Maternal Child Nursing 4th Edition, McKinney Test Bank

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Test Bank For Maternal Child Nursing 4th Edition, McKinney. Note: This is not a text book. Description: ISBN-13: 978-1437727753, ISBN-10: 1437727751.

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Test Bank Maternal Child Nursing 4th Edition, McKinney

Chapter 1: Foundations of Maternity, Women’s Health, and Child Health Nursing
1. Which factor significantly contributed to the shift from home births to hospital births in the early 20th century?
a. Puerperal sepsis was identified as a risk factor in labor and delivery.
b. Forceps were developed to facilitate difficult births.
c. The importance of early parental-infant contact was identified.
d. Technologic developments became available to physicians.
2. Family-centered maternity care developed in response to:
a. Demands by physicians for family involvement in childbirth
b. The Sheppard-Towner Act of 1921
c. Parental requests that infants be allowed to remain with them rather than in a nursery
d. Changes in pharmacologic management of labor
3. Which setting for childbirth allows the least amount of parent-infant contact?
a. Labor/delivery/recovery/postpartum room
b. Birth center
c. Traditional hospital birth
d. Home birth
4. As a result of changes in health care delivery and funding, a current trend seen in the pediatric setting is:
a. Increased hospitalization of children
b. Decreased number of children living in poverty
c. An increase in ambulatory care
d. Decreased use of managed care
5. The Women, Infants, and Children (WIC) program provides:
a. Well-child examinations for infants and children living at the poverty level
b. Immunizations for high-risk infants and children
c. Screening for infants with developmental disorders
d. Supplemental food supplies to low-income women who are pregnant or breastfeeding
6. In most states, adolescents who are not emancipated minors must have the permission of their parents before:
a. Treatment for drug abuse
b. Treatment for sexually transmitted diseases (STDs)
c. Accessing birth control
d. Surgery
7. The maternity nurse should have a clear understanding of the correct use of a clinical pathway. One characteristic of clinical pathways is that they:
a. Are developed and implemented by nurses
b. Are used primarily in the pediatric setting
c. Set specific time lines for sequencing interventions
d. Are part of the nursing process
8. The fastest-growing group of homeless people is:
a. Men and women preparing for retirement
b. Migrant workers
c. Single women and their children
d. Intravenous (IV) substance abusers
9. The United States ranks 25th in infant mortality rates of the world. Which factor has a significant impact on decreasing the mortality rate of infants?
a. Resolving all language and cultural differences
b. Enrolling the pregnant woman in the Medicaid program by the 8th month of pregnancy
c. Ensuring early and adequate prenatal care
d. Providing more women’s shelters
10. The intrapartum woman sees no need for an admission fetal monitoring strip. If she continues to refuse, what is the first action the nurse should take?
a. Consult the family of the woman.
b. Notify the physician.
c. Document the woman’s refusal in the nurse’s notes.
d. Make a referral to the hospital ethics committee.
Chapter 2: The Nurse’s Role in Maternity, Women’s Health, and Pediatric Nursing
1. Which principle of teaching should the nurse use to ensure learning in a family situation?
a. Motivate the family with praise and positive reinforcement.
b. Present complex subject material first, while the family is alert and ready to learn.
c. Families should be taught by using medical jargon so they will be able to understand the technical language used by physicians.
d. Learning is best accomplished using the lecture format.
2. When addressing the questions of a newly pregnant woman, the nurse can explain that the certified nurse-midwife is qualified to perform:
a. Regional anesthesia
b. Cesarean deliveries
c. Vaginal deliveries
d. Internal versions
3. Which nursing intervention is an independent function of the nurse?
a. Administering oral analgesics
b. Teaching the woman perineal care
c. Requesting diagnostic studies
d. Providing wound care to a surgical incision
4. Which response by the nurse to the woman’s statement, “I’m afraid to have a cesarean birth,” would be the most therapeutic?
a. “What concerns you most about a cesarean birth?”
b. “Everything will be OK.”
c. “Don’t worry about it. It will be over soon.”
d. “The doctor will be in later, and you can talk to him.”
5. To evaluate the woman’s learning about performing infant care, the nurse should:
a. Demonstrate infant care procedures.
b. Allow the woman to verbalize the procedure.
c. Observe the woman as she performs the procedure.
d. Routinely assess the infant for cleanliness.
6. What situation is most conducive to learning?
a. A teacher who speaks very little Spanish is teaching a class of Latino students.
b. A class is composed of students of various ages and educational backgrounds.
c. An auditorium is being used as a classroom for 300 students.
d. An Asian nurse provides nutritional information to a group of pregnant Asian women.
7. What is the primary role of practicing nurses in the research process?
a. Designing research studies
b. Collecting data for other researchers
c. Identifying researchable problems
d. Seeking funding to support research studies
8. The step of the nursing process in which the nurse determines the appropriate interventions for the identified nursing diagnosis is called:
a. Assessment
b. Planning
c. Intervention
d. Evaluation
9. Which goal is most appropriate for the collaborative problem of wound infection?
a. The patient will have a temperature of 98.6° F within 2 days.
b. The patient’s fluid intake will be maintained at 1000 mL per 8 hours.
c. The patient will not exhibit further signs of infection.
d. The patient will be monitored to detect therapeutic response to antibiotic therapy.
10. Which nursing intervention is correctly written?
a. Encourage turning, coughing, and deep breathing.
b. Force fluids as necessary.
c. Assist to ambulate for 10 minutes at 8 AM, 2 PM, and 6 PM.
d. Observe interaction with infant.
Chapter 3: The Childbearing and Child-Rearing Family
1. The formula used to guide time-out as a disciplinary method is
a. 1 minute per each year of the child’s age
b. To relate the length of the time-out to the severity of the behavior
c. Never to use time-out for a child younger than 4 years
d. To follow the time-out with a treat
2. The nurse observes that when an 8-year-old boy enters the playroom, he often causes disruption by taking toys from other children. The nurse’s best approach for this behavior is to
a. Ban the child from the playroom.
b. Explain to the children in the playroom that he is very ill and should be allowed to have the toys.
c. Approach the child in his room and ask, “Would you like it if the other children took your toys from you?”
d. Approach the child in his room and state, “I am concerned that you are taking the other children’s toys. It upsets them and me.”
3. Families who deal effectively with stress exhibit which behavior pattern?
a. Focus on family problems
b. Feel weakened by stress
c. Expect that some stress is normal
d. Feel guilty when stress exists
4. Which family will most likely have the most difficulty coping with an ill child?
a. A single-parent mother who has the support of her parents and siblings
b. Parents who have just moved to the area and are living in an apartment while they look for a house
c. The family of a child who has had multiple hospitalizations related to asthma and has adequate relationships with the nursing staff
d. A family in which there is a young child and four older married children who live in the area
5. A nurse determines that a child consistently displays predictable behavior and is regular in performing daily habits. Which temperament is the child displaying?
a. Easy
b. Slow-to-warm-up
c. Difficult
d. Shy
6. The parent of a child who has had numerous hospitalizations asks the nurse for advice because her child has been having behavior problems at home and in school. In discussing effective discipline, what is an essential component?
a. All children display some degree of acting out and this behavior is normal.
b. The child is manipulative and should have firmer limits set on her behavior.
c. Positive reinforcement and encouragement should be used to promote cooperation and the desired behaviors.
d. Underlying reasons for rules should be given and the child should be allowed to decide which rules should be followed.
7. What characteristic would most likely be found in a Mexican-American family?
a. Stoicism
b. Close extended family
c. Considering docile children weak
d. Very interested in health-promoting lifestyles
8. While reviewing the dietary-intake documentation of a 7-year-old Asian boy with a fractured femur, the nurse notes that he consistently refuses to eat the food on his tray. What assumption is most likely accurate?
a. He is a picky eater.
b. He needs less food because he is on bed rest.
c. He may have culturally related food preferences.
d. He is probably eating between meals and spoiling his appetite.
9. A nurse is caring for a child with the religion of Christian Science. What intervention should the nurse include in the care plan for this child?
a. Offer iced tea to the child who is experiencing deficient fluid volume.
b. Inform the spiritual care department that the child has been admitted to the hospital.
c. Allow parents to sign a form opting out of routine immunizations.
d. Ask parents whether the child has been baptized.
10. To resolve family conflict, it is necessary to have open communication, accurate perception of the problem, and a(n)
a. Intact family structure
b. Arbitrator
c. Willingness to consider the view of others
d. Balance in personality types
Chapter 4: Communicating with Children and Families
1. Which information should the nurse include when preparing a 5-year-old child for a cardiac catheterization?
a. A detailed explanation of the procedure
b. A description of what the child will feel and see during procedure
c. An explanation about the dye that will go directly into his vein
d. An assurance to the child that he and the nurse can talk about the procedure when it is over
2. An important consideration for the nurse who is communicating with a very young child is to
a. Speak loudly, clearly, and directly.
b. Use transition objects, such as a puppet.
c. Disguise own feelings, attitudes, and anxiety.
d. Initiate contact with child when parent is not present.
3. An effective technique for communicating with toddlers is to
a. Have the toddler make up a story from a picture.
b. Involve the toddler in dramatic play with dress-up clothing.
c. Use picture books.
d. Ask the toddler to draw pictures of his fears.
4. What is the most important consideration for effectively communicating with a child?
a. The child’s chronologic age
b. The parent-child interaction
c. The child’s receptiveness
d. The child’s developmental level
5. Which behavior is most likely to encourage open communication?
a. Avoiding eye contact
b. Folding arms across chest
c. Standing with head bowed
d. Soft stance with arms loose at the side
6. Which strategy is most likely to encourage a child to express his feelings about the hospital experience?
a. Avoiding periods of silence
b. Asking direct questions
c. Sharing personal experiences
d. Using open-ended questions
7. Which is the most appropriate question to ask when interviewing an adolescent to encourage conversation?
a. “Are you in school?”
b. “Are you doing well in school?”
c. “How is school going for you?”
d. “How do your parents feel about your grades?”
8. What is the most appropriate response for the nurse to make to the parent of a 3-year-old child found in a bed with the side rails down?
a. “You must never leave the child in the room alone with the side rails down.”
b. “I am very concerned about your child’s safety when you leave the side rails down. The hospital has guidelines stating that side rails need to be up if the child is in the bed.”
c. “It is hospital policy that side rails need to be up if the child is in bed.”
d. “When parents leave side rails down, they might be considered as uncaring.”
9. What is an appropriate preoperative teaching plan for a school-age child?
a. Begin preoperative teaching the morning of surgery.
b. Schedule a tour of the hospital a few weeks before surgery.
c. Show the child books and pictures 4 days before surgery.
d. Limit teaching to 5 minutes and use simple terminology.
10. When a child broke her favorite doll during a hospitalization, her primary nurse bought the child a new doll and gave it to her the next day. What is the best interpretation of the nurse’s behavior?
a. The nurse is displaying signs of overinvolvement.
b. The nurse is a kind and generous person.
c. The nurse feels a special closeness to the child.
d. The nurse wants to make the child happy.
Chapter 5: Health Promotion for the Developing Child
1. Which statement best describes development in infants and children?
a. Development, a predictable and orderly process, occurs at varying rates within normal limits.
b. Development is primarily related to the growth in the number and size of cells.
c. Development occurs in a proximodistal direction with fine muscle development occurring first.
d. Development is more easily and accurately measured than growth.
2. Frequent developmental assessments are important for which reason?
a. Stable developmental periods during infancy provide an opportunity to identify any delays or deficits.
b. Infants need stimulation specific to the stage of development.
c. Critical periods of development occur during childhood.
d. Child development is unpredictable and needs monitoring.
3. Which factor has the greatest influence on child growth and development?
a. Culture
b. Environment
c. Genetics
d. Nutrition
4. The nurse is planning a teaching session for a young child and her parents. According to Piaget’s theory, the period of cognitive development in which the child is able to distinguish between concepts related to fact and fantasy, such as human beings are incapable of flying like birds, is the _______ period of cognitive development.
a. Sensorimotor
b. Formal operations
c. Concrete operations
d. Preoperational
5. The theorist who viewed developmental progression as a lifelong series of conflicts that need resolution is
a. Erikson
b. Freud
c. Kohlberg
d. Piaget
6. What does the nurse need to know when observing a chronically ill child at play?
a. Play is not important to hospitalized children.
b. Children need to have structured play periods.
c. Children’s play is a form of communication.
d. Play is to be discouraged because it tires hospitalized children.
7. Which child is most likely to be frightened by hospitalization?
a. A 4-month-old infant admitted with a diagnosis of bronchiolitis
b. A 2-year-old toddler admitted for cystic fibrosis
c. A 9-year-old child hospitalized with a fractured femur
d. A 15-year-old adolescent admitted for abdominal pain
8. Which expected outcome is developmentally appropriate for a hospitalized 4-year-old child?
a. The child will be dressed and fed by the parents.
b. The child will independently ask for play materials or other personal needs.
c. The child will be able to verbalize an understanding of the reason for the hospitalization.
d. The child will have a parent stay in the room at all times.
9. A preschool aged child will be receiving immunizations. Which statement identifies an appropriate level of language development for a 4-year-old child?
a. The child has a vocabulary of 300 words and uses simple sentences.
b. The child uses correct grammar in sentences.
c. The child is able to pronounce consonants clearly.
d. The child uses language to express abstract thought.
10. Which children are at greater risk for not receiving immunizations?
a. Children who attend licensed daycare programs
b. Children entering school
c. Children who are home schooled
d. Young adults entering college
Chapter 6: Health Promotion for the Infant
1. Which milestone is developmentally appropriate for a 2-month-old infant?
a. Pulled to a sitting position, head lag is absent.
b. Pulled to a sitting position, the infant is able to support the head when the trunk is lifted.
c. The infant can lift his or her head from the prone position and briefly hold the head erect.
d. In the prone position, the infant is fully able to support and hold the head in a straight line.
2. Approximately how much would a newborn who weighed 7 pounds 6 ounces at birth weigh at 1 year of age?
a. 14 3/4 lb
b. 22 1/8 lb
c. 29 1/2 lb
d. Unable to estimate weigh at 1 year
3. Which statement made by a mother is consistent with a developmental delay?
a. “I have noticed that my 9-month-old infant responds consistently to the sound of his name.”
b. “I have noticed that my 12-month-old child does not get herself to a sitting position or pull to stand.”
c. “I am so happy when my 1 1/2-month-old infant smiles at me.”
d. “My 5-month-old infant is not rolling over in both directions yet.”
4. The nurse is performing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. This should be interpreted as a(n)
a. Normal finding
b. Questionable finding—infant should be rechecked in 1 month
c. Abnormal finding—indicates need for immediate referral to practitioner
d. Abnormal finding—indicates need for developmental assessment
5. The nurse advises the mother of a 3-month-old exclusively breastfed infant to
a. Start giving the infant a vitamin D supplement.
b. Start using an infant feeder and add rice cereal to the formula.
c. Start feeding the infant rice cereal with a spoon at the evening feeding.
d. Continue breastfeeding without any supplements.
6. At what age is an infant first expected to locate an object hidden from view?
a. 4 months of age
b. 6 months of age
c. 9 months of age
d. 20 months of age
7. The parents of a newborn infant state, “We will probably not have our baby immunized because we are concerned about the risk of our child being injured.” What is the nurse’s best response?
a. “It is your decision.”
b. “Have you talked with your parents about this? They can probably help you think about this decision.”
c. “The risks of not immunizing your baby are greater than the risks from the immunizations.”
d. “You are making a mistake.”
8. The mother of a 9-month-old infant is concerned because the infant cries when approached by an unknown shopper at the grocery store. What is the best response for the nurse to make to the mother?
a. “You could consider leaving the infant more often with other people so he can adjust.”
b. “You might consider taking him to the doctor because he may be ill.”
c. “Have you noticed whether the baby is teething?”
d. “This is a sign of stranger anxiety and demonstrates healthy attachment.”
9. Which statement concerning physiologic factors is true?
a. The infant has a slower metabolic rate than an adult.
b. An infant has an inability to digest protein and lactase.
c. Infants have a slower circulatory response than adults do.
d. The kidneys of an infant are less efficient in concentrating urine than an adult’s kidneys.
10. Which is a priority in counseling parents of a 6-month-old infant?
a. Increased appetite from secondary growth spurt
b. Encouraging the infant to smile
c. Securing a developmentally safe environment for the infant
d. Strategies to teach infants to sit up
Chapter 7: Health Promotion during Early Childhood
1. The mother of a 14-month-old child is concerned because the child’s appetite has decreased. The best response for the nurse to make to the mother is
a. “It is important for your toddler to eat three meals a day and nothing in between.”
b. “It is not unusual for toddlers to eat less.”
c. “Be sure to increase your child’s milk consumption, which will improve nutrition.”
d. “Giving your child a multivitamin supplement daily will increase your toddler’s appetite.”
2. Which toy is the most developmentally appropriate for an 18- to 24-month-old child?
a. A push-and-pull toy
b. Nesting blocks
c. A bicycle with training wheels
d. A computer
3. Which is the priority concern in developing a teaching plan for the parents of a 15-month-old child?
a. Toilet training guidelines
b. Guidelines for weaning children from bottles
c. Instructions on preschool readiness
d. Instructions on a home safety assessment
4. What is the primary purpose of a transitional object?
a. It helps the parents deal with the guilt they feel when they leave the child.
b. It keeps the child quiet at bedtime.
c. It is effective in decreasing anxiety in the toddler.
d. It decreases negativism and tantrums in the toddler.
5. The nurse is teaching parents of a toddler about language development. Which statement best identifies the characteristics of language development in a toddler?
a. Language development skills slow during the toddler period.
b. The toddler understands more than he can express.
c. Most of the toddler’s speech is not easily understood.
d. The toddler’s vocabulary contains approximately 600 words.
6. A mother asks when toilet training is most appropriately initiated. What is the nurse’s best response?
a. “When your child is 12 to 18 months of age.”
b. “When your child exhibits signs of physical and psychological readiness.”
c. “When your child has been walking for 9 months.”
d. “When your child is able to sit on the ‘potty’ for 10 to 15 minutes.”
7. Which statement by a mother of a toddler indicates a correct understanding of the use of discipline?
a. “I always include explanations and morals when I am disciplining my toddler.”
b. “I always try to be consistent when disciplining the children, and I correct my children at the time they are misbehaving.”
c. “I believe that discipline should be done by only one family member.”
d. “My rule of thumb is no more than one spanking a day.”
8. Which comments indicate that the mother of a toddler needs further teaching about dental care?
a. “We use well water so I give my toddler fluoride supplements.”
b. “My toddler brushes his teeth with my help.”
c. “My child will not need a dental checkup until his permanent teeth come in.”
d. “I use a small nylon bristle brush for my toddler’s teeth.”
9. Which assessment finding in a preschooler suggests the need for further investigation?
a. The child is able to dress independently.
b. The child rides a tricycle.
c. The child has an imaginary friend.
d. The child has a 2-lb weight gain in 12 months.
10. A 17-month-old child is expected to be in what stage according to Piaget?
a. Trust
b. Preoperations
c. Secondary circular reaction
d. Sensorimotor period
Chapter 8: Health Promotion for the School-Age Child
1. Which statement made by a mother of a school-age boy indicates a need for further teaching?
a. “My child is playing soccer this year.”
b. “He is always busy with his friends playing games. He is very active.”
c. “I limit his television watching to about 2 hours a day.”
d. “I am glad his coach is a good role model. He emphasizes the importance of winning in today’s society. The kids really are disciplined.”
2. Which behavior is not demonstrated in the 8-year-old child?
a. Understands that his or her point of view is not the only one
b. Enjoys telling riddles and silly jokes
c. Understands that pouring liquid from a small to large container does not change the amount
d. Engages in fantasy and magical thinking
3. The ability to mentally understand that 1 + 3 = 4 and 4 – 1 = 3 occurs in which stage of cognitive development?
a. Concrete operations
b. Formal operations
c. Intuitive thought
d. Preoperations
4. Which activity is most appropriate for developing fine motor skills in the school-age child?
a. Drawing
b. Singing
c. Soccer
d. Swimming
5. A school nurse is teaching a health class for 5th grade children. The nurse plans to include which statement to best describe growth in the early school-age period?
a. Boys grow faster than girls.
b. Puberty occurs earlier in boys than in girls.
c. Puberty occurs at the same age for all races and ethnicities.
d. It is a period of rapid physical growth.
6. Which comment is most developmentally typical of a 7-year-old boy?
a. “I am a Power Ranger, so don’t make me angry.”
b. “I don’t know whether I like Mary or Joan better.”
c. “My mom is my favorite person in the world.”
d. “Jimmy is my best friend.”
7. A school nurse is conducting a class on safety for a group of school-age children. Which statement indicates that the children may need further teaching?
a. “My sister and I know two different ways to get out of the house.”
b. “I can dial 911 if there is a fire or a burglar in the house.”
c. “My mother has told us that if we have a fire, we have to meet at the neighbor’s house.”
d. “If there is a fire I will have to go back in for my cat Fluffy because she will be scared.”
8. Which statement is the most accurate about moral development in the 9-year-old school-age child?
a. Right and wrong are based on physical consequences of behavior.
b. The child obeys parents because of fear of punishment.
c. The school-age child conforms to rules to please others.
d. Parents are the determiners of right and wrong for the school-age child.
9. In providing anticipatory guidance to parents, which parental behavior is the most important in fostering moral development?
a. Telling the child what is right and wrong
b. Vigilantly monitoring the child and her peers
c. Weekly family meetings to discuss behavior
d. Living as the parents say they believe
10. Which behavior by parents or teachers will best assist the child in negotiating the developmental task of industry?
a. Identifying failures immediately and asking the child’s peers for feedback
b. Structuring the environment so that the child can master tasks
c. Completing homework for children who are having difficulty in completing assignments
d. Decreasing expectations to eliminate potential failures
Chapter 9: Health Promotion for the Adolescent
1. The nurse is explaining Tanner staging to an adolescent and her mother. Which statement best describes Tanner staging?
a. Predictable stages of puberty that are based on chronologic age
b. Staging of puberty based on the initiation of menarche and nocturnal emissions
c. Predictable stages of puberty that are based on primary and secondary sexual characteristics
d. Staging of puberty based on the initiation of primary sexual characteristics
2. Which behavior suggests appropriate psychosocial development in the adolescent?
a. The adolescent seeks validation for socially acceptable behavior from older adults.
b. The adolescent is self-absorbed and self-centered and has sudden mood swings.
c. Adolescents move from peers and enjoy spending time with family members.
d. Conformity with the peer group increases in late adolescence.
3. The parents of a 14-year-old girl are concerned that their adolescent spends too much time looking in the mirror. Which statement is the most appropriate for the nurse to make?
a. “Your teenager needs clearer and stricter limits about her behavior.”
b. “Your teenager needs more responsibility at home.”
c. “During adolescence this behavior is not unusual.”
d. “The behavior is abnormal and needs further investigation.”
4. Which statement is the most appropriate advice to give parents of a 16-year-old who is rebellious?
a. “You need to be stricter so that your teen stops trying to test the limits.”
b. “You need to collaborate with your daughter and set limits that are perceived as being reasonable.”
c. “Increasing your teen’s involvement with her peers will improve her self-esteem.”
d. “Allow your teenager to choose the type of discipline that is used in your home.”
5. Which statement by the nurse is most appropriate to a 15-year-old whose friend has mentioned suicide?
a. “Tell your friend to come to the clinic immediately.”
b. “You need to gather details about your friend’s suicide plan.”
c. “Your friend’s threat needs to be taken seriously, and immediate help for your friend is important.”
d. “If your friend mentions suicide a second time, you will want to get your friend some help.”
6. When planning care for adolescents, the nurse should
a. Teach parents first, and they, in turn, will teach the teenager.
b. Provide information for their long-term health needs because teenagers respond best to long-range planning.
c. Maintain the parents’ role by providing explanations for treatment and procedures to the parents only.
d. Give information privately to adolescents about how they can manage the specific problems that they identify.
7. A 17-year-old tells the nurse that he is not having sex because it would make his parents very angry. This response indicates that the adolescent has a developmental lag in which area?
a. Cognitive development
b. Moral development
c. Psychosocial development
d. Psychosexual development
8. What is the best response a nurse can make to a 15-year-old girl who has verbalized a desire to have a baby?
a. “Have you talked with your parents about this?”
b. “Do you have plans to continue school?”
c. “Will you be able to support the baby?”
d. “Can you tell me how your life will be if you have an infant?”
9. Many adolescents decide to follow a vegetarian diet during their teen years. The nurse can advise the adolescent and his or her parents that
a. This diet will not meet the nutritional requirements of growing teens.
b. A vegetarian diet is healthy for this population.
c. An adolescent on a vegetarian diet is less likely to eat high-fat or low-nutrient foods.
d. A vegetarian diet requires little extra meal planning.
10. Which is assessed with Tanner staging?
a. Hormone levels
b. Secondary sex characteristics
c. Response to growth hormone secretion tests
d. Hyperthyroidism
Chapter 10: Hereditary and Environmental Influences on Development
1. How can a woman avoid exposing her fetus to teratogens?
a. Update her immunizations during the first trimester of her pregnancy.
b. Use saunas and hot tubs during the winter months only.
c. Use only class A drugs during her pregnancy.
d. Use alcoholic beverages only in the first and third trimesters of pregnancy.
2. The karyotype of a person is 47, XY, +21. This person is a
a. Normal male
b. Male with Down syndrome
c. Normal female
d. Female with Turner syndrome
3. People who have two copies of the same abnormal autosomal dominant gene will usually be
a. More severely affected by the disorder than will people with one copy of the gene
b. Infertile and unable to transmit the gene
c. Carriers of the trait but not affected with the disorder
d. Mildly affected with the disorder
4. A baby is born with blood type AB. The father is type A, and the mother is type B. The father asks why the baby has a blood type different from those of his parents. The nurse’s answer should be based on the knowledge that
a. Both A and B blood types are dominant.
b. The baby has a mutation of the parents’ blood types.
c. Type A is recessive and links more easily with type B.
d. Types A and B are recessive when linked together.
5. Which statement is true of multifactorial disorders?
a. They may not be evident until later in life.
b. They are usually present and detectable at birth.
c. The disorders are characterized by multiple defects.
d. Secondary defects are rarely associated with multifactorial disease.
6. Both members of an expectant couple are carriers for phenylketonuria (PKU), an autosomal recessive disorder. In counseling them about the risk to their unborn child, the nurse should tell them that
a. The child has a 25% chance of being affected.
b. The child will be a carrier, like the parents.
c. The child has a 50% chance of being affected.
d. One of four of their children will be affected.
7. Which statement should a counselor make when telling a couple about the prenatal diagnosis of genetic disorders?
a. Diagnosis can be obtained promptly through most hospital laboratories.
b. Common disorders can quickly be diagnosed through blood tests.
c. A comprehensive evaluation will result in an accurate diagnosis.
d. Diagnosis may be slow and could be inconclusive.
8. A woman tells the nurse at a prenatal interview that she has quit smoking, only has a glass of wine with dinner, and has cut down on coffee to four cups a day. What response by the nurse will be most helpful in promoting a lifestyle change?
a. “You have made some good progress toward having a healthy baby. Let’s talk about the changes you have made.”
b. “You need to do a lot better than that. You are still hurting your baby.”
c. “Here are some pamphlets for you to study. They will help you find more ways to improve.”
d. “Those few things won’t cause any trouble. Good for you.”
9. A 35-year-old woman has an amniocentesis performed to find out whether her baby has a chromosome defect. Which statement by this patient indicates that she understands her situation?
a. “The doctor will tell me if I should have an abortion when the test results come back.”
b. “I know support groups exist for parents who have a baby with birth defects, but we have plenty of insurance to cover what we need.”
c. “When all the lab results come back, my husband and I will make a decision about the pregnancy.”
d. “My mother must not find out about all this testing. If she does, she will think I’m having an abortion.”
10. Which question by the nurse will most likely promote sharing of sensitive information during a genetic counseling interview?
a. “How many people in your family are mentally retarded or handicapped?”
b. “What kinds of defects or diseases seem to run in the family?”
c. “Did you know that you can always have an abortion if the fetus is abnormal?”
d. “Are there any family members who have learning or developmental problems?”
Chapter 11: Reproductive Anatomy and Physiology
1. Which man is most likely to have abnormal sperm formation resulting in infertility?
a. A 20-year-old man with undescended testicles
b. An uncircumcised 40-year-old man
c. A 35-year-old man with previously treated sexually transmitted disease
d. A 16-year-old adolescent who is experiencing nocturnal emissions
2. Which combination of sex chromosomes is present in a female?
a. XY
b. XYY
c. XXY
d. XX
3. Which of these is a secondary sexual characteristic?
a. Female breast development
b. Production of sperm
c. Maturation of ova
d. Secretion of gonadotropin-releasing hormone
4. Fertilization of the ovum takes place in which part of the fallopian tube?
a. Interstitial portion
b. Ampulla
c. Isthmus
d. Infundibulum
5. Which 16-year-old female is most likely to experience secondary amenorrhea?
a. A girl who is 5 ft 2 in, 130 lb
b. A girl who is 5 ft 9 in, 150 lb
c. A girl who is 5 ft 7 in, 96 lb
d. A girl who is 5 ft 4 in, 120 lb
6. It is important for the nurse to understand that the levator ani is a(n)
a. Imaginary line that divides the true and false pelvis
b. Basin-shaped structure at the lower end of the spine
c. Collection of three pairs of muscles
d. Division of the fallopian tube
7. In describing the size and shape of the nonpregnant uterus to a patient, the nurse would say it is approximately the size and shape of a
a. Cantaloupe
b. Grapefruit
c. Pear
d. Large orange
8. If a woman’s menstrual cycle began on June 2 and normally lasts 28 days, ovulation would mostly likely occur on June
a. 10
b. 16
c. 21
d. 29
9. A patient states, “My breasts are so small, I don’t think I will be able to breastfeed.” The nurse’s best response is
a. “It may be difficult, but you should try anyway.”
b. “You can always supplement with formula.”
c. “All women have approximately the same amount of glandular tissue to secrete milk.”
d. “The ability to produce breast milk depends on increased levels of estrogen and progesterone.”
10. The function of the cremaster muscle in men is to
a. Aid in voluntary control of excretion of urine.
b. Entrap blood in the penis to produce an erection.
c. Assist with transporting sperm.
d. Aid in temperature control of the testicles.
Chapter 12: Conception and Prenatal Development
1. Which part of the mature sperm contains the male chromosomes?
a. The head of the sperm
b. The middle portion of the sperm
c. X-bearing sperm
d. The tail of the sperm
2. One of the assessments performed in the delivery room is checking the umbilical cord for blood vessels. Which finding is considered within normal limits?
a. Two arteries and one vein
b. Two arteries and two veins
c. Two veins and one artery
d. One artery and one vein
3. The purpose of the ovum’s zona pellucida is to
a. Make a pathway for more than one sperm to reach the ovum.
b. Allow the 46 chromosomes from each gamete to merge.
c. Prevent multiple sperm from fertilizing the ovum.
d. Stimulate the ovum to begin mitotic cell division.
4. While teaching an early pregnancy class, the nurse explains that the morula is a
a. Fertilized ovum before mitosis begins
b. Flattened disc-shaped layer of cells within a fluid-filled sphere
c. Double layer of cells that becomes the placenta
d. Solid ball composed of the first cells formed after fertilization
5. The upper uterus is the best place for the fertilized ovum to implant because it is here that the
a. Placenta attaches most firmly
b. Developing baby is best nourished
c. Uterine endometrium is softer
d. Maternal blood flow is lower
6. Some of the embryo’s intestines remain within the umbilical cord during the embryonic period because the
a. Umbilical cord is much larger at this time than it will be at the end of pregnancy.
b. Intestines begin their development within the umbilical cord.
c. Nutrient content of the blood is higher in this location.
d. Abdomen is too small to contain all the organs while they are developing.
7. A woman is 16 weeks pregnant with her first baby. She asks how long it will be before she feels the baby move. The best answer is
a. “You should have felt the baby move by now.”
b. “Within the next month, you should start to feel fluttering sensations.”
c. “The baby is moving, but you can’t feel it yet.”
d. “Some babies are quiet, and you don’t feel them move.”
8. During a centering pregnancy group meeting, the nurse teaches patients that the fetal period is best described as one of
a. Development of basic organ systems
b. Resistance of organs to damage from external agents
c. Maturation of organ systems
d. Development of placental oxygen–carbon dioxide exchange
9. A new mother asks the nurse about the “white substance” covering her infant. The nurse explains that the purpose of vernix caseosa is to
a. Protect the fetal skin from amniotic fluid.
b. Promote normal peripheral nervous system development.
c. Allow transport of oxygen and nutrients across the amnion.
d. Regulate fetal temperature.
10. A woman who is 16 weeks pregnant asks the nurse, “Is it possible to tell by ultrasound if the baby is a boy or girl yet?” The best answer is
a. “A baby’s sex is determined as soon as conception occurs.”
b. “The baby has developed enough that we can determine the sex by examining the genitals through ultrasound.”
c. “Boys and girls look alike until approximately 20 weeks after conception, and then they begin to look different.”
d. “It might be possible to determine your baby’s sex, but the external organs look very similar right now.”
Chapter 13: Adaptations to Pregnancy
1. A pregnant woman’s mother is worried that her daughter is not “big enough” at 20 weeks. The nurse palpates and measures the fundal height at 20 cm, which is even with the woman’s umbilicus. What should the nurse report to the woman and her mother?
a. “The body of the uterus is at the belly button level, just where it should be at this time.”
b. “You’re right. We’ll inform the practitioner immediately.”
c. “When you come for next month’s appointment, we’ll check you again to make sure that the baby is growing.”
d. “Lightening has occurred, so the fundal height is lower than expected.”
2. While you are assessing the vital signs of a pregnant woman in her third trimester, the patient complains of feeling faint, dizzy, and agitated. Which nursing intervention is appropriate?
a. Have the patient stand up and retake her blood pressure.
b. Have the patient sit down and hold her arm in a dependent position.
c. Have the patient lie supine for 5 minutes and recheck her blood pressure on both arms.
d. Have the patient turn to her left side and recheck her blood pressure in 5 minutes.
3. A pregnant woman has come to the emergency department with complaints of nasal congestion and epistaxis. What is the correct interpretation of these symptoms by the practitioner?
a. These conditions are abnormal. Refer the patient to an ear, nose, and throat specialist.
b. Nasal stuffiness and nosebleeds are caused by a decrease in progesterone.
c. Estrogen relaxes the smooth muscles in the respiratory tract, so congestion and epistaxis are within normal limits.
d. Estrogen causes increased blood supply to the mucous membranes and can result in congestion and nosebleeds.
4. Which finding in the urine analysis of a pregnant woman is considered a variation of normal?
a. Proteinuria
b. Glycosuria
c. Bacteria in the urine
d. Ketones in the urine
5. Which suggestion is appropriate for the pregnant woman who is experiencing nausea and vomiting?
a. Eat only three meals a day so the stomach is empty between meals.
b. Drink plenty of fluids with each meal.
c. Eat dry crackers or toast before arising in the morning.
d. Drink coffee or orange juice immediately on arising in the morning.
6. Which statement related to changes in the breasts during pregnancy is the most accurate?
a. During the early weeks of pregnancy there is decreased sensitivity.
b. Nipples and areolae become more pigmented.
c. Montgomery tubercles are no longer visible around the nipples.
d. Venous congestion of the breasts is more visible in the multiparous woman.
7. Alterations in hormonal balance and mechanical stretching are responsible for several changes in the integumentary system during pregnancy. Stretch marks often occur on the abdomen and breasts. These are referred to as
a. Chloasma
b. Linea nigra
c. Striae gravidarum
d. Angiomas
8. The maternity nurse understands that vascular volume increases 40% to 60% during pregnancy to
a. Compensate for decreased renal plasma flow.
b. Provide adequate perfusion of the placenta.
c. Eliminate metabolic wastes of the mother.
d. Prevent maternal and fetal dehydration.
9. A number of cardiovascular system changes occur during pregnancy. Which finding is considered normal for a woman during pregnancy?
a. Cardiac output rises by 25%
b. Increased pulse rate
c. Increased blood pressure
d. Decreased red blood cell (RBC) production
10. Physiologic anemia often occurs during pregnancy as a result of
a. Inadequate intake of iron
b. Dilution of hemoglobin concentration
c. The fetus establishing iron stores
d. Decreased production of erythrocytes
Chapter 14: Nutrition for Childbearing
1. Which pregnant woman should restrict her weight gain during pregnancy?
a. Woman pregnant with twins
b. Woman in early adolescence
c. Woman shorter than 62 inches or 157 cm
d. Woman who was 20 pounds overweight before pregnancy
2. The major source of nutrients in the diet of a pregnant woman should be composed of
a. Simple sugars
b. Fats
c. Fiber
d. Complex carbohydrates
3. To increase the absorption of iron in a pregnant woman, the iron preparation should be given with
a. Milk
b. Tea
c. Orange juice
d. Coffee
4. Health teaching during routine prenatal care includes providing patients with the recommended weight gain during pregnancy. For a woman with a single fetus who begins pregnancy at a normal weight, this amount is _____ lb.
a. 10 to 15
b. 15 to 20
c. 37 to 50
d. 28 to 40
5. A pregnant woman’s diet may not meet her need for folates. A good source of this nutrient is
a. Chicken
b. Cheese
c. Potatoes
d. Green leafy vegetables
6. One danger in using nonfood supplementation of nutrients is
a. Increased absorption of all vitamins
b. Development of pregnancy-induced hypertension (PIH)
c. Increased caloric intake
d. Toxic effects on the fetus
7. When providing care to the prenatal patient, the nurse understands that pica is defined as
a. Intolerance of milk products
b. Iron deficiency anemia
c. Ingestion of nonfood substances
d. Episodes of anorexia and vomiting
8. The breastfeeding woman whose recommended prepregnant caloric intake was 2000 calories per day needs how many calories per day to meet her current needs?
a. 2300
b. 2500
c. 2750
d. 3000
9. The most important reason for evaluating the pattern of weight gain in pregnancy is to
a. Prevent excessive adipose tissue deposits.
b. Identify potential nutritional problems or complications of pregnancy.
c. Assess the need to limit caloric intake in obese women.
d. Determine cultural influences on the woman’s diet.
10. If a patient’s normal prepregnancy diet contains 45 g of protein daily, how many more grams of protein should she consume per day during pregnancy?
a. 5
b. 10
c. 26
d. 30
Chapter 15: Prenatal Diagnostic Tests
1. A pregnant woman’s biophysical profile score is 8. She asks the nurse to explain the results. The nurse’s best response is
a. “The test results are within normal limits.”
b. “Immediate delivery by cesarean birth is being considered.”
c. “Further testing will be performed to determine the meaning of this score.”
d. “An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your options regarding delivery.”
2. Which analysis of maternal serum may predict chromosomal abnormalities in the fetus?
a. Multiple-marker screening
b. Lecithin/sphingomyelin (L/S) ratio
c. Biophysical profile
d. Type and crossmatch of maternal and fetal serum
3. The nurse providing care for the pregnant woman understands that a factor indicating the need for fetal diagnostic procedures is
a. Maternal diabetes
b. Maternal age older than 30 years
c. Previous infant more than 3000 g at birth
d. Weight gain of 25 pounds
4. When is the best time to determine gestational age based on biparietal diameter through ultrasound?
a. 4 to 6 weeks
b. 5 to 7 weeks
c. 7 to 10 weeks
d. 12 to 20 weeks
5. The primary reason for evaluating alpha-fetoprotein (AFP) levels in maternal serum is to determine if the fetus has
a. Hemophilia
b. A neural tube defect
c. Sickle cell anemia
d. A normal lecithin/sphingomyelin (L/S) ratio
6. While working with the pregnant woman in her first trimester, the nurse is aware that chorionic villus sampling can be performed during pregnancy as early as _____ weeks.
a. 4
b. 8
c. 10
d. 12
7. The nurse’s role in diagnostic testing is to provide
a. Advice to the couple
b. Assistance with decision-making
c. Information about the tests
d. Reassurance about fetal safety
8. Which diagnostic test evaluates the effect of fetal movement on fetal heart activity?
a. Contraction stress test (CST)
b. Sonography
c. Biophysical profile
d. Nonstress test (NST)
9. Which nursing intervention is necessary before a second-trimester transabdominal ultrasound?
a. Place the woman NPO for 12 hours.
b. Instruct the woman to drink 1 to 2 quarts of water.
c. Administer a soapsuds enema.
d. Perform an abdominal prep.
10. The major advantage of chorionic villus sampling (CVS) over amniocentesis is that it
a. Is not an invasive procedure
b. Does not require hospitalization
c. Has less risk of spontaneous abortion
d. Is performed earlier in pregnancy
Chapter 16: Giving Birth
1. The maternity nurse understands that as the uterus contracts during labor, maternal-fetal exchange of oxygen and waste products
a. Continues except when placental functions are reduced
b. Increases as blood pressure decreases
c. Diminishes as the spiral arteries are compressed
d. Is not significantly affected
2. Which statement is the best rationale for assessing maternal vital signs between contractions?
a. During a contraction, assessing fetal heart rates is the priority.
b. Maternal circulating blood volume increases temporarily during contractions.
c. Maternal blood flow to the heart is reduced during contractions.
d. Vital signs taken during contractions are not accurate.
3. Which mechanism of labor occurs when the largest diameter of the fetal presenting part passes the pelvic inlet?
a. Engagement
b. Extension
c. Internal rotation
d. External rotation
4. To adequately care for patients, the nurse understands that labor contractions facilitate cervical dilation by
a. Contracting the lower uterine segment
b. Enlarging the internal size of the uterus
c. Promoting blood flow to the cervix
d. Pulling the cervix over the fetus and amniotic sac
5. It is important for the nurse providing care during labor to be aware that pregnant women can usually tolerate the normal blood loss associated with childbirth because they have
a. A higher hematocrit
b. Increased blood volume
c. A lower fibrinogen level
d. Increased leukocytes
6. To assess the duration of labor contractions, the nurse determines the time
a. From the beginning of one contraction to the beginning of the next
b. From the beginning to the end of each contraction
c. Of the strongest intensity of each contraction
d. Of uterine relaxation between two contractions
7. To adequately teach patients about the process of labor, the nurse knows that which event is the best indicator of true labor?
a. Bloody show
b. Cervical dilation and effacement
c. Fetal descent into the pelvic inlet
d. Uterine contractions every 7 minutes
8. Which factor ensures that the smallest anterior-posterior diameter of the fetal head enters the pelvis?
a. Descent
b. Engagement
c. Flexion
d. Station
9. What results from the adaptation of the fetus to the size and shape of the pelvis?
a. Lightening
b. Lie
c. Molding
d. Presentation
10. A patient whose cervix is dilated to 5 cm is considered to be in which phase of labor?
a. Latent phase
b. Active phase
c. Second stage
d. Third stage
Chapter 17: Intrapartum Fetal Surveillance
1. The nurse sees a pattern on the fetal monitor that looks similar to early decelerations, but the deceleration begins near the acme of the contraction and continues well beyond the end of the contraction. Which nursing action indicates the proper evaluation of this situation?
a. Continue to monitor these early decelerations, which occur as the fetal head is compressed during a contraction.
b. This deceleration pattern is associated with uteroplacental insufficiency, so the nurse acts quickly to improve placental blood flow and fetal oxygen supply.
c. This pattern reflects variable decelerations. No interventions are necessary at this time.
d. Document this reassuring fetal heart rate pattern, but decrease the rate of the intravenous fluid.
2. Which maternal condition is considered a contraindication for the application of internal monitoring devices?
a. Unruptured membranes
b. Cervix is dilated to 4 cm
c. External monitors are currently being used
d. Fetus has a known heart defect
3. Which method of assessing the fetal heart rate requires the use of a gel?
a. Fetoscope
b. Tocodynamometer
c. Doppler
d. Scalp electrode
4. How does the available staff influence the selection of either continuous electronic or intermittent auscultation as the fetal-monitoring method?
a. There must be a 1:1 nurse-to-patient ratio regardless of the method used.
b. Staffing patterns do not influence fetal monitoring choices.
c. Use of intermittent auscultation requires a lower nurse-to-patient ratio.
d. More nurses are needed when electronic fetal monitoring is used because of increased medical interventions.
5. The nurse knows that proper placement of the tocotransducer for electronic fetal monitoring is
a. Over the uterine fundus
b. On the fetal scalp
c. Inside uterus
d. Over the mother’s lower abdomen
6. Perinatal nurses are legally responsible for
a. Correctly interpreting FHR patterns, initiating appropriate nursing interventions, and documenting the outcomes
b. Greeting the patient on arrival, assessing her, and starting an IV line
c. Applying the external fetal monitor and notifying the care provider
d. Making sure the woman is comfortable
7. Which is the most appropriate method of intrapartum fetal monitoring when a woman has a history of hypertension during pregnancy?
a. Continuous auscultation with a fetoscope
b. Continuous electronic fetal monitoring
c. Intermittent assessment with a Doppler transducer
d. Intermittent electronic fetal monitoring for 15 minutes each hour
8. Why is continuous electronic fetal monitoring usually used when oxytocin is administered?
a. The mother may become hypotensive.
b. Uteroplacental exchange may be compromised.
c. Maternal fluid volume deficit may occur.
d. Fetal chemoreceptors are stimulated.
9. The nurse-midwife is concerned that a woman’s uterine activity is too intense and that her obesity is preventing accurate assessment of the actual intrauterine pressure. On the basis of this information, the nurse should obtain a(n)
a. Tocotransducer
b. Scalp electrode
c. Intrauterine pressure catheter
d. Doppler transducer
10. In which situation is a baseline fetal heart rate of 160 to 170 beats per minute be considered a normal finding?
a. The fetus is at 28 weeks of gestation.
b. The mother has been given an epidural block.
c. The mother has a history of fast labors.
d. The mother has mild preeclampsia but is not in labor.
Chapter 18: Pain Management for Childbirth
1. Childbirth preparation can be considered successful if the outcome is described as
a. Labor was pain-free.
b. Birth experiences of friends and families were discredited.
c. The woman rehearsed labor and practiced skills to master pain.
d. Only nonpharmacologic methods for pain control were used.
2. In order to help patients manage discomfort and pain during labor, nurses should be aware that
a. The predominant pain of the first stage of labor is the visceral pain located in the lower portion of the abdomen.
b. Somatic pain is the extreme discomfort between contractions.
c. The somatic pain of the second stage of labor is more generalized and related to fatigue.
d. Pain during the third stage is a somewhat milder version of the second stage.
3. The nurse caring for women in labor understands that childbirth pain is different from other types of pain in that it is
a. More responsive to pharmacologic management
b. Associated with a physiologic process
c. Designed to make one withdraw from the stimulus
d. Less intense
4. Excessive anxiety in labor heightens the woman’s sensitivity to pain by increasing
a. Muscle tension
b. Blood flow to the uterus
c. The pain threshold
d. Rest time between contractions
5. When providing labor support, the nurse knows that which fetal position might cause the laboring woman more back discomfort?
a. Right occiput anterior
b. Left occiput anterior
c. Right occiput transverse
d. Left occiput posterior
6. It is important for the nurse to develop a realistic birth plan with the pregnant woman. The nurse can explain that a major advantage of nonpharmacologic pain management is that
a. More complete pain relief is possible.
b. No side effects or risks to the fetus are involved.
c. The woman remains fully alert at all times.
d. A more rapid labor is likely.
7. The best time to teach nonpharmacologic pain control methods to an unprepared laboring woman is during which phase?
a. Latent phase
b. Active phase
c. Transition phase
d. Second stage
8. The nurse providing newborn stabilization must be aware that the primary side effect of maternal narcotic analgesia in the newborn is
a. Respiratory depression
b. Bradycardia
c. Acrocyanosis
d. Tachypnea
9. A woman received 50 mcg of Fentanyl intravenously 1 hour before delivery. What drug should the nurse have readily available?
a. Promethazine (Phenergan)
b. Nalbuphine (Nubain)
c. Butorphanol (Stadol)
d. Naloxone (Narcan)
10. The nerve block used in labor that provides anesthesia to the lower vagina and perineum is called a(n)
a. Epidural
b. Pudendal
c. Local
d. Spinal block
Chapter 19: Nursing Care during Obstetric Procedures
1. The nurse knows that a urinary catheter is added to the instrument table if a forceps-assisted birth is anticipated. What is the correct rationale for this intervention?
a. Spontaneous release of urine might contaminate the sterile field.
b. An empty bladder provides more room in the pelvis.
c. A sterile urine specimen is needed preoperatively.
d. A Foley catheter prevents the membranes from spontaneously rupturing.
2. After a forceps-assisted birth, the mother is observed to have continuous bright red lochia but a firm fundus. What other data indicates the presence of a potential vaginal wall hematoma?
a. Mild, intermittent perineal pain
b. Edema and discoloration of the labia and perineum
c. Lack of an episiotomy
d. Lack of pain in the perineal area
3. When positioning the Foley catheter before cesarean birth, the nurse knows that the catheter drainage tube and catheter bag should be
a. Positioned on top of the patient’s leg
b. Placed near the head of the table
c. Clamped during the cesarean section
d. Positioned at the foot of the surgeon under the sterile drapes
4. To provide safe care for the woman, the nurse understands that which condition is a contraindication for an amniotomy?
a. Dilation less than 3 cm
b. Cephalic presentation
c. –2 station
d. Right occiput posterior position
5. Which patient status is an acceptable indication for serial oxytocin induction of labor?
a. Past 42 weeks’ gestation
b. Multiple fetuses
c. Polyhydramnios
d. History of long labors
6. The standard of care for obstetrics dictates that an internal version might be used to manipulate the
a. Fetus from a breech to a cephalic presentation before labor begins
b. Fetus from a transverse lie to a longitudinal lie before cesarean birth
c. Second twin from an oblique lie to a transverse lie before labor begins
d. Second twin from a transverse lie to a breech presentation during vaginal birth
7. An indication for an episiotomy would be a woman who
a. Has a routine vaginal birth
b. Has fetal shoulder dystocia
c. Is delivering a preterm infant
d. Has a history of rapid deliveries
8. The greatest risk to the newborn after an elective cesarean birth is
a. Trauma due to manipulation during delivery
b. Tachypnea due to maternal anesthesia
c. Prematurity due to miscalculation of gestation
d. Tachycardia due to maternal narcotics
9. The nurse practicing in a labor setting knows that the woman most at risk for a uterine rupture is a gravida
a. 3 who has had two low-segment transverse cesarean births
b. 2 who had a low-segment vertical incision for delivery of a 10-pound infant
c. 5 who had two vaginal births and two cesarean births
d. 4 who has had all cesarean births
10. The nurse caring for a woman in labor understands that the primary risk associated with an amniotomy is
a. Maternal infection
b. Maternal hemorrhage
c. Prolapse of the umbilical cord
d. Separation of the placenta
Chapter 20: Postpartum Adaptations
1. A postpartum woman overhears the nurse tell the obstetrics clinician that she has a positive Homans sign and asks what it means. The nurse’s best response is
a. “You have pitting edema in your ankles.”
b. “You have deep tendon reflexes rated 2+.”
c. “You have calf pain when the nurse flexes your foot.”
d. “You have a ‘fleshy’ odor to your vaginal drainage.”
2. Which woman is most likely to have severe afterbirth pains and request a narcotic analgesic?
a. Gravida 5, para 5
b. Woman who is bottle-feeding her first child
c. Primipara who delivered a 7-lb boy
d. Woman who wishes to breastfeed as soon as her baby is out of the neonatal intensive care unit
3. Which maternal event is abnormal in the early postpartum period?
a. Diuresis and diaphoresis
b. Flatulence and constipation
c. Extreme hunger and thirst
d. Lochial color changes from rubra to alba
4. Which finding 12 hours after birth requires further assessment?
a. The fundus is palpable two fingerbreadths above the umbilicus.
b. The fundus is palpable at the level of the umbilicus.
c. The fundus is palpable one fingerbreadth below the umbilicus.
d. The fundus is palpable two fingerbreadths below the umbilicus.
5. If the patient’s white blood cell (WBC) count is 25,000/mm3 on her second postpartum day, the nurse should
a. Tell the physician immediately.
b. Have the laboratory draw blood for reanalysis.
c. Recognize that this is an acceptable range at this point postpartum.
d. Begin antibiotic therapy immediately.
6. Postpartal overdistention of the bladder and urinary retention can lead to which complication?
a. Postpartum hemorrhage and eclampsia
b. Fever and increased blood pressure
c. Postpartum hemorrhage and urinary tract infection
d. Urinary tract infection and uterine rupture
7. A postpartum patient asks, “Will these stretch marks go away?” The nurse’s best response is
a. “They will continue to fade and should be gone by your 6-week checkup.”
b. “No, never.”
c. “Yes, eventually.”
d. “They will fade to silvery lines but won’t disappear completely.”
8. A pregnant patient asks when the dark line on her abdomen (linea nigra) will go away. The nurse knows the pigmentation will decrease after delivery because of
a. Increased estrogen
b. Increased progesterone
c. Decreased melanocyte-stimulating hormone
d. Decreased human placental lactogen
9. If the fundus is palpated on the right side of the abdomen above the expected level, the nurse should suspect that the patient has
a. Been lying on her right side too long
b. A distended bladder
c. Stretched ligaments that are unable to support the uterus
d. A normal involution
10. A woman gave birth vaginally to a 9-pound, 12-ounce girl yesterday. Her primary health care provider has written orders for perineal ice packs, use of a sitz bath tid, and a stool softener. What information is most closely correlated with these orders?
a. The woman is a gravida 2, para 2.
b. The woman had a vacuum-assisted birth.
c. The woman received epidural anesthesia.
d. The woman has an episiotomy.