MCHN QUIZLET

Question 1

A 42-year-old is at the clinic for her first prenatal visit. The nurse is doing the initial assessment and is aware that the woman is at risk for
A. Having a spontaneous abortion prior to 12 weeks
B. Having a sexually transmitted disease
C. Developing abnormalities of the reproductive organs
D. Not obtaining adequate prenatal care

Answer 1

A. Having a spontaneous abortion prior to 12 weeks

Question 2

When comparing threatened abortion to inevitable abortion, inevitable abortion has
A. increased cramping
B. increased nausea
C. cervical dilation
D. lower levels of beta-human chorionic gonadotropin

Answer 2

C. cervical dilation

Question 3

A woman is seeing her primary physician for complaints of frequent nosebleeds. She states she thought she was pregnant about 3 months ago, but her periods started and the symptoms disappeared. The health care provider should be alert for what complication of a missed abortion?
A. infection
B. infertility
C. disseminated intravascular coagulation
D. thrombocytopenia

Answer 3

C. disseminated intravascular coagulation

Question 4

When doing an initial assessment on a newly diagnosed pregnant woman, she tells the nurse, “In my younger days, I did some stupid things and had different types of STDs and once had a pelvic inflammatory disease.” The nurse is aware that the woman is at risk for
A. more STDS
B. preeclampsia
C. ectopic pregnancy
D. gestational diabetes

Answer 4

C. ectopic pregnancy

Question 5

A woman has been admitted to the birthing unit with a diagnosis of spontaneous abortion. She has increased bleeding and is having her pads weighed to estimate the blood loss. The weight of an unused pad is 1.5 grams, the pads used between 7 AM and 9 AM weigh 4.5, 6.5, 10, 15, and 11.5 grams. What is the estimated blood loss?
A. 20 ml
B. 40 ml
C. 60 ml
D. unable to determine with information provided

Answer 5

B. 40 ml

Question 6

When taking an initial prenatal history on a woman, she admitted to cocaine use during the early days of the pregnancy. The nurse is aware that this would put her at risk for
A. placenta previa
B. abruptio placentae
C. large for gestational age baby
D. both a and b

Answer 6

D. both a and b

Question 7

A woman is admitted with a diagnosis of hyperemesis gravidarum. The nurse is assessing for deficient fluid and signs of dehydration. (Choose all that apply.)
A. decreased urinary output
B. urine specific gravity of 1.015
C. nonelastic skin turgor
D. constipation

Answer 7

A. decreased urinary output
C. nonelastic skin turgor
D. constipation

Question 8

A woman with preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The drug classification of this medication is
A. tocolytic
B. anticonvulsant
C. antihypertensive
D. diuretic

Answer 8

B. anticonvulsant

Question 9

What is the only known cure for preeclampsia?
A. magnesium sulfate
B. antihypertensive medications
C. delivery of the fetus
D. administration of ASA every day of the pregnancy

Answer 9

C. delivery of the fetus

Question 10

The classic sign of placenta previa is the sudden onset of _____ uterine bleeding in the latter half of pregnancy.

Answer 10

painless

Question 11

choose the primary distinction between threatened and inevitable abortion
A. presence of cramping
B. rupture of membranes
C. vaginal bleeding
D. pelvic pressure

Answer 11

B. rupture of membranes

Question 12

a woman is admitted to the ED with a possible ectopic pregnancy. choose the sign/ symptom that should be immediately reported to her physician
A. low level of B-hGC
B. hemoglobin of 11.5; hematocrit of 34%
C. light vaginal bleeding
D. pulse increase from 78 to 100

Answer 12

D. pulse increase from 78 to 100

Question 13

when caring for the woman who has hydatidiform mole evacuated, the clinic nurse should primarily:
A. reinforce the need to delay a new pregnancy for 1 year
B. ask the woman whether she has any cramping or bleeding
C. observe return of her blood pressure to normal
D. palpate the uterus for return to its normal size

Answer 13

A. reinforce the need to delay a new pregnancy for 1 year

Question 14

the woman who is receiving methotrexate for an ectopic pregnancy should be cautioned to avoid:
A. driving or operating machinery
B. eating raw vegetables or fruits
C. using latex condoms for intercourse
D. taking vitamins with folic acid

Answer 14

D. taking vitamins with folic acid

Question 15

a woman who is 34 weeks pregnant is admitted with contractions every 2 minutes, lasting 60 second and high uterine resting tone. she says she had some vaginal bleeding at home and there is a small amount on her perineal pad. the priority action of the nurse is to:
A. establish whether she is in labor by performing a vaginal examination
B. ask her whether she has had recent intercourse or vaginal examination
C. evaluate the maternal and fetal circulation and oxygen
D. determine whether this is the first episode of pain she has had

Answer 15

C. evaluate the maternal and fetal circulation and oxygen

Question 16

nursing teaching for the woman who has hyperemesis gravidarum should include;
A. adding favorite seasonings to foods while cooking
B. eating simple foods such as breads and fruits
C. lying down on the right side after eating
D. eating creamed soup with every meal

Answer 16

B. eating simple foods such as breads and fruits

Question 17

the nurse makes the following assessments on a woman who is receiving IV magnesium sulfate:
FHR: 148-158 bpm
HR: 88 bpm
RR: 10 breaths per min
BPL: 158/96

The priority nursing action is to:
A. increase rate of magnesium
B. maintain the rate of the magnesium
C. slow the rate of the magnesium
D. stop the magnesium

Answer 17

D. stop the magnesium

Question 18

when providing intrapartal care for the woman with severe preeclampsia, priority nursing care is to:
A. maintain the ordered rate of anticonvulsant medications
B. promote placental blood flow and prevent maternal injury
C. give IV fluids and observe urine output
D. reduce the maternal blood pressure to the prepregnancy level

Answer 18

B. promote placental blood flow and prevent maternal injury

Question 19

clonus indicates that the:
A: CNS is very irritable
B. renal blood flow is severely reduced
C. lungs are filling with interstitial fluid
D. muscles of the foot are inflamed

Answer 19

A: CNS is very irritable

Question 20

the feature that distinguishes preeclampsia from eclampsia is:
A. amount of blood pressure elevation
B. edema of the face and fingers
C. presence of proteinuria
D. onset of convulsions

Answer 20

D. onset of convulsions

Question 21

which woman should receive RhoGAM?

A. Rh neg mother; Rh pos infant; pos direct Coombs test
B. Rh pos mother; Rh neg infant; neg direct Coombs test
C. Rh neg mother; Rh pos infant; neg direct Coombs test
D. Rh pos mother; Rh pos infant; pos direct Coombs test

Answer 21

C. Rh neg mother; Rh pos infant; neg direct Coombs test

Question 22

Choose the primary distinction between threatened and inevitable abortion.
a. Presence of cramping
b. Rupture of membranes
c. Vaginal bleeding
d. Pelvic pressure

Answer 22

b. Rupture of membranes

Question 23

A woman is admitted to the emergency department with a possible ectopic pregnancy. Choose the sign or symptom that should be immediately reported to her physician.
a. Low level of beta-hCG (human chorionic gonadotropin)
b. Hemoglobin level, 11.5 g/dL; hematocrit level, 34%
c. Light vaginal bleeding
d. Pulse rate increases from 78 to 112 beats per minute (bpm)

Answer 23

d. Pulse rate increases from 78 to 112 beats per minute (bpm)

Question 24

When caring for a woman who has had gestational trophoblastic tissue evacuated, the clinic nurse’s priority intervention is to:
a. Reinforce the need to delay a new pregnancy for 1 year.
b. Ask the woman whether she has any cramping or bleeding.
c. Observe return of her blood pressure to normal.
d. Palpate the uterus for return to its normal size.

Answer 24

a. Reinforce the need to delay a new pregnancy for 1 year.

Question 25

The woman who is receiving methotrexate for an ectopic pregnancy should be cautioned to avoid:
a. Driving or operating machinery.
b. Eating raw vegetables or fruits.
c. Using latex condoms for intercourse.
d. Taking vitamins with folic acid.

Answer 25

d. Taking vitamins with folic acid.

Question 26

A woman who is 34 weeks pregnant is admitted with contractions every 2 minutes, lasting 60 seconds, and a high uterine resting tone. She says she had some vaginal bleeding at home, and there is a small amount of blood on her perineal pad. The priority action of the nurse is to:
a. Establish whether she is in labor by performing a vaginal examination.
b. Ask her whether she has had recent intercourse or a vaginal examination.
c. Evaluate the maternal and fetal circulation and oxygenation.
d. Determine whether this is the first episode of pain that she has had.

Answer 26

c. Evaluate the maternal and fetal circulation and oxygenation.

Question 27

Nursing teaching for the woman who has hyperemesis gravidarum should include which of the following?
a. Adding favorite seasonings to foods while cooking
b. Eating simple foods, such as breads and fruits
c. Lying down on her right side after eating d. Eating creamed soup with every meal

Answer 27

b. Eating simple foods, such as breads and fruits

Question 28

The nurse makes the following assessments of a woman who is receiving intravenous magnesium sulfate: fetal heart rate (FHR), 148 to 158 bpm; pulse, 88 bpm; respirations, 9 breaths/min; blood pressure, 158/96 mm Hg. The woman is drowsy. The priority nursing action is to:

a. Increase the rate of the magnesium infusion.
b. Maintain the magnesium infusion at the current rate.
c. Slow the rate of the magnesium infusion.
d. Stop the magnesium infusion.

Answer 28

d. Stop the magnesium infusion.

Question 29

When providing intrapartum care for the woman with severe preeclampsia, priority nursing care is to:
a. Maintain the ordered rate of anticonvulsant medications.
b. Promote placental blood flow
and prevent maternal injury.
c. Give intravenous fluids and observe urine output.
d. Reduce maternal blood pressure to the pregnancy level.

Answer 29

b. Promote placental blood flow
and prevent maternal injury.

Question 30

Clonus indicates which of the following?
a. The central nervous system is very irritable.
b. Renal blood flow is severely reduced.
c. Lungs are filling with interstitial fluid
d. Muscles of the foot are inflamed.

Answer 30

a. The central nervous system is very irritable.

Question 31

The feature that distinguishes preeclampsia from eclampsia is the:
a. Amount of blood pressure elevation.
b. Edema of the face and fingers.
c. Presence of 41 proteinuria.
d. Onset of one or more seizures.

Answer 31

d. Onset of one or more seizures.

Question 32

Which woman should receive Rho(D) immune globulin after birth?

a. Rh-negative mother, Rh-positive infant, positive direct Coombs’ test
b. Rh-positive mother, Rh-negative infant, negative direct Coombs’ test
c. Rh-negative mother, Rh-positive infant, negative direct Coombs’ test
d. Rh-positive mother, Rh-positive infant, positive direct Coombs’ test

Answer 32

c. Rh-negative mother, Rh-positive infant, negative direct Coombs’ test

Question 33

The nursing student doing a clinical obstetrics rotation correctly picks which term to label a pregnancy that continues past the end of the 42nd week of gestation?

a. Term pregnancy
b. Post-term pregnancy
c. Preterm pregnancy
d. Full term pregnancy

Answer 33

b. Post-term pregnancy

Question 34

A nurse is caring for a pregnant client whose fetus has been diagnosed with macrosomia. When reviewing the client’s history, which information would the nurse expect to find?

a. Preterm pregnancy
b. Small BMI for mother
c. Maternal rickets
d. Gestational diabetes

Answer 34

d. Gestational diabetes

Question 35

A multigravida client at 31 weeks gestation is admitted with confirmed preterm labor. As the nurse continues to monitor the client now receiving magnesium sulfate, which assessment findings will the nurse prioritize and report immediately to the provider?

a. Low potassium, elevated glucose, tachycardia, chest pain
b. Respiratory depression, hypotension, absent tendon reflexes
c. Severe lower back pain, leg cramps, sweating
d. Abdominal pain, back pain

Answer 35

b. Respiratory depression, hypotension, absent tendon reflexes

Question 36

Hypertonic labor is labor characterized by short, irregular contractions without complete relaxation of the uterine wall in between contractions. Hypertonic labor can be caused by an increased sensitivity to oxytocin. What would the nurse do for a client who is in hypertonic labor because of oxytocin augmentation?

a. Increase oxytocin
b. Turn off oxytocin
c. Increase methotrexate
d. Turn off methotrexate

Answer 36

b. Turn off oxytocin

Question 37

A woman in active labor with a history of two previous cesarean births is being monitored frequently as she tries to have a vaginal birth. Suddenly, the woman grabs the nurse’s hand and states “something inside me is tearing.” The nurse notes her BP is 80/50 mmHg, pulse is 130 bpm and weak, skin is cool and clammy and the fetal monitor shows bradycardia. The nurse suspects the client may be experiencing which complication?

a. Compression on the inferior vena cava
b. Amniotic embolism to the lungs
c. Undiagnosed abdominal aorta aneurysm
d. Uterine rupture

Answer 37

d. Uterine rupture

Question 38

When educating a post-term mother in the clinic, what should the nurse be sure to include to prevent fetal complications?

a. Increase fluid intake to prevent fetal complications
b. Be sure to measure 24-hour urine output daily
c. Be sure to monitor fetal movements daily
d. Monitor bowel movements

Answer 38

c. Be sure to monitor fetal movements daily

Question 39

A G3P2 woman at 39 weeks gestation presents highly agitated, reporting something “came out” when her membranes just ruptured. Which action should the nurse prioritize after noting the umbilical cord is hanging out of the vagina?

a. Put her in bed immediately, call for help and hold the presenting part off the cord
b. With the woman in lithotomy position, hold her legs and sharply flex them toward her shoulders
c. Go find the provider to care for patient
d. Prep the woman for emergent vaginal birth

Answer 39

a. Put her in bed immediately, call for help and hold the presenting part off the cord

Question 40

A client is experiencing shoulder dystocia during birth. The nurse would place priority on performing which assessment post-birth?

a. Extensive lacerations
b. Monitor for cardiac anomaly
c. Assess for cleft palate
d. Brachial plexus assessment

Answer 40

d. Brachial plexus assessment

Question 41

A woman is admitted through the emergency department with a medical diagnosis of ruptured ectopic pregnancy. The primary nursing diagnosis at this time is:

a. Acute pain related to irritation of the peritoneum with blood
b. Risk for infection related to tissue trauma
c. Deficient fluid volume related to blood loss associated with rupture of the uterine tube
d. Anticipatory grieving related to unexpected pregnancy outcome

Answer 41

c. Deficient fluid volume related to blood loss associated with rupture of the uterine tube

Question 42

A pregnant woman at 32 weeks of gestation comes to the emergency department because she has begun to experience bright red vaginal bleeding. She reports that she has no pain. The admission nurse suspects that the woman is experiencing:

a. Abruptio placentae
b. Disseminated intravascular coagulation
c. Placenta previa
d. Preterm labor

Answer 42

c. Placenta previa

Question 43

A pregnant woman at 38 weeks of gestation and diagnosed with marginal placenta previa has just given birth to a healthy newborn male. The nurse recognizes that the immediate focus for the care of this woman is:

a. Preventing hemorrhage
b. Relieving acute pain
c. Preventing infection
d. Fostering attachment of the woman with her new son

Answer 43

a. Preventing hemorrhage

Question 44

The nurse should recognize that a complication of pregnancy associated with the intravenous use of cocaine is:

a. Prolonged, difficult labor
b. Premature separation of the placenta
c. Increased risk for vaginal and urinary tract infections
d. Severe fetal/neonatal central nervous system (CNS) depression

Answer 44

b. Premature separation of the placenta

Question 45

A nurse is caring for a pregnant woman at 30 weeks of gestation in preterm labor. The woman’s physician orders betamethasone 12 mg IM for two doses, with the first dose to begin at 11 am. In implementing this order the nurse should:

a. Consult the physician, because the dose is too high
b. Explain to the woman that this medication will reduce her heart rate and help her to breathe easier
c. Prepare to administer the medication intravenously between contractions
d. Schedule the second dose for 11 am on the next day

Answer 45

d. Schedule the second dose for 11 am on the next day

Question 46

__14. Abruptio placentae
__15. Hydramnios
__16. Placenta accreta
__17. Shoulder dystocia
__18. Tocolytic

a. Delayed or difficult birth of the shoulders after the head has emerged
b. Premature separation of a normally implanted placenta
c. Excessive volume of amniotic fluid
d. Placenta that is abnormally adherent to the uterine muscle
e. Medication to stop preterm or hypertonic labor contractions

Answer 46

B 14. Abruptio placentae
C 15. Hydramnios
D 16. Placenta accreta
A 17. Shoulder dystocia
E 18. Tocolytic

Question 47

The best way for the nurse to evaluate the quality of a pregnant adolescent’s diet is to:

a. ask her how well she eats in a non-threatening manner.
b. assume it is inadequate and give her advice.
c. ask her to describe what she ate the previous day.
d. have her record everything she eats for 1 week

Answer 47

d. have her record everything she eats for 1 week

Question 48

Correct advice for women who ask about using alcohol during pregnancy is that it is:

a. safest if taken during the last trimester.
b. best to avoid consumption during the first 12 weeks.
c. unknown if there is any fetal harm from its use.
d. important to avoid it entirely throughout pregnancy.

Answer 48

d. important to avoid it entirely throughout pregnancy.

Question 49

Choose the primary distinction between a threatened and inevitable abortion.

a. Presence of cramping
b. Rupture of membranes
c. Vaginal bleeding
d. Pelvic pressure

Answer 49

b. Rupture of membranes

Question 50

When caring for a woman who had a hydatidiform mole evacuated, the clinic nurse should primarily:

a. reinforce the need to delay a new pregnancy for 1 year.
b. ask the woman whether she has any cramping or bleeding.
c. observe the return of her blood pressure to normal.
d. palpate the uterus for the return to its normal size.

Answer 50

a. reinforce the need to delay a new pregnancy for 1 year.

Question 51

The feature that distinguishes preeclampsia from eclampsia is the:

a. amount of blood pressure elevation.
b. edema of the face and fingers.
c. presence of proteinuria
d. onset of generalized seizures.

Answer 51

d. onset of generalized seizures

Question 52

The nurse is caring for a patient diagnosed with HELLP syndrome. The nurse knows that the hypertension disorder is characterized by the following (select all that apply):

a. Elevated liver enzymes
b. Elevated white blood cells
c. Low platelet count
d. Low creatinine levels
e. Hemolysis of red blood cells

Answer 52

a. Elevated liver enzymes
c. Low platelet count
e. Hemolysis of red blood cells

Question 53

A cervical cerclage is a treatment for:

a. Hydatidiform mole
b. Placenta accreta
c. Cervical incompetency
d. Cervical cancer

Answer 53

c. Cervical incompetency

Question 54

The best treatment for a woman in labor with a positive group B streptococcus (GBS) status would be to

a. Give betamethasone
b. Give antibiotic (ampicillin/ penicillin)
c. Start on intravenous Pitocin
d. Give the rubella vaccine

Answer 54

b. Give antibiotic (ampicillin/ penicillin)

Question 55

Cigarette smoking during pregnancy is associated with a higher rate of this in the newborn.

a. Large for gestational age infant
b. Diarrhea
c. Sudden infant death syndrome
d. Colic

Answer 55

c. Sudden infant death syndrome

Question 56

The nurse in a birthing room is monitoring a client with dysfunctional labor for signs of fetal or maternal compromise. Which assessment finding should alert the nurse to a compromise?

a. Spontaneous rupture of membranes
b. Coordinated uterine contractions
c. Progressive changes in the cervix
d. Persistent non-reassuring fetal heart rate

Answer 56

d. Persistent non-reassuring fetal heart rate

Question 57

The nurse has created a plan of care for a client experiencing dystocia and includes several nursing actions in the plan of care. What is the priority nursing action?

a. Providing comfort measures
b. Monitoring the fetal heart rate
c. Changing the client’s position frequently
d. Keeping the significant other informed of the progress of the labor

Answer 57

b. Monitoring the fetal heart rate

Question 58

The home care nurse visits a pregnant client who has a diagnosis of preeclampsia. Which assessment finding indicates a worsening of the preeclampsia and the need to notify the primary health care provider (PHCP)?

a. Urinary output has increased
b. Dependent edema has resolved.
c. Blood pressure reading is at the prenatal baseline.
d. The client complains of a headache and blurred vision.

Answer 58

d. The client complains of a headache and blurred vision.

Question 59

A stillborn baby was delivered in the birthing suite a few hours ago. After the delivery, the family remained together, holding and touching the baby. Which statement by the nurse would assist the family in their period of grief?

a. “What can I do for you?”
b. “Now you have an angel in heaven.”
c. “Don’t worry, there is nothing you could have done to prevent this from happening.”
d. “We will see to it that you have an early discharge so that you don’t have to be reminded of this experience.”

Answer 59

a. “What can I do for you?”

Question 60

The nurse is performing an assessment on a pregnant client in the last trimester with a diagnosis of preeclampsia. The nurse reviews the assessment findings and determines that which finding is most closely associated with a complication of this diagnosis?

a. Enlargement of the breasts
b. Complaints of feeling hot when the room is cool
c. Periods of fetal movement followed by quiet periods
d. Evidence of bleeding, such as in the gums, petechiae, and purpura

Answer 60

d. Evidence of bleeding, such as in the gums, petechiae, and purpura

Question 61

The nurse is assessing a pregnant client with type 1 diabetes mellitus about her understanding regarding changing insulin needs during pregnancy. The nurse determines that further teaching is needed if the client makes which statement?

a. “I will need to increase my insulin dosage during the first 3 months of pregnancy.”
b. “My insulin dose will likely need to be increased during the second and third trimesters.”
c. “Episodes of hypoglycemia are more likely to occur during the first 3 months of pregnancy.”
d. “My insulin needs should return to pre-pregnant levels within 7 to 10 days after birth if I am bottle-feeding.”

Answer 61

a. “I will need to increase my insulin dosage during the first 3 months of pregnancy.”

Question 62

The nurse is assessing a pregnant client in the second trimester of pregnancy who was admitted to the maternity unit with a suspected diagnosis of abruptio placentae. Which assessment finding should the nurse expect to note if this condition is present?

a. Soft abdomen
b. Uterine tenderness
c. Absence of abdominal pain
d. Painless, bright red vaginal bleeding

Answer 62

b. Uterine tenderness

Question 63

The maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the primary health care provider’s prescriptions and should question which prescription?

a. Prepare the client for an ultrasound.
b. Obtain equipment for a manual pelvic examination.
c. Prepare to draw a hemoglobin and hematocrit blood sample.
d. Obtain equipment for external electronic fetal heart rate monitoring.

Answer 63

b. Obtain equipment for a manual pelvic examination.

Question 64

Which of the following women should receive RhoGAM postpartum?

a) Nonsensitized Rh-negative mother with an Rh-negative newborn
b) Nonsensitized Rh-negative mother with an Rh-positive newborn
c) Sensitized Rh-negative mother with an Rh-positive newborn
d) Sensitized Rh-negative mother with an Rh-negative newborn

Answer 64

b) Nonsensitized Rh-negative mother with an Rh-positive newborn

Question 65

A woman is suspected of having abruptio placentae. Which of the following would the nurse expect to assess as a classic symptom?

a) Painless, bright-red bleeding
b) “Knife-like” abdominal pain
c) Excessive nausea and vomiting
d) Hypertension and headache

Answer 65

b) “Knife-like” abdominal pain

Question 66

RhoGAM is given to Rh-negative women to prevent maternal sensitization. In addition to pregnancy, Rh-negative women would also receive this medication after which of the following?

a) Therapeutic or spontaneous abortion
b) Head injury from a car accident
c) Blood transfusion after a hemorrhage
d) Unsuccessful artificial insemination procedure

Answer 66

a) Therapeutic or spontaneous abortion

Question 67

After teaching a woman about hyperemesis gravidarum and how it differs from the typical nausea and vomiting of pregnancy, which statement by the woman indicates that the teaching was successful?

a) “I can expect the nausea to last through my second trimester.”
b) “I should drink fluids with my meals instead of in between them.”
c) “I need to avoid strong odors, perfumes, or flavors.”
d) “I should lie down after I eat for about 2 hours.”

Answer 67

c) “I need to avoid strong odors, perfumes, or flavors.”

Question 68

A pregnant woman, approximately 12 weeks’ gestation, comes to the emergency department after calling her health care provider’s office and reporting moderate vaginal bleeding. Assessment reveals cervical dilation and moderately strong abdominal cramps. She reports that she has passed some tissue with the bleeding. The nurse interprets these findings to suggest which of the following?

a) Threatened abortion
b) Inevitable abortion
c) Incomplete abortion
d) Missed abortion

Answer 68

b) Inevitable abortion

Question 69

A woman is being discharged after receiving treatment for a hydatidiform molar pregnancy. The nurse should include which of the following in her discharge teaching?

a) Do not become pregnant for at least a year; use contraceptives to prevent it
b) Have the client’s blood
pressure checked weekly in the clinic
c) RhoGAM must be given within the next month to her at the clinic
d) An amniocentesis can detect a recurrence of this disorder in the future

Answer 69

a) Do not become pregnant for at least a year; use contraceptives to prevent it

Question 70

When administering magnesium sulfate to a client with preeclampsia, the nurse explains to her that this drug is given to:

a) Reduce blood pressure
b) Increase the progress of labor
c) Prevent seizures
d) Lower blood glucose levels

Answer 70

c) Prevent seizures

Question 71

Which of the following would the nurse include when teaching a pregnant woman about the pathophysiologic mechanisms associated with gestational diabetes?

a) Pregnancy fosters the development of carbohydrate cravings.
b) There is progressive resistance to the effects of insulin.
c) Hypoinsulinemia develops early in the first trimester.
d) Glucose levels decrease to accommodate fetal growth.

Answer 71

b) There is progressive resistance to the effects of insulin.

Question 72

When providing prenatal education to a pregnant woman with asthma, which of the following would be important for the nurse to do?

a) Explain that she should avoid steroids during her pregnancy.
b) Demonstrate how to assess her blood glucose levels.
c) Teach correct administration of subcutaneous bronchodilators.
d) Ensure she seeks treatment for any acute exacerbation.

Answer 72

d) Ensure she seeks treatment for any acute exacerbation.

Question 73

Which of the following conditions would most likely cause a pregnant woman with type 1 diabetes the greatest difficulty during her pregnancy?

a) Placenta previa
b) Hyperemesis gravidarum
c) Abruptio placentae
d) Rh incompatibility

Answer 73

b) Hyperemesis gravidarum

Question 74

Women who drink alcohol during pregnancy:

a) Often produce more alcohol dehydrogenase.
b) Usually become intoxicated faster than before.
c) Can give birth to an infant with fetal alcohol spectrum disorder.
d) Gain fewer pounds throughout the gestation.

Answer 74

c) Can give birth to an infant with fetal alcohol spectrum disorder.

Question 75

When explaining to a pregnant woman about HIV infection and transmission, which of the following would the nurse include?

a) It primarily occurs when there is a large viral load in the blood.
b) HIV is most commonly transmitted via sexual contact.
c) It affects the majority of infants of mothers with HIV infection.
d) Nurses are most frequently affected due to needle sticks.

Answer 75

b) HIV is most commonly transmitted via sexual contact.

Question 76

Women who are obese have a greater risk of developing which of the following during pregnancy?

a) Type 1 diabetes
b) Hypotension
c) Low birth weight infant
d) Gestational hypertension

Answer 76

d) Gestational hypertension

Question 77

Maintenance on methadone or buprenorphine is the most common medical treatment for which of the following drug addictions?

a) Alcohol
b) Nicotine
c) Opiates
d) Marijuana

Answer 77

c) Opiates

Question 78

When reviewing the medical record of a client, the nurse notes that the woman has a condition in which the fetus cannot physically pass through the maternal pelvis. The nurse interprets this as:

a) Cervical insufficiency
b) Contracted pelvis
c) Maternal disproportion
d) Fetopelvic disproportion

Answer 78

d) Fetopelvic disproportion

Question 79

The nurse would anticipate a cesarean birth for a client who has which active infection present at the onset of labor?

a) Hepatitis
b) Herpes simplex virus
c) Toxoplasmosis
d) Human papillomavirus

Answer 79

b) Herpes simplex virus

Question 80

After a vaginal examination, the nurse determines that the client’s fetus is in an occiput posterior position. The nurse would anticipate that the client will have:

a) Intense back pain
b) Frequent leg cramps
c) Nausea and vomiting
d) A precipitous birth

Answer 80

a) Intense back pain

Question 81

When assessing the following women, which would the nurse identify as being at the greatest risk for preterm labor?

a) Woman who had twins in a previous pregnancy
b) Client living in a large city close to the subway
c) Woman working full time as a computer programmer
d) Client with a history of a previous preterm birth

Answer 81

d) Client with a history of a previous preterm birth

Question 82

The rationale for using a prostaglandin gel for a client prior to the induction of labor is to:

a) Stimulate uterine contractions
b) Numb cervical pain receptors
c) Prevent cervical lacerations
d) Soften and efface the cervix

Answer 82

d) Soften and efface the cervix

Question 83

A client who was in active labor and whose cervix had dilated to 4 cm experiences a weakening in the intensity and frequency of her contractions and exhibits no further progress in labor. The nurse interprets this as a sign of:

a) Hypertonic labor
b) Precipitate labor
c) Hypotonic labor
d) Dysfunctional labor

Answer 83

c) Hypotonic labor

Question 84

The nurse is developing a plan of care for a woman experiencing dystocia. Which of the following nursing interventions would be the nurse’s high priority?

a) Changing the woman’s position frequently
b) Providing comfort measures to the woman
c) Monitoring the fetal heart rate patterns
d) Keeping the couple informed of the labor progress

Answer 84

c) Monitoring the fetal heart rate patterns

Question 85

The nurse is caring for a woman experiencing hypertonic uterine dystocia. The woman’s contractions are erratic in their frequency, duration, and of high intensity. The priority nursing intervention would be to:

a) Encourage ambulation every 30 minutes
b) Provide pain relief measures
c) Monitor the Pitocin infusion rate closely
d) Prepare the woman for an amniotomy

Answer 85

b) Provide pain relief measures

Question 86

Which information on a client’s health history would the nurse identify as contributing to the client’s risk for an ectopic pregnancy?

A. recurrent pelvic infections
B. use of oral contraceptives for 5 years
C. ovarian cyst 2 years ago
D. heavy, irregular menses

Answer 86

A. recurrent pelvic infections

Question 87

A woman pregnant with twins comes to the clinic for an evaluation. The nurse closely assesses the client for which potential problem?

A. preeclampsia
B. oligohydramnios
C. chorioamnionitis
D. post-term labor

Answer 87

A. preeclampsia

Question 88

A nurse is conducting an assessment of a woman who has experienced PROM. Which finding would lead the nurse to suspect infection as the cause of a client’s PROM?

A. foul odor
B. ferning
C. yellow-green fluid
D. blue color on Nitrazine testing

Answer 88

A. foul odor

Question 89

A pregnant woman is admitted with premature rupture of the membranes. The nurse is assessing the woman closely for possible infection. Which findings would lead the nurse to suspect that the woman is developing an infection? Select all that apply.

A. abdominal tenderness
B. elevated maternal pulse rate
C. cloudy malodorous fluid
D. decreased C-reactive protein levels
E. fetal bradycardia

Answer 89

A. abdominal tenderness
B. elevated maternal pulse rate
C. cloudy malodorous fluid

Question 90

After teaching a group of nurses working at the women’s health clinic about the impact of pregnancy on the older woman, which statement by the group indicates that the teaching was successful?

A. “Women over age 35 and are pregnant have an increased risk for spontaneous abortions.”
B. “The majority of women who become pregnant over age 35 experience complications.”
C. “Women over the age of 35 who become pregnant require a specialized type of assessment.”
D. “Women over age 35 are more likely to have a substance use disorder.”

Answer 90

A. “Women over age 35 and are pregnant have an increased risk for spontaneous abortions.”

Question 91

A nurse is conducting an in-service presentation to a group of perinatal nurses about sexually transmitted infections and their effect on pregnancy. The nurse determines that the teaching was successful when the group identifies which two infections as being responsible for ophthalmia neonatorum? Choose two.

A. gonorrhea
B. syphilis
C. chlamydia
D. HPV

Answer 91

A. gonorrhea
C. chlamydia

Question 92

After teaching a pregnant woman with iron deficiency anemia about nutrition, the nurse determines that the teaching was successful when the woman identifies which foods as being good sources of iron in her diet? Select all that apply.

A. dried fruits
B. peanut butter
C. meats
D. white bread
E. milk

Answer 92

A. dried fruits
B. peanut butter
C. meats

Question 93

A nurse is providing care to several pregnant women at different weeks of gestation. The nurse would expect to screen for group B streptococcus infection in the client who is at:

A. 36 weeks’ gestation.
B. 32 weeks’ gestation.
C. 28 weeks’ gestation.
D. 16 weeks’ gestation.

Answer 93

A. 36 weeks’ gestation

Question 94

The nurse would be alert for possible placental abruption during labor when assessment reveals which finding?

A. gestational hypertension
B. macrosomia
C. gestational diabetes
D. low parity

Answer 94

A. gestational hypertension

Question 95

The nurse would be alert for possible placental abruption during labor when assessment reveals which finding?

A. gestational hypertension
B. macrosomia
C. gestational diabetes
D. low parity

Answer 95

A. gestational hypertension

Question 96

A nurse is reviewing the medical record of a pregnant client. The nurse suspects that the client may be at risk for dystocia based on which factors? Select all that apply.

A. short maternal stature
B. plan for pudendal block anesthetic use
C. multiparity
D. maternal age over 35
E. breech fetal presentation

Answer 96

A. short maternal stature
D. maternal age over 35
E. breech fetal presentation

Question 97

A woman with a history of crack cocaine use disorder is admitted to the labor and birth area. While caring for the client, the nurse notes a sudden onset of fetal bradycardia. Inspection of the abdomen reveals an irregular wall contour. The client also reports acute abdominal pain that is continuous. Which condition would the nurse suspect?

A. uterine rupture
B. amniotic fluid embolism
C. shoulder dystocia
D. umbilical cord prolapse

Answer 97

A. uterine rupture

Question 98

A nurse is conducting an in-service program for a group of labor and birth unit nurses about cesarean birth. The group demonstrates understanding of the information when they identify which conditions as absolute indications? Select all that apply.

A. active genital herpes infection
B. placenta previa
C. fetal distress
D. prolonged labor

Answer 98

A. active genital herpes infection
B. placenta previa
C. fetal distress

Question 99

The nurse is caring for a client with preeclampsia and understands the need to auscultate this client’s lung sounds every 2 hours. Why would the nurse do this?

A. Pulmonary edema
B. Pulmonary hypertension
C. Pulmonary emboli
D. Pulmonary atelectasis

Answer 99

A. Pulmonary edema

Question 100

A woman at 8 weeks’ gestation is admitted for ectopic pregnancy.

She is asking why this has occurred. The nurse knows that which factor is a known risk factor for ectopic pregnancy?

A. use of IUD for contraception
B. high number of pregnancies
C. multiple gestation pregnancy
D. use of oral contraceptives

Answer 100

A. use of IUD for contraception

Question 101

The nurse is preparing the plan of care for a woman hospitalized for hyperemesis gravidarum. Which interventions would the nurse most likely include? Select all that apply.

A. maintaining NPO status for the first day or two
B. preparing the woman for insertion of a feeding tube
C. administering antiemetic agents
D. obtaining baseline blood electrolyte levels
E. monitoring intake and output

Answer 101

A. maintaining NPO status for the first day or two
C. administering antiemetic agents
D. obtaining baseline blood electrolyte levels
E. monitoring intake and output

Question 102

A pregnant client is admitted to a health care unit with disseminated intravascular coagulation (DIC). Which prescription is the nurse most likely to receive regarding the therapy for such a client?

A. Administer cryoprecipitate and platelets
B. Administer a ratio of 1 unit of blood to 4 units of frozen plasma.
C. Aim at keeping the client’s hematocrit above 20%.
D. Give each unit of blood to raise the hematocrit by 3 g/dL.

Answer 102

A. Administer cryoprecipitate and platelets

Question 103

A client in her 20th week of gestation develops HELLP syndrome. What are features of HELLP syndrome? Select all that apply.

A. hemolysis
B. elevated liver enzymes
C. low platelet count
D. hyperthermia
E. leukocytosis

Answer 103

A. hemolysis
B. elevated liver enzymes
C. low platelet count

Question 104

During a routine prenatal visit, a client is found to have proteinuria and a blood pressure rise to 140/90 mm Hg. The nurse recognizes that the client has which condition?

A. mild preeclampsia
B. gestational hypertension
C. severe preeclampsia
D. eclampsia

Answer 104

A. mild preeclampsia

Question 105

After a regular prenatal visit, a pregnant client asks the nurse to describe the differences between abruptio placentae and placenta previa. Which statement should the nurse include in the teaching?

A. “Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix; abruptio placentae is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor.”

B. “Placenta previa causes painful, dark red bleeding during pregnancy due to an abnormally implanted placentae that is too close to or covers the cervix; abruptio placenta is associated with bright red painless bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor.”

C. “Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the fundus; abruptio placentae is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor.”

D. “Placenta previa causes painful, dark red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the fundus; abruptio placentae is associated with right red painless bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor.”

Answer 105

A. “Placenta previa causes painless, bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix; abruptio placentae is associated with dark red painful bleeding caused by premature separation of the placenta from the wall of the uterus before the end of labor.”

Question 106

When caring for a client with premature rupture of membranes (PROM), the nurse observes an increase in the client’s pulse. What should the nurse do next?

A. Assess the client’s temperature.
B. Monitor the client for preterm labor.
C. Assess for cord compression.
D. Monitor the fetus for respiratory distress.

Answer 106

A. Assess the client’s temperature.