1. The clinical instructor is having discussion with her students on fetal circulation. Which of the following statements when made by a student indicates understanding about the umbilical cord?

A. the umbilical cord is of 2 arteries and 1 veinB. the umbilical cord is of2 veins and 1 arteryC. the umbilical cord is of1 artery and 2 veinsD. the umbilical cord is of2 veins

2. Which of the following statements in not true about the placenta?

A. it provides exchange of nutrients and waste between fetus and motherB. it develops by the third month of gestationC. it allows transfer of maternal immunoglobulinD. allows passage of bacteria and virus

3. The mother reported to the clinic for prenatal check-up. She asks the nurse when will the sex of the fetus be determined by the ultrasound. Which of the following would be the most appropriate response by the nurse?

A. on the 16th week of pregnancyB. on the 20th week of pregnancyC. on the 24th week of pregnancyD. on the 28th week of pregnancy

4. Which of the following assessment data is most accurate indication that the woman is pregnant?

A. positive pregnancy testB. presence of fetal heart rateC. absence of menstruationD. quickening

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5. The client is on her first trimester of pregnancy. She is experiencing nausea and vomiting each morning that she wakes up. Which of the following should not be included when giving health teachings to this client?

A. take small, frequent feedingsB. take dry toast or crackersC. take anti-emeticsD. take low-fat diet

6. The nurse is giving health teachings to a pregnant client. Which of the following information should be included for prevention of toxoplasmosis?

a) avoid traveling to foreign countries during the entire pregnancyb) avoid persons with cough and coldsc) avoid eating raw meats or handling cat littersd) avoid overcrowded places

7. Which of the following potential problems should the nurse be alert for in a client with pregnancy-induced hypertension (PIH)

a)abruptio placentab) post term deliveryc) uterine inversiond) placenta previa

8. The presenting part of the fetus is at 2 cm. below the ischial spine. The nurse properly assesses that the fetus is at

a) station 0b) station negative 2c) station positive 2d) station (+-) 2

9. Which of the following assessment findings indicates that the woman is experiencing false labor?

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a) contractions decrease in duration and intensityb) back pain not relieved by walkingc) dilatation and effacement of the cervix are notedd) bloody show occurs

10. The client is diagnosed to have placenta previa. What warning sign should be placed by the nurse in client's unit?

a) no abdominal palpationb) no vaginal examinationc) no BP-takingd) no cigarette smoking

11. The client experiences abruptio placenta. Which of the following signs and symptoms supports the diagnosis?

a) painless vaginal bleedingb) rising fundal heightc) soft uterusd) elevated BP

12. The nurse is caring for a mother who experiences fetal distress. Which of the following should not be included in her nursing care plan?

a) continue pitocin dripb) administer oxygen by face maskc) turn to left sided) prepare for cesarean section

13. The client has delivered a live baby boy 4 hours ago. Which of the following findings should be given highest priority by the nurse?

a) bright red vaginal dischargeb) fundus at the level of the umbilicus, palpated towards the right side of the

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abdomenc) urine output of 25o ml since after deliveryd) body temperture of 37.6 C

14. The mother had breastfed her newborn. Which of the following actions of the mother indicates the need for further teaching?

a) the mother inserts a clean finger into the baby's mouth before removing him from breastb) the mother burps the baby after feeding from each breastc) the mother places the baby on the left side after feedingd) the mother exposes her nipples to air for 10-20 minutes after feeding

15. The postpartum client who delivered her newborn 5 hours ago is receiving methergine (methylergonovine maleate). Which of the following should be given highest priority when monitoring the client?

a) perineal pad countb) vital signsc) intake and outputd) calf pain

16. The charge nurse assigned a postpartum client with thrombophlebitis to an RN. Which of the following actions by the RN needs intervention by the charge nurse?

a) the RN elevates the legs of the client with pillowsb) the RN applies support hose to the clientc) the RN massages the legs of the clientd) the RN applies moist heat on the legs of the client

17. Which of the following drugs does the nurse expect to be ordered if preterm delivery is inevitable?

a) yutopar (ritodrine)b) pitocin (oxytocin)

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c) bricanyl (terbutaline)d) betamethasone

18. Using Nagele's rule for a client whose last normal menstrual period began on May 10, the nurse determines that the client's estimated date of delivery would be which of the following?

a) January 13b) January 17c) February 13d) February 17

19. A newly diagnosed pregnant client tells the nurse, "If I'm going to have all of these discomforts, I'm not sure I want to be pregnant!" The nurse interprets the client's statement as an indication of which of the following?

a) fear of pregnancy outcomeb) rejection of pregnancyc) normal ambivalenced) inability to care for the newborn

20. Which of the following is a common problem in the newborn of a diabetic mother?

a) hyperglycemiab) large for gestational age (LGA)c) changes in facial featuresd) meconium aspiration syndrome

21. How should the nurse determine the frequency of uterine contraction?

a) time from the beginning of one contraction to the beginning of the next contractionb) time from the beginning of one contraction to the end of the same contractionc) time from the peak of one contraction to the peak of the next contractiond) time from the end of one contraction to the beginning of the next contraction

22. A pregnant woman experiencing severe abruptio placenta would most likely exhibit:

a) fetal bradycardia

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b) painless vaginal bleedingc) rigid, boardlike abdomend) vague abdominal discomfort

23. Which of the following drugs is used to treat the candidal infection of a pregnant woman?

a) doxycycline (vibramycin)b) azithromycin (zithromax)c) acyclovir (zovirax)d) miconazole (monistat)

24. Which of the following signs indicate that the placenta has separated and is ready to be delivered? Select all that apply:

a) slowing of vaginal bleedingb) cessation of uterine contractionsc) lengthening of the umbilical cordd) round firm uterine shapee) discoid uterine shapef) sudden gush of vaginal blood

25. Which of the following measurements indicates that the fetal presenting part is engaged?

a) -2b) 0c) +2d) +4

26. On the second postpartum day, where would the nurse expect to palpate the fundus?

a) 1 cm. above the umbilicusb) at the level of the umbilicusc) 1 cm. below the umbilicusd) 2 cm. below the umbilicus

27. When assessing a woman's lochia on the sixth postpartum day, what would the nurse expect to find?

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a) lochia rubrab) lochia serosac) lochia albad) absence of lochia

28. After the nurse instructs a 20-year-old nulligravid client on how to perform breast self-examination, which of the following client statements indicates that the teaching has been successful?

a. I should perform BSE on the day my menstrual flow beginsb. It is important that I perform BSE on the same day each monthc. If I notice that one of my breasts is much smaller than the other, I shouldn’t worryd. If there is some discharge from my nipples, I should avoid squeezing them

29. After counseling a 35-year-old client about breast self-examination and mammography, the nurse determines that the client has understood the instructions when the client states which of the following?

a. I should have a mammogram every year once I’m 40b. I should schedule a mammography examination during my menstrual periodc. Mammography screening is inexpensived. Mammography is an extremely painful procedure

30. After instructing a primigravid client about the functions of the placenta, the nurse determines that the client needs additional teaching when she says that which of the following hormones is produced by the placenta?

a. Estrogenb. progesteronec. hCGd. Testosterone

31. A client about 8 weeks pregnant, asks the nurse when she will be able to hear the fetal heartbeat. The nurse would respond by telling the client that the fetal

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heartbeat can be heard with Doppler ultrasound device when gestation is as early as which of the following?

a. 4 weeksb. 8 weeksc. 15 weeksd. 18 weeks

32. A primiparous client at 10 weeks gestation questions the nurse about the need for ultrasound. The nurse would incorporate which statement as the underlying reason for performing the ultrasound now.

a. Identification of fetal parts and possible Downs syndromeb. View the heart beating to indicate that fetus is healthyc. To determine gender of babyd. Evaluation of sufficient nutrient supply for the fetus

33. RhoGAM is ordered for a client before she is discharged after a spontaneous abortion. The nurse understands the rationale for administration is to prevent which of the following?

a. Development of a future Rh – positive fetusb. An antibody response to Rh – negative bloodc. A future pregnancy resulting in abortiond. Development of Rh- positive antibodies

34. While caring for a 24 year old primigravid client scheduled for emergency surgery because of a probable ectopic pregnancy, the nurse would expect to do which of the following

a. Witness an informed consent for surgeryb. Assess the client for massive external bleedingc. Explain that the fallopian tube can be salvagedd. Monitor the client for uterine contractions

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35. After instructing a primigravid client at 38 weeks gestation how preeclampsia can affect both the client and growing fetus, the nurse realizes that the client needs additional instruction when she says that preeclampsia can lead to which of the following?

a. Hydrocephalic infantb. Abruption placentac. Intrauterine growth retardationd. Poor placental perfusion

36. After instructing a multigravid client diagnosed with mild preeclampsia how to keep a record of fetal movement patterns at home, the nurse determines that the teaching has been effective when the client says that she will count the number of times the baby moves during which of the following time spans?

a. 30-minute period three times a dayb. 45-minute period after lunch each dayc. 1-hour period each dayd. 12-hour period each week

37. A 24 year old client G3P1 at 32 weeks gestation is admitted to the hospital because of vaginal bleeding. After reviewing the clients history, which of the following factors might lead the nurse to suspect abruptio placenta?

a. Several hypotensive episodesb. Previous low transverse ceasarian deliveryc. One induced abortiond. History of cocaine use

38. When assessing a 34 year old multigravid client at 34 weeks gestation experiencing moderate vaginal bleeding, which of the following would most likely alert the nurse that placenta previa is present?

a. Painless vaginal bleedingb. Uterine tetanyc. Intermittent pain with spotting

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d. Dull lower back pain

39. The physician orders whole blood replacement for a multigravid client with abruption placenta. Before administering the intravenous blood product, which of the following should the nurse do first?

a. Validate client information and the blood product with another nurseb. Check the vital signs before transfusing over 5 to 6 hoursc. Ask the client if she has ever has any allergiesd. Administer 100 ml of 5% dextrose solution intravenously

40. The nurse is planning care for a multigravid client hospitalized at 36 weeks gestation with confirmed rupture of membranes and no evidence of labor. Which of the following would the nurse expect the physician to order?

a. Frequent assessment of cervical dilatationb. Intravenous oxytocin administrationc. Vaginal culture for Neiseria gonorrhead. Sonogram for amniotic fluid volume index

41. On arrival at the emergency department, a client tells the nurse that she may be pregnant but has been having a small amount of bleeding and has severe pain in the lower abdomen. The nurse notifies the physician immediately because which of the following is suspected?

a. Ectopic pregnancyb. Abruption placentac. Gestational trophoblastic diseased. Complete abortion

42. A multigravid client seen in the emergency department complaining of sharp abdominal pain and vaginal spotting is diagnosed with ectopic pregnancy. When explaining to the client and family members about an ectopic pregnancy, which of the following would the nurse include as the most common site for implantation?

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a. Fallopian tubeb. Intestinec. Interstitial liningd. Ovary

43. After instruction of a primigravid client at 8 weeks gestation about measures to overcome early morning nausea and vomiting, which of the following client statements indicates the need for additional teaching?

a. I’ll eat dry crackers or toast before arising in the morningb. I’ll drink adequate fluids separate from my meals and snacksc. I’ll eat two large meals daily with frequent protein snacksd. I’ll snack on a small amount of carbohydrates throughout the day

44. A nurse who is teaching smoking cessation programs to healthy adult smokers is participating in what type of prevention activity?

a. Primaryb. Secondaryc. Tertiaryd. Non specific

******************* GOOD LUCK *********************

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