Chapter 1- Perspectives on Maternal, Newborn, and Women’s Health Care
1. The United States ranks 50th in the world for maternal mortality and 41st among industrialized nations for infant mortality rate. When developing programs to assist in decreasing these rates, which factor would most likely need to be addressed as having the greatest impact?
A) Resolving all language and cultural differences
B) Assuring early and adequate prenatal care
C) Providing more extensive women’s shelters
D) Encouraging all women to eat a balanced diet
2. When integrating the principles of family-centered care, the nurse would include which of the following?
A) Childbirth is viewed as a procedural event
B) Families are unable to make informed choices
C) Childbirth results in changes in relationships
D) Families require little information to make appropriate decisions
3. When preparing a teaching plan for a group of first-time pregnant women, the nurse expects to review how maternity care has changed over the years. Which of the following would the nurse include when discussing events of the 20th century?
A) Epidemics of puerperal fever
B) Performance of the first cesarean birth
C) Development of the x-ray to assess pelvic size
D) Creation of free-standing birth centers
4. After teaching a group of students about pregnancy-related mortality, the instructor determines that additional teaching is needed when the students identify which condition as a leading cause?
C) Obstructed labor
5. The nurse is working with a group of community health members to develop a plan to address the special health needs of women. Which of the following conditions would the group address as the major problem?
B) Heart disease
6. When assessing a family for possible barriers to health care, the nurse would consider which factor to be most important?
B) Health care workers’ attitudes
7. After teaching a group of nursing students about the issue of informed consent. Which of the following, if identified by the student, would indicate an understanding of a violation of informed consent?
A) Performing a procedure on a 15-year-old without consent
B) Serving as a witness to the signature process
C) Asking whether the client understands what she is signing
D) Getting verbal consent over the phone for emergency procedures
8. The nurse is trying to get consent to care for an 11-year-old boy with diabetic ketoacidosis. His parents are out of town on vacation, and the child is staying with a neighbor. Which action would be the priority?
A) Getting telephone consent with two people listening to the verbal consent
B) Providing emergency care without parental consent
C) Contacting the child’s aunt or uncle to obtain their consent
D) Advocating for termination of parental rights for this situation
9. After teaching nursing students about the basic concepts of family-centered care, the instructor determines that the teaching was successful when the students state which of the following?
A) “Childbirth affects the entire family, and relationships will change.”
B) “Families are not capable of making health care decisions for themselves.”
C) “Mothers are the family members affected by childbirth.”
D) “Childbirth is a medical procedure.”
10. A nursing instructor is preparing a class discussion on the trends in health care and health care delivery over the past several centuries. When discussing the changes during the past century, which of the following would the instructor be least likely to include?
A) Disease prevention
B) Health promotion
D) Analysis of morbidity and mortality
Chapter 2- Family-Centered Community-Based Care
1. The nurse is caring for a 2-week-old newborn girl with a metabolic disorder. Which of the following activities would deviate from the characteristics of family-centered care?
A) Softening unpleasant information or prognoses
B) Evaluating and changing the nursing plan of care
C) Collaborating with the child and family as equals
D) Showing respect for the family’s beliefs and wishes
2. The nurse is providing home care for a 6-year-old girl with multiple medical challenges. Which of the following activities would be considered the tertiary level of prevention?
A) Arranging for a physical therapy session
B) Teaching parents to administer albuterol
C) Reminding parent to give a full course of antibiotics
D) Giving a DTaP vaccination at the proper interval
3. A nursing student is reviewing information about documenting client care and education in the medical record and the purposes that it serves. The student demonstrates a need for additional study when the nurse identifies which of the following as a reason?
A) Serves as a communication tool for the interdisciplinary team.
B) Demonstrates education the family has received if legal matters arise.
C) Permits others access to allow refusal of medical insurance coverage.
D) Verifies meeting client education standards set by the Joint Commission.
4. A pregnant client tells her nurse that she is interested in arranging a home birth. After educating the client on the advantages and disadvantages, which statement would indicate that the client understood the information?
A) “I like having the privacy, but it might be too expensive for me to set up in my home.”
B) “I want to have more control, but I am concerned if an emergency would arise.”
C) “It is safer because I will have a midwife.”
D) “The midwife is trained to resolve any emergency, and she can bring any pain meds.”
5. The nurse is making a home visit to a client who had a cesarean birth 3 days ago. Assessment reveals that the client is complaining of intermittent pain, rating it as 8 on a scale of 1 to 10. She states, “I’m pretty tired. And with this pain, I haven’t been drinking and eating like I should. The medication helps a bit but not much. My mom has been helping with the baby.” Her incision is clean, dry, and intact. Which nursing diagnosis would the nurse identify as the priority for this client?
A) Impaired skin integrity related to cesarean birth incision
B) Fatigue related to effects of surgery and caretaking activities
C) Imbalanced nutrition, less than body requirements related to poor fluid and food intake
D) Acute pain related to incision and cesarean birth
6. When caring for childbearing families from cultures different from one’s own, which of the following must be accomplished first?
A) Adapt to the practices of the family’s culture
B) Determine similarities between both cultures
C) Assess personal feelings about that culture
D) Learn as much as possible about that culture
7. After teaching a group of students about the changes in health care delivery and funding, which of the following, if identified by the group as a current trend seen in the maternal and child health care settings, would indicate that the teaching was successful?
A) Increase in community settings for care
B) Decrease in family poverty level
C) Increase in hospitalization of children
D) Decrease in managed care
8. The nurse would recommend the use of which supplement as a primary prevention strategy to prevent neural tube defects with pregnant women?
B) Folic acid
C) Vitamin C
9. Which action would the nurse include in a primary prevention program in the community to help reduce the incidence of HIV infection?
A) Provide treatment for clients who test positive for HIV
B) Monitor viral load counts periodically
C) Educate clients in how to practice safe sex
D) Offer testing for clients who practice unsafe sex
10. When assuming the role of discharge planner for a woman requiring ventilator support at home, the nurse would do which of the following?
A) Confer with the client’s mother
B) Teach new self-care skills to the client
C) Determine if there is a need for back-up power
D) Discuss coverage with the insurance company
Chapter 3- Anatomy and Physiology of the Reproductive System
1. When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle?
2. After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman’s first:
A) Sexual experience
B) Full hormonal cycle
C) Menstrual period
D) Sign of breast development
3. A client with a 28-day cycle reports that she ovulated on May 10. The nurse would expect the client’s next menses to begin on:
A) May 24
B) May 26
C) May 30
D) June 1
4. Which female reproductive tract structure would the nurse describe to a group of young women as containing rugae that enable it to dilate during labor and birth?
B) Fallopian tube
5. After teaching a group of pregnant women about breast-feeding, the nurse determines that the teaching was successful when the group identifies which hormone as important for the production of breast milk after childbirth?
A) Placental estrogen
C) Gonadotropin-releasing hormone
6. The nurse is assessing a 13-year-old girl who has had her first menses. Which of the following events would the nurse expect to have occurred first?
A) Evidence of pubic hair
B) Development of breast buds
C) Onset of menses
D) Growth spurt
7. When describing the ovarian cycle to a group of students, which phase would the instructor include?
A) Luteal phase
B) Proliferative phase
C) Menstrual phase
D) Secretory phase
8. The nurse is explaining the events that lead up to ovulation. Which hormone would the nurse identify as being primarily responsible for ovulation?
C) Follicle-stimulating hormone
D) Luteinizing hormone
9. The nurse is teaching a health education class on male reproductive anatomy and asks the students to identify the site of sperm production. Which structure, if identified by the group, would indicate to the nurse that the teaching was successful?
B) Seminal vesicles
D) Prostate gland
10. The nurse is creating a diagram that illustrates the components of the male reproductive system. Which structure would be inappropriate for the nurse to include as an accessory gland?
A) Seminal vesicles
B) Prostate gland
C) Cowper’s glands
D) Vas deferens
Chapter 4- Common Reproductive Issues
1. After discussing various methods of contraception with a client and her partner, the nurse determines that the teaching was successful when they identify which contraceptive method as providing protection against sexually transmitted infections (STIs)?
A) Oral contraceptives
B) Tubal ligation
D) Intrauterine system
2. When discussing contraceptive options, which method would the nurse recommend as being the most reliable?
A) Coitus interruptus
B) Lactational amenorrheal method (LAM)
C) Natural family planning
D) Intrauterine system
3. A client comes to the clinic with abdominal pain. Based on her history the nurse suspects endometriosis. The nurse expects to prepare the client for which of the following to confirm this suspicion?
A) Pelvic examination
B) Transvaginal ultrasound
4. A client is to receive an implantable contraceptive. The nurse describes this contraceptive as containing:
A) Synthetic progestin
B) Combined estrogen and progestin
C) Concentrated spermicide
D) Concentrated estrogen
5. The nurse discusses various contraceptive methods with a client and her partner. Which method would the nurse explain as being available only with a prescription?
D) Basal body temperature
6. When developing a teaching plan for a couple considering contraception options, which of the following statements would the nurse include?
A) “You should select one that is considered to be 100% effective.”
B) “The best one is the one that is the least expensive and most convenient.”
C) “A good contraceptive doesn’t require a physician’s prescription.”
D) “The best contraceptive is one that you will use correctly and consistently.”
7. Which of the following measures would the nurse include in the teaching plan for a woman to reduce the risk of osteoporosis after menopause?
A) Taking vitamin supplements
B) Eating high-fiber, high-calorie foods
C) Restricting fluid to 1,000 mL daily
D) Participating in regular daily exercise
8. When teaching a group of postmenopausal women about hot flashes and night sweats, the nurse would address which of the following as the primary cause?
A) Poor dietary intake
B) Estrogen deficiency
C) Active lifestyle
D) Changes in vaginal pH
9. A client states that she is to have a test to measure bone mass to help diagnose osteoporosis. The nurse would most likely plan to prepare the client for:
A) DEXA scan
D) Pelvic x-ray
10. The nurse is reviewing the medical records of several clients. Which client would the nurse expect to have an increased risk for developing osteoporosis?
A) A woman of African American descent
B) A woman who plays tennis twice a week
C) A thin woman with small bones
D) A woman who drinks one cup of coffee a day
Chapter 5- Sexually Transmitted Infections
1. The nurse is developing a plan of care for a client who is receiving highly active antiretroviral therapy (HAART) for treatment of HIV. The goal of this therapy is to:
A) Promote the progression of disease
B) Intervene in late-stage AIDS
C) Improve survival rates
D) Conduct additional drug research
2. A woman who is HIV-positive is receiving HAART and is having difficulty with compliance. To promote adherence, which of the following areas would be most important to assess initially?
A) The woman’s beliefs and education
B) The woman’s financial situation and insurance
C) The woman’s activity level and nutrition
D) The woman’s family and living arrangements
3. When developing a teaching plan for a community group about HIV infection, which group would the nurse identify as an emerging risk group for HIV infection?
A) Native Americans
B) Heterosexual women
C) New health care workers
D) Asian immigrants
4. After teaching a group of adolescents about HIV, the nurse asks them to identify the major means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which of the following?
A) Sexual intercourse
B) Sharing needles for IV drug use
C) Perinatal transmission
D) Blood transfusion
5. The nurse reviews the CD4 cell count of a client who is HIV-positive. A result less than which of the following would indicate to the nurse that the client has AIDS?
A) 1,000 cells/mm3
B) 700 cells/mm3
C) 450 cells/mm3
D) 200 cells/mm3
6. When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)?
A) Hive-like rash for the past 2 days
B) Five different sexual partners
C) Weight gain of 5 lbs in 1 year
D) Clear vaginal discharge
7. Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:
B) Bacterial vaginosis
D) Genital herpes simplex
8. A client with trichomoniasis is to receive metronidazole (Flagyl). The nurse instructs the client to avoid which of the following while taking this drug?
9. A woman gives birth to a healthy newborn. As part of the newborn’s care, the nurse instills erythromycin ophthalmic ointment as a preventive measure related to which STI?
A) Genital herpes
B) Hepatitis B
10. Which findings would the nurse expect to find in a client with bacterial vaginosis?
A) Vaginal pH of 3
B) Fish-like odor of discharge
C) Yellowish-green discharge
D) Cervical bleeding on contact
Chapter 6- Disorders of the Breasts
1. The nurse is developing the discharge plan for a woman who has had a left-sided modified radical mastectomy. The nurse is including instructions for ways to minimize lymphedema. Which suggestion would most likely increase the woman’s symptoms?
A) “Wear gloves when you are doing any gardening.”
B) “Have your blood pressure taken in your right arm.”
C) “Wear clothing with elasticized sleeves.”
D) “Avoid driving to and from work every day.”
2. A laboratory technician arrives to draw blood for a complete blood count (CBC. for a client who had a right-sided mastectomy 8 hours ago. The client has an intravenous line with fluid infusing in her left antecubital space. To obtain the blood specimen, the technician places a tourniquet on the client’s right arm. Which action by the nurse would be most appropriate?
A) Assist in holding the client’s arm still.
B) Suggest a finger stick be done on one of the client’s left fingers.
C) Tell the technician to obtain the blood sample from the client’s left arm.
D) Call the surgeon to perform a femoral puncture.
3. The nurse determines that a woman has implemented prescribed therapy for her fibrocystic breast disease when the client reports that she has eliminated what from her diet?
C) Dairy products
4. When assessing a client with suspected breast cancer, which of the following would the nurse expect to find?
A) Painful lump
B) Absence of dimpling
C) Regularly shaped mass
D) Nipple retraction
5. A woman who has undergone a right modified-radical mastectomy returns from surgery. Which nursing intervention would be most appropriate at this time?
A) Ask the client how she feels about having her breast removed.
B) Attach a sign above her bed to have BP, IV lines, and lab work in her right arm.
C) Encourage her to turn, cough, and deep breathe at frequent intervals.
D) Position her right arm below heart level.
6. A breast biopsy indicates the presence of malignant cells, and the client is scheduled for a mastectomy. Which nursing diagnosis would the nurse most likely include in the client’s preoperative plan of care as the priority?
A) Risk for deficient fluid volume
B) Activity intolerance
C) Disturbed body image
D) Impaired urinary elimination
7. A 42-year-old woman is scheduled for a mammogram. Which of the following would the nurse include when teaching the woman about the procedure?
A) “The room will be darkened throughout the procedure.”
B) “Each breast will be firmly compressed between two plates.”
C) “Make sure to refrain from eating or drinking after midnight.”
D) “A small needle will be inserted to get a sample for evaluation.”
8. During a clinical breast examination, the nurse palpates a well-defined, firm, mobile lump in a 60-year-old woman’s left breast. The nurse notifies the physician. Which of the following would the nurse anticipate the physician to order next?
B) Hormone receptor status
C) Fine-needle aspiration
D) Genetic testing for BRCA
9. A client with advanced breast cancer, who has had both chemotherapy and radiation therapy, is to start hormonal therapy. Which agent would the nurse expect the client to receive?
10. As part of discharge planning, the nurse refers a woman to Reach to Recovery. This group’s primary purpose is to:
A) Help support women who have undergone mastectomies
B) Raise funds to support early breast cancer detection programs
C) Provide all supplies needed after breast surgery for no cost
D) Collect statistics for research for the American Cancer Society
Chapter 7- Benign Disorders of the Female Reproductive Tract
1. A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, which of the following would the nurse expect to find?
A) Sporadic vaginal bleeding accompanied by chronic pelvic pain
B) Heavy leukorrhea with vulvar pruritus
C) Menstrual irregularities and hirsutism on the chin
D) Stress incontinence with feeling of low abdominal pressure
2. To assist the woman in regaining control of the urinary sphincter for urinary incontinence, the nurse should teach the client to do which of the following?
A) Perform Kegel exercises daily.
B) Void every hour while awake.
C) Limit her intake of fluid.
D) Take a laxative every night.
3. When developing the plan of care for a woman who has had an abdominal hysterectomy, which of the following would be contraindicated?
A) Ambulating the client
B) Massaging the client’s legs
C) Applying elasticized stockings
D) Encouraging range-of-motion exercises
4. Which of the following would the nurse include when teaching women about preventing pelvic support disorders?
A) Performing Kegel isometric exercises
B) Consuming low-fiber diets
C) Using hormone replacement
D) Voiding every 2 hours
5. A client is diagnosed with an enterocele. The nurse interprets this condition as:
A) Protrusion of the posterior bladder wall downward through the anterior vaginal wall
B) Sagging of the rectum with pressure exerted against the posterior vaginal wall
C) Bulging of the small intestine through the posterior vaginal wall
D) Descent of the uterus through the pelvic floor into the vagina
6. A woman is scheduled for an anterior and posterior colporrhaphy as treatment for a cystocele. When the nurse is explaining this treatment to the client, which of the following descriptions would be most appropriate to include?
A) “This procedure helps to tighten the vaginal wall in the front and back so that your bladder and urethra are in the proper position.”
B) “Your uterus will be removed through your vagina, helping to relieve the organ that is putting the pressure on your bladder.”
C) “This is a series of exercises that you will learn to do so that you can strengthen your bladder muscles.”
D) “These are plastic devices that your physician will insert into your vagina to provide support to the uterus and keep it in the proper position.”
7. The nurse would be least likely to find which of the following in a client with uterine fibroids?
A) Regularly shaped, shrunken uterus
B) Acute pelvic pain
D) Complaints of bloating
8. A client with polycystic ovarian syndrome (PCOS. is receiving oral contraceptives as part of her treatment plan. The nurse understands that the rationale for this therapy is to:
A) Restore menstrual regularity
B) Induce ovulation
C) Improve insulin uptake
D) Alleviate hirsutism
9. When teaching a woman how to perform Kegel exercises, the nurse explains that these exercises are designed to strengthen which muscles?
B) Lower abdominal
C) Pelvic floor
10. A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect?
A) Increased vaginal discharge
B) Urinary tract infection
D) Vaginal ulceration
Chapter 8- Cancers of the Female Reproductive Tract
1. The nurse would refer a client, age 54, for follow-up for suspected endometrial carcinoma if she reports which of the following?
A) Use of oral contraceptives between ages 18 and 25
B) Onset of painless, red postmenopausal bleeding
C) Menopause occurring at age 46
D) Use of intrauterine device for 3 years
2. Which of the following instructions would the nurse include when preparing a woman for a Pap smear?
A) “Refrain from sexual intercourse for 1 week before the test.”
B) “Wear cotton panties on the day of the test.”
C) “Avoid taking any medications for 24 hours.”
D) “Do not douche for 48 hours before the test.”
3. A woman comes to the clinic for a routine checkup. A history of exposure to which of the following would alert the nurse that she is at increased risk for cervical cancer?
B) Human papillomavirus
D) Epstein-Barr virus
4. A client is scheduled to have a Pap smear. After the nurse teaches the client about the Pap smear, which of the following client statements indicates successful teaching?
A) “I need to douche the night before with a mild vinegar solution.”
B) “I will take a bath first thing that morning to make sure I’m clean.”
C) “I will not engage in sexual intercourse for 48 hours before the test.”
D) “I will get a clean urine specimen when I first wake up the morning of the test.”
5. Which finding obtained during a client history would the nurse identify as increasing a client’s risk for ovarian cancer?
A) Multiple sexual partners
B) Consumption of a high-fat diet
D) Grand multiparity (more than five children)
6. A client is scheduled for cryosurgery to remove some abnormal tissue on the cervix. The nurse teaches the client about this treatment, explaining that the tissue will be removed by which method?
7. Which of the following statements best indicates that a client has taken self-care measures to reduce her risk for cervical cancer?
A) “I’ve really cut down on the amount of caffeine I drink every day.”
B) “I’ve thrown out all my bubble baths and just use soap and water now.”
C) “Every time I have sexual intercourse, I douche.”
D) “My partner always uses a condom when we have sexual intercourse.”
8. A client is suspected of having endometrial cancer. The nurse would most likely prepare the client for which procedure to confirm the diagnosis?
A) Transvaginal ultrasound
C) Pap smear
D) Endometrial biopsy
9. Which of the following descriptions would the nurse include when teaching a client about her scheduled colposcopy?
A) “A gel will be applied to your abdomen and a microphone-like device will be moved over the area to identify problem areas.”
B) “A solution will be wiped on your cervix to identify any abnormal cells, which will be visualized with a magnifying instrument.”
C) “Scrapings of tissue will be obtained and placed on slides to be examined under the microscope.”
D) “After you receive anesthesia, a small device will be inserted into your abdomen near your belly button to obtain tissue samples.”
10. The nurse is preparing a presentation for a local women’s group about ways to reduce the risk of reproductive tract cancers. Which of the following would the nurse include?
A) Blood pressure evaluation every 6 months
B) Yearly Pap smears starting at age 40
C) Yearly cholesterol screening starting at age 45
D) Consumption of two to three glasses of red wine per day
Chapter 9- Violence and Abuse
1. The nurse is presenting a class at a local community health center on violence during pregnancy. Which of the following would the nurse include as a possible complication?
A) Hypertension of pregnancy
C) Placenta previa
D) Postterm labor
2. Which approach would be most appropriate when counseling a woman who is a suspected victim of violence?
A) Offer her a pamphlet about the local battered women’s shelter.
B) Call her at home to ask her some questions about her marriage.
C) Wait until she comes in a few more times to make a better assessment.
D) Ask, “Have you ever been physically hurt by your partner?”
3. When describing an episode, the victim reports that she attempted to calm her partner down to keep things from escalating. This behavior reflects which phase of the cycle of violence?
4. A battered pregnant woman reports to the nurse that her husband has stopped hitting her and promises never to hurt her again. Which of the following is an appropriate response?
A) “That’s great. I wish you both the best.”
B) “The cycle of violence often repeats itself.”
C) “He probably didn’t mean to hurt you.”
D) “You need to consider leaving him.”
5. Which of the following nursing actions would be least helpful for a client who is a victim of violence?
A) Assist the client to project her anger.
B) Provide information about a safe home and crisis line.
C) Teach her about the cycle of violence.
D) Discuss her legal and personal rights.
6. When describing the cycle of violence to a community group, the nurse explains that the first phase usually is:
A) Somehow triggered by the victim’s behavior
B) Characterized by tension-building and minor battery
C) Associated with loss of physical and emotional control
D) Like a honeymoon that lulls the victim
7. Which of the following statements would be most appropriate to empower victims of violence to take action?
A) “Give your partner more time to come around.”
B) “Remember—children do best in two-parent families.”
C) “Change your behavior so as not to trigger the violence.”
D) “You are a good person and you deserve better than this.”
8. When a nurse suspects that a client may have been abused, the first action should be to:
A) Ask the client about the injuries and if they are related to abuse.
B) Encourage the client to leave the batterer immediately.
C) Set up an appointment with a domestic violence counselor.
D) Ask the suspected abuser about the victim’s injuries.
9. Which of the following would the nurse describe as a characteristic of the second phase of the cycle of violence?
A) The batterer is contrite and attempts to apologize for the behavior.
B) The physical battery is abrupt and unpredictable.
C) Verbal assaults begin to escalate toward the victim.
D) The victim accepts the anger as legitimately directed at her.
10. In addition to providing privacy, which of the following would be most appropriate initially in situations involving suspected abuse?
A) Allow the client to have a good cry over the situation.
B) Tell the client, “Injuries like these don’t usually happen by accident.”
C) Call the police immediately so they can question the victim.
D) Ask the abuser to describe his side of the story first.
Chapter 10- Fetal Development and Genetics
1. While talking with a pregnant woman who has undergone genetic testing, the woman informs the nurse that her baby will be born with Down syndrome. The nurse understands that Down syndrome is an example of:
A) Multifactorial inheritance
B) X-linked recessive inheritance
C) Trisomy numeric abnormality
D) Chromosomal deletion
2. A nurse is describing advances in genetics to a group of students. Which of the following would the nurse least likely include?
A) Genetic diagnosis is now available as early as the second trimester.
B) Genetic testing can identify presymptomatic conditions in children.
C) Gene therapy can be used to repair missing genes with normal ones.
D) Genetic agents may be used in the future to replace drugs.
3. After teaching a group of students about fetal development, the instructor determines that the teaching was successful when the students identify which of the following as providing the barrier to other sperm after fertilization?
A) Zona pellucida
4. A nurse is teaching a class on X-linked recessive disorders. Which of the following statements would the nurse most likely include?
A) Males are typically carriers of the disorders.
B) No male-to-male transmission occurs.
C) Daughters are more commonly affected with the disorder.
D) Both sons and daughters have a 50% risk of the disorder.
5. A pregnant woman undergoes maternal serum alpha-fetoprotein (MSAFP) testing at 16 to 18 weeks’ gestation. Which of the following would the nurse suspect if the woman’s level is decreased?
A) Down syndrome
B) Sickle-cell anemia
C) Cardiac defects
D) Open neural tube defect
6. The nurse is developing a presentation for a community group of young adults discussing fetal development and pregnancy. The nurse would identify that the sex of offspring is determined at the time of:
C) Formation of morula
7. When describing amniotic fluid to a pregnant woman, the nurse would include which of the following?
A) “This fluid acts as transport mechanism for oxygen and nutrients.”
B) “The fluid is mostly protein to provide nourishment to your baby.”
C) “This fluid acts as a cushion to help to protect your baby from injury.”
D) “The amount of fluid remains fairly constant throughout the pregnancy.”
8. Assessment of a pregnant woman reveals oligohydramnios. The nurse would be alert for the development of which of the following?
A) Maternal diabetes
B) Placental insufficiency
C) Neural tube defects
D) Fetal gastrointestinal malformations
9. A couple comes to the clinic for preconception counseling and care. As part of the visit, the nurse teaches the couple about fertilization and initial development, stating that the zygote formed by the union of the ovum and sperm consists of how many chromosomes?
10. A woman just delivered a healthy term newborn. Upon assessing the umbilical cord, the nurse would identify which of the following as normal? (Select all that apply.)
A) One vein
B) Two veins
C) One artery
D) Two arteries
E) One ligament
F) Two ligaments
Chapter 11- Maternal Adaptation During Pregnancy
1. During a vaginal exam, the nurse notes that the cervix has a bluish color. The nurse documents this finding as:
A) Hegar’s sign
B) Goodell’s sign
C) Chadwick’s sign
D) Ortolani’s sign
2. The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. The mother will most likely experience which of the following at that time?
D) Urinary frequency
3. A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, “I’ve never urinated as often as I have for the past three weeks.” Which response would be most appropriate for the nurse to make?
A) “Having to urinate so often is annoying. I suggest that you watch how much fluid you are drinking and limit it.”
B) “You shouldn’t be urinating this frequently now; it usually stops by the time you’re eight weeks pregnant. Is there anything else bothering you?”
C) “By the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is likely to return toward the end of your pregnancy.”
D) “Women having their second child generally don’t have frequent urination. Are you experiencing any burning sensations?”
4. In a client’s seventh month of pregnancy, she reports feeling “dizzy, like I’m going to pass out, when I lie down flat on my back.” The nurse integrates which of the following in to the explanation?
A) Pressure of the gravid uterus on the vena cava
B) A 50% increase in blood volume
C) Physiologic anemia due to hemoglobin decrease
D) Pressure of the presenting fetal part on the diaphragm
5. A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which of the following would the nurse include?
A) Ankle edema
B) Urinary frequency
6. A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating which of the following?
A) Iron-deficiency anemia
B) A multiple gestation pregnancy
C) Greater-than-expected weight gain
D) Hemodilution of pregnancy
7. The nurse is discussing the insulin needs of a primaparous client with diabetes who has been using insulin for the past few years. The nurse informs the client that her insulin needs will increase during pregnancy based on the nurse’s understanding that the placenta produces:
A) hCG, which increases maternal glucose levels
B) hPL, which deceases the effectiveness of insulin
C) Estriol, which interferes with insulin crossing the placenta
D) Relaxin, which decreases the amount of insulin produced
8. When teaching a pregnant client about the physiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. Which of the following would the nurse include as the underlying reason for the effect?
A) Pancreatic function is affected by pregnancy.
B) Glucose is utilized more rapidly during a pregnancy.
C) The pregnant woman increases her dietary intake.
D) Glucose moves through the placenta to assist the fetus.
9. When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find?
D) Emotional lability
10. The nurse is assessing a pregnant woman in the second trimester. Which of the following tasks would indicate to the nurse that the client is incorporating the maternal role into her personality?
A) The woman demonstrates concern for herself and her fetus as a unit.
B) The client identifies what she must give up to assume her new role.
C) The woman acknowledges the fetus as a separate entity within her.
D) The client demonstrates unconditional acceptance without rejection.
Chapter 12- Nursing Management During Pregnancy
1. A woman in the 34th week of pregnancy says to the nurse, “I still feel like having intercourse with my husband.” The woman’s pregnancy has been uneventful. The nurse responds based on the understanding that:
A) It is safe to have intercourse at this time.
B) Intercourse at this time is likely to cause rupture of membranes.
C) There are other ways that the couple can satisfy their needs.
D) Intercourse at this time is likely to result in premature labor.
2. On the first prenatal visit, examination of the woman’s internal genitalia reveals a bluish coloration of the cervix and vaginal mucosa. The nurse records this finding as:
A) Hegar’s sign
B) Goodell’s sign
C) Chadwick’s sign
D) Homans’ sign
3. When describing perinatal education to a pregnant woman and her partner, the nurse emphasizes that the primary goal of these classes is to:
A) Equip a couple with the knowledge to experience a pain-free childbirth
B) Provide knowledge and skills to actively participate in birth and parenting
C) Eliminate anxiety so that they can have an uncomplicated birth
D) Empower the couple to totally control the birth process
4. When assessing a woman at follow-up prenatal visits, the nurse would anticipate which of the following to be performed?
A) Hemoglobin and hematocrit
B) Urine for culture
C) Fetal ultrasound
D) Fundal height measurement
5. During a routine prenatal visit, a client, 36 weeks pregnant, states she has difficulty breathing and feels like her pulse rate is really fast. The nurse finds her pulse to be 100 beats per minute (increased from baseline readings of 70 to 74 beats per minute. and irregular, with bilateral crackles in the lower lung bases. Which nursing diagnosis would be the priority for this client?
A) Ineffective tissue perfusion related to supine hypotensive syndrome
B) Impaired gas exchange related to pulmonary congestion
C) Activity intolerance related to increased metabolic requirements
D) Anxiety related to fear of pregnancy outcome
6. When preparing a woman for an amniocentesis, the nurse would instruct her to do which of the following?
A) Shower with an antiseptic scrub.
B) Swallow the preprocedure sedative.
C) Empty her bladder.
D) Lie on her left side.
7. A client who is 4 months pregnant is at the prenatal clinic for her initial visit. Her history reveals she has 7-year-old twins who were born at 34 weeks gestation, a 2-year old son born at 39 weeks gestation, and a spontaneous abortion 1 year ago at 6 weeks gestation. Using the GTPAL method, the nurse would document her obstetric history as:
A) 3 2 1 0 3
B) 3 1 2 2 3
C) 4 1 1 1 3
D) 4 2 1 3 1
8. A client’s last menstrual period was April 11. Using Nagele’s rule, her expected date of birth (EDB. would be:
A) January 4
B) January 18
C) January 25
D) February 24
9. During a nonstress test, when monitoring the fetal heart rate, the nurse notes that when the expectant mother reports fetal movement, the heart rate increases 15 beats or more above the baseline. The nurse interprets this as:
A) Variable decelerations
B) Fetal tachycardia
C) A nonreactive pattern
D) Reactive pattern
10. A client’s maternal serum alpha-fetoprotein (MSAFP. level was unusually elevated at 17 weeks. The nurse suspects which of the following?
A) Fetal hypoxia
B) Open spinal defects
C) Down syndrome
D) Maternal hypertension
Chapter 13- Labor and Birth Process
1. A woman in her 40th week of pregnancy calls the nurse at the clinic and says she’s not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor?
A) “I’m feeling contractions mostly in my back.”
B) “My contractions are about 6 minutes apart and regular.”
C) “The contractions slow down when I walk around.”
D) “If I try to talk to my partner during a contraction, I can’t.”
2. Which of the following would indicate to the nurse that the placenta is separating?
A) Uterus becomes globular
B) Fetal head is at vaginal opening
C) Umbilical cord shortens
D) Mucous plug is expelled
3. When assessing cervical effacement of a client in labor, the nurse assesses which of the following characteristics?
A) Extent of opening to its widest diameter
B) Degree of thinning
C) Passage of the mucous plug
D) Fetal presenting part
4. A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which of the following?
A) Increased energy level with alternating strong and weak contractions
B) Moderately strong contractions every 4 minutes, lasting about 1 minute
C) Contractions noted in the front of abdomen that stop when she walks
D) Pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds
5. A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor?
6. A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating:
A) Latent phase of the first stage of labor
B) Active phase of the first stage of labor
C) Transition phase of the first stage of labor
D) Pelvic phase of the second stage of labor
7. The fetus of a nulliparous woman is in a shoulder presentation. The nurse would most likely prepare the client for which type of birth?
D) Vacuum extraction
8. Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in:
A) Latent phase of the first stage
B) Active phase of the first stage
C) Transition phase of the first stage
D) Perineal phase of the second stage
9. A client is admitted to the labor and birthing suite in early labor. On review of her medical record, the nurse determines that the client’s pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal delivery. Which pelvic shape would the nurse have noted?
10. A woman telephones her health care provider and reports that her “water just broke.” Which suggestion by the nurse would be most appropriate?
A) “Call us back when you start having contractions.”
B) “Come to the clinic or emergency department for an evaluation.”
C) “Drink 3 to 4 glasses of water and lie down.”
D) “Come in as soon as you feel the urge to push.”
Chapter 14- Nursing Management During Labor and Birth
1. A woman in labor who received an opioid for pain relief develops respiratory depression. The nurse would expect which agent to be administered?
2. A client’s membranes spontaneously ruptured, as evidenced by a gush of clear fluid with a contraction. Which of the following would the nurse do next?
A) Check the fetal heart rate.
B) Perform a vaginal exam.
C) Notify the physician immediately.
D) Change the linen saver pad.
3. A woman has just entered the second stage of labor. The nurse would focus care on which of the following?
A) Encouraging the woman to push when she has a strong desire to do so
B) Alleviating perineal discomfort with the application of ice packs
C) Palpating the woman’s fundus for position and firmness
D) Completing the identification process of the newborn with the mother
4. The nurse notes persistent early decelerations on the fetal monitoring strip. Which of the following would the nurse do next?
A) Continue to monitor the FHR because this pattern is benign.
B) Perform a vaginal exam to assess cervical dilation and effacement.
C) Stay with the client while reporting the finding to the physician.
D) Administer oxygen after turning the client on her left side.
5. A woman is admitted to the labor and birthing suite. Vaginal examination reveals that the presenting part is approximately 2 cm above the ischial spines. The nurse documents this finding as:
A) +2 station
B) 0 station
C) –2 station
6. The nurse is performing Leopold’s maneuvers to determine fetal presentation, position, and lie. Which action would the nurse do first?
A) Feel for the fetal buttocks or head while palpating the abdomen.
B) Feel for the fetal back and limbs as the hands move laterally on the abdomen.
C) Palpate for the presenting part in the area just above the symphysis pubis.
D) Determine flexion by pressing downward toward the symphysis pubis.
7. A client states, “I think my waters broke! I felt this gush of fluid between my legs.” The nurse tests the fluid with Nitrazine paper and confirms membrane rupture if the paper turns:
B) Olive green
8. A woman in labor is to receive continuous internal electronic fetal monitoring. The nurse reviews the woman’s medical record to ensure which of the following as being required?
A) Intact membranes
B) Cervical dilation of 2 cm or more
C) Floating presenting fetal part
D) A neonatologist to insert the electrode
9. When assessing fetal heart rate, the nurse finds a heart rate of 175 bpm, accompanied by a decrease in variability and late decelerations. Which of the following would the nurse do next?
A) Have the woman change her position.
B) Administer oxygen.
C) Notify the health care provider.
D) Continue to monitor the pattern every 15 minutes.
10. A woman in labor has chosen to use hydrotherapy as a method of pain relief. Which statement by the woman would lead the nurse to suspect that the woman needs additional teaching?
A) “The warmth and buoyancy of the water has a nice relaxing effect.”
B) “I can stay in the bath for as long as I feel comfortable.”
C) “My cervix should be dilated more than 5 cm before I try using this method.”
D) “The temperature of the water should be at least 105° F.”
Chapter 15- Postpartum Adaptations
1. A primipara client gave birth vaginally to a healthy newborn girl 48 hours ago. The nurse palpates the client’s fundus, expecting it to be at which location?
A) Two fingerbreadths above the umbilicus
B) At the level of the umbilicus
C) Two fingerbreadths below the umbilicus
D) Four fingerbreadths below the umbilicus
2. When caring for a mother who has had a cesarean birth, the nurse would expect the client’s lochia to be:
A) Greater than after a vaginal delivery
B) About the same as after a vaginal delivery
C) Less than after a vaginal delivery
D) Saturated with clots and mucus
3. The nurse is developing a teaching plan for a client who has decided to bottle feed her newborn. Which of the following would the nurse include in the teaching plan to facilitate suppression of lactation?
A) Encouraging the woman to manually express milk
B) Suggesting that she take frequent warm showers to soothe her breasts
C) Telling her to limit the amount of fluids that she drinks
D) Instructing her to apply ice packs to both breasts every other hour
4. The nurse is making a follow-up home visit to a woman who is 12 days postpartum. Which of the following would the nurse expect to find when assessing the client’s fundus?
A) Cannot be palpated
B) 2 cm below the umbilicus
C) 6 cm below the umbilicus
D) 10 cm below the umbilicus
5. A client who is breast-feeding her newborn tells the nurse, “I notice that when I feed him, I feel fairly strong contraction-like pain. Labor is over. Why am I having contractions now?” Which response by the nurse would be most appropriate?
A) “Your uterus is still shrinking in size; that’s why you’re feeling this pain.”
B) “Let me check your vaginal discharge just to make sure everything is fine.”
C) “Your body is responding to the events of labor, just like after a tough workout.”
D) “The baby’s sucking releases a hormone that causes the uterus to contract.”
6. When the nurse is assessing a postpartum client approximately 6 hours after delivery, which finding would warrant further investigation?
A) Deep red, fleshy-smelling lochia
B) Voiding of 350 cc
C) Heart rate of 120 beats/minute
D) Profuse sweating
7. A postpartum client who is bottle feeding her newborn asks, “When should my period return?” Which response by the nurse would be most appropriate?
A) “It’s difficult to say, but it will probably return in about 2 to 3 weeks.”
B) “It varies, but you can estimate it returning in about 7 to 9 weeks.”
C) “You won’t have to worry about it returning for at least 3 months.”
D) “You don’t have to worry about that now. It’ll be quite a while.”
8. The nurse interprets which of the following as evidence that a client is in the taking-in phase?
A) Client states, “He has my eyes and nose.”
B) Client shows interest in caring for the newborn.
C) Client performs self-care independently.
D) Client confidently cares for the newborn.
9. Which of the following would the nurse interpret as being least indicative of paternal engrossment?
A) Demonstrating pleasure when touching or holding the newborn
B) Identifying imperfections in the newborn’s appearance
C) Being able to distinguish his newborn from others in the nursery
D) Showing feelings of pride with the birth of the newborn
10. A postpartum client comes to the clinic for her 6-week postpartum checkup. When assessing the client’s cervix, the nurse would expect the external cervical os to appear:
Chapter 16- Nursing Management During the Postpartum Period
1. A woman who is 12 hours postpartum had a pulse rate around 80 beats per minute during pregnancy. Now, the nurse finds a pulse of 60 beats per minute. Which of these actions should the nurse take?
A) Document the finding, as it is a normal finding at this time.
B) Contact the physician, as it indicates early DIC.
C) Contact the physician, as it is a first sign of postpartum eclampsia.
D) Obtain an order for a CBC, as it suggests postpartum anemia.
2. To decrease the pain associated with an episiotomy immediately after birth, which action by the nurse would be most appropriate?
A) Offer warm blankets.
B) Encourage the woman to void.
C) Apply an ice pack to the site.
D) Offer a warm sitz bath.
3. A postpartum client has a fourth-degree perineal laceration. The nurse would expect which of the following medications to be ordered?
A) Ferrous sulfate (Feosol)
B) Methylergonovine (Methergine)
C) Docusate (Colace)
D) Bromocriptine (Parlodel)
4. Which statement would alert the nurse to the potential for impaired bonding between mother and newborn?
A) “You have your daddy’s eyes.”
B) “He looks like a frog to me.”
C) “Where did you get all that hair?”
D) “He seems to sleep a lot.”
5. After a normal labor and birth, a client is discharged from the hospital 12 hours later. When the community health nurse makes a home visit 2 days later, which finding would alert the nurse to the need for further intervention?
A) Presence of lochia serosa
B) Frequent scant voidings
C) Fundus firm, below umbilicus
D) Milk filling in both breasts
6. A primipara client who is bottle feeding her baby begins to experience breast engorgement on her third postpartum day. Which instruction would be most appropriate to aid in relieving her discomfort?
A) “Express some milk from your breasts every so often to relieve the distention.”
B) “Remove your bra to relieve the pressure on your sensitive nipples and breasts.”
C) “Apply ice packs to your breasts to reduce the amount of milk being produced.”
D) “Take several warm showers daily to stimulate the milk let-down reflex.”
7. The nurse administers RhoGAM to an Rh-negative client after delivery of an Rh-positive newborn based on the understanding that this drug will prevent her from:
A) Becoming Rh positive
B) Developing Rh sensitivity
C) Developing AB antigens in her blood
D) Becoming pregnant with an Rh-positive fetus
8. Which of the following factors in a client’s history would alert the nurse to an increased risk for postpartum hemorrhage?
A) Multiparity, age of mother, operative delivery
B) Size of placenta, small baby, operative delivery
C) Uterine atony, placenta previa, operative procedures
D) Prematurity, infection, length of labor
9. After teaching parents about their newborn, the nurse determines that the teaching was successful when they identify the development of a close emotional attraction to a newborn by parents during the first 30 to 60 minutes after birth as which of the following?
10. A nurse is working as part of a committee to establish policies to promote bonding and attachment. Which practice would be least effective in achieving this goal?
A) Allowing unlimited visiting hours on maternity units
B) Offering round-the-clock nursery care for all infants
C) Promoting rooming-in
D) Encouraging infant contact immediately after birth
Chapter 17- Newborn Transitioning
1. When explaining how a newborn adapts to extrauterine life, the nurse would describe which body systems as undergoing the most rapid changes?
A) Gastrointestinal and hepatic
B) Urinary and hematologic
C) Respiratory and cardiovascular
D) Neurological and integumentary
2. A new mother reports that her newborn often spits up after feeding. Assessment reveals regurgitation. The nurse responds integrating understanding that this most likely is due to which of the following?
A) Placing the newborn prone after feeding
B) Limited ability of digestive enzymes
C) Underdeveloped pyloric sphincter
D) Relaxed cardiac sphincter
3. After teaching a class about hepatic system adaptations after birth, the instructor determines that the teaching was successful when the class identifies which of the following as the process of changing bilirubin from a fat-soluble product to a water-soluble product?
4. Twenty minutes after birth, a baby begins to move his head from side to side, making eye contact with the mother, and pushes his tongue out several times. The nurse interprets this as indicating which of the following?
A) A good time to initiate breast-feeding
B) The period of decreased responsiveness preceding sleep
C) The need to be alert for gagging and vomiting
D) Evidence that the newborn is becoming chilled
5. The nurse institutes measure to maintain thermoregulation based on the understanding that newborns have limited ability to regulate body temperature because they:
A) Have a smaller body surface compared to body mass
B) Lose more body heat when they sweat than adults
C) Have an abundant amount of subcutaneous fat all over
D) Are unable to shiver effectively to increase heat production
6. A new mother is changing the diaper of her 20-hour-old newborn and asks why the stool is almost black. Which response by the nurse would be most appropriate?
A) “You probably took iron during your pregnancy.”
B) “This is meconium stool, normal for a newborn.”
C) “I’ll take a sample and check it for possible bleeding.”
D) “This is unusual and I need to report this.”
7. A client expresses concern that her 2-hour-old newborn is sleepy and difficult to awaken. The nurse explains that this behavior indicates which of the following?
A) Normal progression of behavior
B) Probable hypoglycemia
C) Physiological abnormality
D) Inadequate oxygenation
8. After the birth of a newborn, which of the following would the nurse do first to assist in thermoregulation?
A) Dry the newborn thoroughly.
B) Put a hat on the newborn’s head.
C) Check the newborn’s temperature.
D) Wrap the newborn in a blanket.
9. Assessment of a newborn reveals rhythmic spontaneous movements. The nurse interprets this as indicating:
B) Motor maturity
D) Social behaviors
10. After teaching new parents about the sensory capabilities of their newborn, the nurse determines that the teaching was successful when they identify which sense as being the least mature?
Chapter 18- Nursing Management of the Newborn
1. Prior to discharging a 24-hour-old newborn, the nurse assesses her respiratory status. Which of the following would the nurse expect to assess?
A) Respiratory rate 45, irregular
B) Costal breathing pattern
C) Nasal flaring, rate 65
D) Crackles on auscultation
2. The nurse encourages the mother of a healthy newborn to put the newborn to the breast immediately after birth for which reason?
A) To aid in maturing the newborn’s sucking reflex
B) To encourage the development of maternal antibodies
C) To facilitate maternal–infant bonding
D) To enhance the clearing of the newborn’s respiratory passages
3. When making a home visit, the nurse observes a newborn sleeping on his back in a bassinet. In one corner of the bassinet is a soft stuffed animal and at the other end is a bulb syringe. The nurse determines that the mother needs additional teaching because of which of the following?
A) The newborn should not be sleeping on his back.
B) Stuffed animals should not be in areas where infants sleep.
C) The bulb syringe should not be kept in the bassinet.
D) This newborn should be sleeping in a crib.
4. Assessment of a newborn reveals a heart rate of 180 beats/minute. To determine whether this finding is a common variation rather than a sign of distress, what else does the nurse need to know?
A) How many hours old is this newborn?
B) How long ago did this newborn eat?
C) What was the newborn’s birth weight?
D) Is acrocyanosis present?
5. Just after delivery, a newborn’s axillary temperature is 94° C. What action would be most appropriate?
A) Assess the newborn’s gestational age.
B) Rewarm the newborn gradually.
C) Observe the newborn every hour.
D) Notify the physician if the temperature goes lower.
6. The parents of a newborn become concerned when they notice that their baby seems to stop breathing for a few seconds. After confirming the parents’ findings by observing the newborn, which of the following actions would be most appropriate?
A) Notify the health care provider immediately.
B) Assess the newborn for signs of respiratory distress.
C) Reassure the parents that this is an expected pattern.
D) Tell the parents not to worry since his color is fine.
7. When assessing a newborn 1 hour after birth, the nurse measures an axillary temperature of 95.8° F, an apical pulse of 114 beats/minute, and a respiratory rate of 60 breaths/minute. Which nursing diagnosis takes highest priority?
A) Hypothermia related to heat loss during birthing process
B) Impaired parenting related to addition of new family member
C) Risk for deficient fluid volume related to insensible fluid loss
D) Risk for infection related to transition to extrauterine environment
8. The nurse places a newborn with jaundice under the phototherapy lights in the nursery to achieve which goal?
A) Prevent cold stress
B) Increase surfactant levels in the lungs
C) Promote respiratory stability
D) Decrease the serum bilirubin level
9. The nurse completes the initial assessment of a newborn. Which finding would lead the nurse to suspect that the newborn is experiencing difficulty with oxygenation?
A) Respiratory rate of 54 breaths/minute
B) Abdominal breathing
C) Nasal flaring
10. During a physical assessment of a newborn, the nurse observes bluish markings across the newborn’s lower back. The nurse documents this finding as which of the following?
B) Mongolian spots
C) Stork bites
D) Birth trauma
Chapter 19- Nursing Management of Pregnancy at Risk- Pregnancy
1. After teaching a woman who has had an evacuation for a hydatidiform mole (molar pregnancy. about her condition, which of the following statements indicates that the nurse’s teaching was successful?
A) “I will be sure to avoid getting pregnant for at least 1 year.”
B) “My intake of iron will have to be closely monitored for 6 months.”
C) “My blood pressure will continue to be increased for about 6 more months.”
D) “I won’t use my birth control pills for at least a year or two.”
2. Which of the following findings on a prenatal visit at 10 weeks might lead the nurse to suspect a hydatidiform mole?
A) Complaint of frequent mild nausea
B) Blood pressure of 120/84 mm Hg
C) History of bright red spotting 6 weeks ago
D) Fundal height measurement of 18 cm
3. A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication?
A) Urinary output of 20 mL per hour
B) Respiratory rate of 10 breaths/minute
C) Deep tendons reflexes 2+
D) Difficulty in arousing
4. Upon entering the room of a client who has had a spontaneous abortion, the nurse observes the client crying. Which of the following responses by the nurse would be most appropriate?
A) “Why are you crying?”
B) “Will a pill help your pain?”
C) “I’m sorry you lost your baby.”
D) “A baby still wasn’t formed in your uterus.”
5. Which of the following data on a client’s health history would the nurse identify as contributing to the client’s risk for an ectopic pregnancy?
A) Use of oral contraceptives for 5 years
B) Ovarian cyst 2 years ago
C) Recurrent pelvic infections
D) Heavy, irregular menses
6. In a woman who is suspected of having a ruptured ectopic pregnancy, the nurse would expect to assess for which of the following as a priority?
7. Which of the following findings would the nurse interpret as suggesting a diagnosis of gestational trophoblastic disease?
A) Elevated hCG levels, enlarged abdomen, quickening
B) Vaginal bleeding, absence of FHR, decreased hPL levels
C) Visible fetal skeleton on ultrasound, absence of quickening, enlarged abdomen
D) Gestational hypertension, hyperemesis gravidarum, absence of FHR
8. It is determined that a client’s blood Rh is negative and her partner’s is positive. To help prevent Rh isoimmunization, the nurse anticipates that the client will receive RhoGAM at which time?
A) At 34 weeks’ gestation and immediately before discharge
B) 24 hours before delivery and 24 hours after delivery
C) In the first trimester and within 2 hours of delivery
D) At 28 weeks’ gestation and again within 72 hours after delivery
9. The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse includes interventions focusing on which of the following because of the woman’s increased risk?
C) Post-term labor
10. A woman hospitalized with severe preeclampsia is being treated with hydralazine to control blood pressure. Which of the following would the lead the nurse to suspect that the client is having an adverse effect associated with this drug?
A) Gastrointestinal bleeding
B) Blurred vision
Chapter 20- Nursing Management of the Pregnancy at Risk
1. The nurse is teaching a pregnant woman with type 1 diabetes about her diet during pregnancy. Which client statement indicates that the nurse’s teaching was successful?
A) “I’ll basically follow the same diet that I was following before I became pregnant.”
B) “Because I need extra protein, I’ll have to increase my intake of milk and meat.”
C) “Pregnancy affects insulin production, so I’ll need to make adjustments in my diet.”
D) “I’ll adjust my diet and insulin based on the results of my urine tests for glucose.”
2. A nurse is developing a program for pregnant women with diabetes about reducing complications. Which factor would the nurse identify as being most important in helping to reduce the maternal/fetal/neonatal complications associated with pregnancy and diabetes?
A) Stability of the woman’s emotional and psychological status
B) Degree of glycemic control achieved during the pregnancy
C) Evaluation of retinopathy by an ophthalmologist
D) Blood urea nitrogen level (BUN. within normal limits
3. Because a pregnant client’s diabetes has been poorly controlled throughout her pregnancy, the nurse would be alert for which of the following in the neonate at birth?
C) Low birth weight
4. A woman with diabetes is considering becoming pregnant. She asks the nurse whether she will be able to take oral hypoglycemics when she is pregnant. The nurse’s response is based on the understanding that oral hypoglycemics:
A) Can be used as long as they control serum glucose levels
B) Can be taken until the degeneration of the placenta occurs
C) Are usually suggested primarily for women who develop gestational diabetes
D) Show promising results but more studies are needed to confirm their effectiveness
5. A 10-week pregnant woman with diabetes has a glycosylated hemoglobin (HbA1C. level of 13%. At this time the nurse should be most concerned about which of the following possible fetal outcomes?
A) Congenital anomalies
B) Incompetent cervix
C) Placenta previa
D) Abruptio placentae
6. After teaching a group of students about the use of antiretroviral agents in pregnant women who are HIV-positive, the instructor determines that the teaching was successful when the group identifies which of the following as the underlying rationale?
A) Reduction in viral loads in the blood
B) Treatment of opportunistic infections
C) Adjunct therapy to radiation and chemotherapy
D) Can cure acute HIV/AIDS infections
7. Assessment of a pregnant woman and her fetus reveals tachycardia and hypertension. There is also evidence suggesting vasoconstriction. The nurse would question the woman about use of which substance?
8. When teaching a class of pregnant women about the effects of substance abuse during pregnancy, which of the following would the nurse most likely include?
A) Low-birth-weight infants
B) Excessive weight gain
C) Higher pain tolerance
D) Longer gestational periods
9. A client who is HIV-positive is in her second trimester and remains asymptomatic. She voices concern about her newborn’s risk for the infection. Which of the following statements by the nurse would be most appropriate?
A) “You’ll probably have a cesarean birth to prevent exposing your newborn.”
B) “Antibodies cross the placenta and provide immunity to the newborn.”
C) “Wait until after the infant is born and then something can be done.”
D) “Antiretroviral medications are available to help reduce the risk of transmission.”
10. When assessing a pregnant woman with heart disease throughout the antepartal period, the nurse would be especially alert for signs and symptoms of cardiac decompensation at which time?
A) 16 to 20 weeks’ gestation
B) 20 to 24 weeks’ gestation
C) 24 to 28 weeks’ gestation
D) 28 to 32 weeks’ gestation
AND MUCH MORE