurse palpated the posterior fontanel to be at the left side of the mother at the upper quadrant. The interpretation is that the position of the fetus is: A. LOA B. ROP C. LOP D. ROA 47\. The following are types of breech presentation EXCEPT: A. Footling B. Frank C. Complete D. Incomplete 48\. When the nurse palpates the suprapubic area of the mother and found that the presenting part is still movable, the right term for this observation that the fetus is A. Engaged B. Descended C. Floating D. Internal Rotation 49\. The placenta should be delivered normally within \_\_\_ minutes after the delivery of the baby. A. 5 minutes B. 30 minutes C. 45 minutes D. 60 minutes 50\. When shaving a woman in preparation for cesarean section, the area to be shaved should be from \_\_\_ to \_\_\_ A. Under breast to mid-thigh including the pubic area B. The umbilicus to the mid-thigh C. Xyphoid process to the pubic area D. Above the umbilicus to the pubic area JFOIWSUDON9ICUYOEW9UIJCBGCOAVWUEIFHOVA9EUFO9uaSHFO ICZUGSLIDU VGZEOISDU 1\. Postpartum Period: The fundus of the uterus is expected to go down normally postpartally about \_\_ cm per day. A. 1.0 cm B. 2.0 cm C. 2.5 cm D. 3.0 cm 2\. The lochia on the first few days after delivery is characterized as A. Pinkish with some blood clots B. Whitish with some mucus C. Reddish with some mucus D. Serous with some brown tinged mucus 3\. Lochia normally disappears after how many days postpartum? A. 5 days B. 7-10 days C. 18-21 days D. 28-30 days 4\. After an Rh(-) mother has delivered her Rh (+) baby, the mother is given RhoGam. This is done in order to: A. Prevent the recurrence of Rh(+) baby in future pregnancies B. Prevent the mother from producing antibodies against the Rh(+) antigen that she may have gotten when she delivered to her Rh(+) baby C. Ensure that future pregnancies will not lead to maternal illness D. To prevent the newborn from having problems of incompatibility when it breastfeeds 5\. To enhance milk production, a lactating mother must do the following interventions EXCEPT: A. Increase fluid intake including milk B. Eat foods that increases lactation which are called galactagues C. Exercise adequately like aerobics D. Have adequate nutrition and rest 6\. The nursing intervention to relieve pain in breast engorgement while the mother continues to breastfeed is A. Apply cold compress on the engorged breast B. Apply warm compress on the engorged breast C. Massage the breast D. Apply analgesic ointment 7\. A woman who delivered normally per vagina is expected to void within \_\_\_ hours after delivery. A. 3 hrs B. 4 hrs. C. 6-8 hrs D. 12-24 hours 8\. To ensure adequate lactation the nurse should teach the mother to: A. Breast feed the baby on self-demand day and night B. Feed primarily during the day and allow the baby to sleep through the night C. Feed the baby every 3-4 hours following a strict schedule D. Breastfeed when the breast are engorged to ensure adequate supply 9\. An appropriate nursing intervention when caring for a postpartum mother with thrombophlebitis is: A. Encourage the mother to ambulate to relieve the pain in the leg B. Instruct the mother to apply elastic bondage from the foot going towards the knee to improve venous return flow C. Apply warm compress on the affected leg to relieve the pain D. Elevate the affected leg and keep the patient on bedrest 10\. 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 born C. An episiotomy had to be done to facilitate delivery of the head D. The labor and delivery lasted for 12 hours 11\. According to Rubin's theory of maternal role adaptation, the mother will go through 3 stages during the post partum period. These stages are: A. Going through, adjustment period, adaptation period B. Taking-in, taking-hold and letting-go C. Attachment phase, adjustment phase, adaptation phase D. Taking-hold, letting-go, attachment phase 12\. The neonate of a mother with diabetes mellitus is prone to developing hypoglycemia because: A. The pancreas is immature and unable to secrete the needed insulin B. There is rapid diminution of glucose level in the baby's circulating blood and his pancreas is normally secreting insulin C. The baby is reacting to the insulin given to the mother D. His kidneys are immature leading to a high tolerance for glucose 13\. Which of the following is an abnormal vital sign in postpartum? A. Pulse rate between 50-60/min B. BP diastolic increase from 80 to 95mm Hg C. BP systolic between 100-120mm Hg D. Respiratory rate of 16-20/min 14\. The uterine fundus right after delivery of placenta is palpable at A. Level of Xyphoid process B. Level of umbilicus C. Level of symphysis pubis D. Midway between umbilicus and symphysis pubis 15\. After how many weeks after delivery should a woman have her postpartal check-up based on the protocol followed by the DOH? A. 2 weeks B. 3 weeks C. 6 weeks D. 12 weeks 16\. In a woman who is not breastfeeding, menstruation usually occurs after how many weeks? A. 2-4 weeks B. 6-8 weeks C. 6 months D. 12 months 17\. The following are nursing measures to stimulate lactation EXCEPT A. Frequent regular breast feeding B. Breast pumping C. Breast massage D. Application of cold compress on the breast 18\. When the uterus is firm and contracted after delivery but there is vaginal bleeding, the nurse should suspect A. Laceration of soft tissues of the cervix and vagina B. Uterine atony C. Uterine inversion D. Uterine hypercontractility 19\. The following are interventions to make the fundus contract postpartally EXCEPT A. Make the baby suck the breast regularly B. Apply ice cap on fundus C. Massage the fundus vigorously for 15 minutes until contracted D. Give oxytocin as ordered 20\. The following are nursing interventions to relieve episiotomy wound pain EXCEPT A. Giving analgesic as ordered B. Sitz bath C. Perineal heat D. Perineal care 21\. Postpartum blues is said to be normal provided that the following characteristics are present. These are 1. Within 3-10 days only; 2. Woman exhibits the following symptoms- episodic tearfulness, fatigue, oversensitivity, poor appetite; 3. Maybe more severe symptoms in primpara A. All of the above B. 1 and 2 C. 2 only D. 2 and 3 22\. The neonatal circulation differs from the fetal circulation because A. The fetal lungs are non-functioning as an organ and most of the blood in the fetal circulation is mixed blood. B. The blood at the left atrium of the fetal heart is shunted to the right atrium to facilitate its passage to the lungs C. The blood in left side of the fetal heart contains oxygenated blood while the blood in the right side contains unoxygenated blood. D. None of the above 23\. The normal respiration of a newborn immediately after birth is characterized as: A. Shallow and irregular with short periods of apnea lasting not longer than 15 seconds, 30-60 breaths per minute B. 20-40 breaths per minute, abdominal breathing with active use of intercostals muscles C. 30-60 breaths per minute with apnea lasting more than 15 seconds, abdominal breathing D. 30-50 breaths per minute, active use of abdominal and intercostal muscles 24\. The anterior fontanelle is characterized as: A. 3-4 cm antero-posterior diameter and 2-3 cm transverse diameter, diamond shape B. 2-3 cm antero-posterior diameter and 3-4 cm transverse diameter and diamond shape C. 2-3 cm in both antero-posterior and transverse diameter and diamond shape D. none of the above 25\. The ideal site for vitamin K injection in the newborn is: A. Right upper arm B. Left upper arm C. Either right or left buttocks D. Middle third of the thigh 26\. At what APGAR score at 5 minutes after birth should resuscitation be initiated? A. 1-3 B. 7-8 C. 9-10 D. 6-7 27\. Right after birth, when the skin of the baby's trunk is pinkish but the soles of the feet and palm of the hands are bluish this is called: A. Syndactyly B. Acrocyanosis C. Peripheral cyanosis D. Cephalo-caudal cyanosis 28\. The minimum birth weight for full term babies to be considered normal is: A. 2,000gms B. 1,500gms C. 2,500gms D. 3,000gms 29\. The procedure done to prevent ophthalmia neonatorum is: A. Marmet's technique B. Crede's method C. Ritgen's method D. Ophthalmic wash 30\. Which of the following characteristics will distinguish a postmature neonate at birth? A. Plenty of lanugo and vernix caseosa B. Lanugo mainly on the shoulders and vernix in the skin folds C. Pinkish skin with good turgor D. Almost leather-like, dry, cracked skin, negligible vernix caseosa 31\. According to the Philippine Nursing Law, a registered nurse is allowed to handle mothers in labor and delivery with the following considerations: 1. The pregnancy is normal.; 2. The labor and delivery is uncomplicated; 3. Suturing of perineal laceration is allowed provided the nurse had special training; 4. As a delivery room nurse she is not allowed to insert intravenous fluid unless she had special training for it. A. 1 and 2 B. 1, 2, and 3 C. 3 and 4 D. 1, 2, and 4 32\. Birth Control Methods and Infertility: In basal body temperature (BBT) technique, the sign that ovulation has occurred is an elevation of body temperature by A. 1.0-1.4 degrees centigrade B. 0.2-0.4 degrees centigrade C. 2.0-4.0 degrees centigrade D. 1.0-4.0 degrees centigrade 33\. Lactation Amenorrhea Method(LAM) can be an effective method of natural birth control if A. The mother breast feeds mainly at night time when ovulation could possibly occur B. The mother breastfeeds exclusively and regularly during the first 6 months without giving supplemental feedings C. The mother uses mixed feeding faithfully D. The mother breastfeeds regularly until 1 year with no supplemental feedings 34\. Intra-uterine device prevents pregnancy by the ff. mechanism EXCEPT A. Endometrium inflames B. Fundus contracts to expel uterine contents C. Copper embedded in the IUD can kill the sperms D. Sperms will be barred from entering the fallopian tubes 35\. Oral contraceptive pills are of different types. Which type is most appropriate for mothers who are breastfeeding? A. Estrogen only B. Progesterone only C. Mixed type- estrogen and progesterone D. 21-day pills mixed type 36\. The natural family planning method called Standard Days (SDM), is the latest type and easy to use method. However, it is a method applicable only to women with regular menstrual cycles between \_\_\_ to \_\_\_ days. A. 21-26 days B. 26-32 days C. 28-30 days D. 24- 36 days 37\. Which of the following are signs of ovulation? 1. Mittelschmerz; 2. Spinnabarkeit; 3. Thin watery cervical mucus; 4. Elevated body temperature of 4.0 degrees centigrade A. 1 & 2 B. 1, 2, & 3 C. 3 & 4 D. 1, 2, 3, 4 38\. The following methods of artificial birth control works as a barrier device EXCEPT: A. Condom B. Cervical cap C. Cervical Diaphragm D. Intrauterine device (IUD) 39\. Which of the following is a TRUE statement about normal ovulation? A. It occurs on the 14th day of every cycle B. It may occur between 14-16 days before next menstruation C. Every menstrual period is always preceded by ovulation D. The most fertile period of a woman is 2 days after ovulation 40\. If a couple would like to enhance their fertility, the following means can be done: 1. Monitor the basal body temperature of the woman everyday to determine peak period of fertility; 2. Have adequate rest and nutrition; 3. Have sexual contact only during the dry period of the woman; 4. Undergo a complete medical check-up to rule out any debilitating disease A. 1 only B. 1 & 4 C. 1,2,4 D. 1,2,3,4 41\. In sympto-thermal method, the parameters being monitored to determine if the woman is fertile or infertile are: A. Temperature, cervical mucus, cervical consistency B. Release of ovum, temperature and vagina C. Temperature and wetness D. Temperature, endometrial secretion, mucus 42\. The following are important considerations to teach the woman who is on low dose (mini-pill) oral contraceptive EXCEPT: A. The pill must be taken everyday at the same time B. If the woman fails to take a pill in one day, she must take 2 pills for added protection C. If the woman fails to take a pill in one day, she needs to take another temporary method until she has consumed the whole pack D. If she is breast feeding, she should discontinue using mini-pill and use the progestin-only type 43\. To determine if the cause of infertility is a blockage of the fallopian tubes, the test to be done is A. Huhner's test B. Rubin's test C. Postcoital test D. None of the above 44\. 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 45\. Spinnabarkeit 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 C. Thin mucus that is yellowish in color with fishy odor D. Thick mucus vaginal discharge influence by high level of estrogen 46\. 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 47\. Breast self examination is best done by the woman on herself every month during A. The middle of her cycle to ensure that she is ovulating B. During the menstrual period C. Right after the menstrual period so that the breast is not being affected by the increase in hormones particularly estrogen D. Just before the menstrual period to determine if ovulation has occurred 48\. A woman is considered to be menopause if she has experienced cessation of her menses for a period of A. 6 months B. 12 months C. 18 months D. 24 months 49\. Which of the following is the correct practice of self breast examination in a menopausal woman? A. She should do it at the usual time that she experiences her menstrual period in the past to ensure that her hormones are not at its peak B. Any day of the month as long it is regularly observed on the same day every month C. Anytime she feels like doing it ideally every day D. Menopausal women do not need regular self breast exam as long as they do it at least once every 6 months 50\. In assisted reproductive technology (ART), there is a need to stimulate the ovaries to produce more than one mature ova. The drug commonly used for this purpose is: A. Bromocriptine B. Clomiphene C. Provera D. Estrogen

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