Nursing 3 Test 1 Practice questions

Question 1

In Leopold’s maneuver step #1, you palpated a soft broad mass that moves with the rest of the mass. The correct interpretation of this finding is:
A)The mass palpated at the fundal part is the head part.
B) The presentation is breech.
C) The mass palpated is the back
D) The mass palpated is the buttocks.

Answer 1

The palpated mass is the fetal buttocks since it is broad and soft and moves with the rest of the mass.

Question 2

In Leopold’s maneuver step # 3 you palpated a hard round movable mass at the supra pubic area. The correct interpretation is that the mass palpated is:
A) The buttocks because the presentation is breech.
B) The mass palpated is the head.
C) The mass is the fetal back.
D) The mass palpated is the fetal small part

Answer 2

When the mass palpated is hard round and movable, it is the fetal head.

Question 3

The hormone responsible for a positive pregnancy test is:
A) Estrogen
B) Progesterone
C)Human Chorionic Gonadotropin
D) Follicle Stimulating hormone

Answer 3

Human chorionic gonadotropin (HCG) is the hormone secreted by the chorionic villi which is the precursor of the placenta. In the early stage of pregnancy, while the placenta is not yet fully developed, the major hormone that sustains the pregnancy is HCG.

Question 4

The hormone responsible for the maturation of the graafian follicle is:
A) Follicle stimulating hormone
B) Progesterone
C) Estrogen
D) Luteinizing hormone

Answer 4

The hormone that stimulates the maturation if the of the graafian follicle is the Follicle Stimulating Hormone which is released by the anterior pituitary gland.

Question 5

Which of the following findings in a woman would be consistent with a pregnancy of two months duration?
A) Weight gain of 6-10 lbs. and presence of striae gravidarum
B) Fullness of the breast and urinary frequency
C) Braxton Hicks contractions and quickening
D) Increased respiratory rate and ballottement

Answer 5

Fullness of the breast is due to the increased amount of progesterone in pregnancy. The urinary frequency is caused by the compression of the urinary bladder by the gravid uterus which is still within the pelvic cavity during the first trimester.

Question 6

Which of the following is a positive sign of pregnancy?
A) Fetal movement felt by mother
B) Enlargement of the uterus
C) (+) pregnancy test
D) (+) ultrasound

Answer 6

A positive ultrasound will definitely confirm that a woman is pregnant since the fetus in utero is directly visualized.

Question 7

What event occurring in the second trimester helps the expectant mother to accept the pregnancy?
A) Lightening
B) Ballottement
C) Pseudocyesis
D) Quickening

Answer 7

Quickening is the first fetal movement felt by the mother makes the woman realize that she is truly pregnant. In early pregnancy, the fetus is moving but too weak to be felt by the mother. In the 18th-20th week of gestation, the fetal movements become stronger thus the mother already feels the movements.

Question 8

The diet that is appropriate in normal pregnancy should be high in
A) Protein, minerals and vitamins
B) Carbohydrates and vitamins
C) Proteins, carbohydrates and fats
D) Fats and minerals

Answer 8

In normal pregnancy there is a higher demand for protein (body building foods), vitamins (esp. vitamin A, B, C, folic acid) and minerals (esp. iron, calcium, phosphorous, zinc, iodine, magnesium) because of the need of the growing fetus.

Question 9

You want to perform a pelvic examination on one of your pregnant clients. You prepare your client for the procedure by:
A) Asking her to void
B) Taking her vital signs and recording the readings
C) Giving the client a perineal care
D) Doing a vaginal prep

Answer 9

A pelvic examination includes abdominal palpation. If the pregnant woman has a full bladder, the manipulation may cause discomfort and accidental urination because of the pressure applied during the abdominal palpation. Also, a full bladder can impede the accuracy of the examination because the bladder (which is located in front of the uterus) can block the uterus.

Question 10

When preparing the mother who is on her 4th month of pregnancy for abdominal ultrasound, the nurse should instruct her to:
A) Observe NPO from midnight to avoid vomiting
B) Do perineal flushing properly before the procedure
C)Drink at least 2 liters of fluid 2 hours before the procedure and not void until the procedure is done
D) Void immediately before the procedure for better visualization

Answer 10

Drinking at least 2 liters of water 2 hours before the procedure will result to a distended bladder. A full bladder is needed when doing an abdominal ultrasound to serve as a “window” for the ultrasonic sound waves to pass through and allow visualization of the uterus (located behind the urinary bladder).

Question 11

The nursing intervention to relieve “morning sickness” in a pregnant woman is by giving
A) Dry carbohydrate food like crackers
B) Low sodium diet
C) Intravenous infusion
D) Antacid

Answer 11

Morning sickness maybe caused by hypoglycemia early in the morning thus giving carbohydrate food will help.

Question 12

Mrs. Santos is on her 5th pregnancy and has a history of abortion in the 4th pregnancy and the first pregnancy was a twin. She is considered to be
A) G 4 P 3
B) G 5 P 3
C) G 5 P 4
D) G 4 P 4

Answer 12

B) Gravida refers to the total number of pregnancies including the current one. Para refers to the number of pregnancies that have reached viability(past 2o weeks). Thus, if the woman has had one abortion, she would be considered Para 3. Twin pregnancy is counted only as 1 for parity and gravida because twins are considered one birth. total of 5 pregnancies=G5

Question 13

The following are skin changes in pregnancy EXCEPT:
A) Chloasma
B) Striae gravidarum
C) Linea nigra
D) Chadwick’s sign

Answer 13

Chadwick’s sign is bluish discoloration of the vaginal mucosa as a result of the increased vascularization in the area.

Question 14

Which of the following statements is TRUE of conception?
A) Within 2-4 hours after intercourse conception is possible in a fertile woman
B) Generally, fertilization is possible 4 days after ovulation
C) Conception is possible during menstruation in a long menstrual cycle
D) To avoid conception, intercourse must be avoided 5 days before and 3 days after menstruation

Answer 14

The sperms when deposited near the cervical os will be able to reach the fallopian tubes within 4 hours. If the woman has just ovulated (within 24 hours after the rupture of the graafian follicle), fertilization is possible.

Question 15

Smoking is contraindicated in pregnancy because
A) Nicotine causes vasodilation of the mother’s blood vessels
B) Carbon monoxide binds with the hemoglobin of the mother reducing available hemoglobin for the fetus
C) The smoke will make the fetus and the mother feel dizzy
D) Nicotine will cause vasoconstriction of the fetal blood vessels

Answer 15

Carbon monoxide is one of the substances found in cigarette smoke. This substance diminishes the ability of the hemoglobin to bind with oxygen thus reducing the amount of oxygenated blood reaching the fetus.

Question 16

To prevent preterm labor from progressing, drugs are usually prescribed to halt the labor. The drugs commonly given are:
A) Magnesium sulfate and terbutaline
B) Prostaglandin and oxytocin
C) Progesterone and estrogen
D) Dexamethasone and prostaglandin

Answer 16

Magnesium sulfate acts as a CNS depressant as well as a smooth muscle relaxant. Terbutaline is a drug that inhibits the uterine smooth muscles from contracting. On the other hand, oxytocin and prostaglandin stimulates contraction of smooth muscles.

Question 17

You are doing an assessment on a female patient. She tells you she gave birth to twin girls at 39 weeks. You would chart the following regarding parity?
Primipara 
Nullipara
Multipara
Gravida

Answer 17

This describes a primipara woman because she had one birth that occurred after 20 weeks gestation. Note parity is the number of births NOT the number of fetuses as with twins in this situation. Multipara is a woman who has had two or more pregnancies resulting in a successful delivery, and nullipara is a woman who has not had a birth at more than 20 weeks gestation.

Question 18

During an assessment of a pregnant patient (who is 20 weeks pregnant) she tells you the following information regarding her pregnancy outcomes: She currently has 3 children (ages: 3, 8, 19), all of them were born at 39 and 40 weeks gestation, she has been pregnant 5 times (including this pregnancy). How would you document her GTPAL?
G: 5, T: 3, P: 0, A: 1, L: 3 
G: 4, T: 3, P: 0, A: 0, L: 4
G: 4, T: 4, P: 0, A: 0, L: 3
G: 5, T: 3, P: 0, A: 1, L: 4

Answer 18

The answer is G: 5, T: 3, P: 0, A: 1, L: 3. G is the number of pregnancies including the present one. T is the number of babies born after 37 weeks gestation. P is the number of babies born before 37 weeks gestation. A is the number of abortions or miscarriages and L is the number of current living children.

Question 19

Your patient has underwent testing of her blood type and Rh factor. She has A- blood type. Which of the following statement is correct?
At 36 weeks she will receive Rh immune globulin.
At 28 weeks she should receive the Rh immune globulin.
No further testing will be done because the patient is Rh negative, instead of Rh positive.
The patient will be checked for clotting problems.

Answer 19

The patient’s Rh factor is negative so she will need to receive the Rh immune globulin at 28 weeks. If the patient was A+ (meaning her Rh factor is positive) she would not have to receive the Rh immune globulin.

Question 20

A patient is wanting to become pregnant and has underwent prenatal counsel and testing. Her rubella titer is lower than 1:8. She consents to receiving the rubella vaccine. What education will you provide to the patient?
She must use an effective birth control method at the time of immunization and not become pregnant for 1-3 months.
Once she has a positive pregnancy test she is to call the office to schedule another appointment.
The patient’s rubella titer is normal and therefore the vaccine is not needed. This question is incorrect.
It is okay to come into contact with people who are immunocompromised.

Answer 20

The only correct option is: She must use an effective birth control method at the time of immunization and not become pregnant for 1-3 months. Other options are incorrect statements about education regarding the rubella vaccine.

Question 21

A patient who is 8 1/2 months pregnant tells you she has been counting her baby’s kicks and is concerned because within a 4 hour period the baby has only kicked 32 times. What nursing intervention is correct?
Reassure the patient this kick count is normal.
Notify the MD of this finding.
Prep the patient for an abdominal ultrasound.
Assess the patient’s urine for protein and glucose.

Answer 21

Reassuring the patient this is normal is the correct answer. The mother should feel the baby kick at least 10 times in two consecutive 2 hour periods.

Question 22

) A pregnant patient has a nonstress test performed. The results showed the baby had 4 fetal heart rate accelerations of at least 15 beats/min that lasted 15 seconds from start to finish in association with fetal movement during 20 minutes. The results of this would be documented as:
"Reactive" Nonstress Test
"Nonreactive" Nonstress Test 
Negative Contraction Stress Test
Positive Contraction Stress Test

Answer 22

The results of the question describe a “reactive” nonstress test and the fetus is healthy.

Question 23

A patient is having an abdominal ultrasound to assess fetal gestational age and estimated date of delivery. Which statement is incorrect about this type of testing?
Before the abdominal ultrasound is performed the patient should empty bladder.
An abdominal ultrasound can outline and identify fetal and maternal structures.
Generally, at 20 weeks an abdominal ultrasound can be performed to assess fetal gender.
There are two types of ultrasounds that can be safely performed on a pregnant patient: abdominal and transvaginal

Answer 23

A patient should have a full bladder before the procedure so better images of the fetus can be obtained. So instructing the patient to drink water to fill the bladder for the procedure would be ideal.

Question 24

During stage 3 of labor, you note a gush of blood and that the uterus changes shape from an oval shape to globular shape. This indicates?
A. Postpartum hemorrhage
B. Imminent delivery of the baby
C. Signs of placental separation
D. Answers B and C

Answer 24

The answer is C. Signs that the placenta is about to be delivered: Umbilical cord starts to lengthen, Trickling/gush of blood, and uterus changes from an oval shape to globular.

Question 25

After birth, where do you expect to assess fundal height?
A. At the xiphoid process
B. 5 cm below the umbilicus
C. 2 cm above the pubic symphysis 
D. At or near the umbilicus

Answer 25

The answer is D. It should be found at or near the umbilicus. It will decrease 1 cm a day and after 10 days post-delivery it can not be palpated.

Question 26

The mother has delivered the placenta. You note that the shiny surface of the placenta was delivered first. What delivery mechanism is this known as AND is this the maternal or baby’s surface of the placenta?
A. Duncan mechanism, maternal 
B. Schultze mechanism, maternal
C. Schultze mechanism, baby
D. Duncan mechanism, baby

Answer 26

The answer is C. Remember “SHINY” Schultze. This is the side from the baby. Try to remember the baby is shiny and new so it is the SHINY Schultze side. The Schultze mechanism is where the baby’s surface is delivered first. Duncan mechanism is where the maternal side is delivered first. Remember “DULL/DIRTY” Duncan. This side will be dull/dirty, red, and rough and is the side from the mother. Try to remember the mother is dirty from labor and is in rough shape.

Question 27

Your laboring patient has transitioned to stage 2 of labor. What changes in the perineum indicate the birth of the baby is imminent?
A. Increase in meconium-stained fluid and retracting perineum
B. Retracting perineum and anus with an increase of bloody show
C. Rapid and intense contractions
D. Bulging perineum and rectum with an increase in bloody show

Answer 27

The answer is D. Bulging perineum and rectum with an increase in bloody show (and presenting of the baby’s head or other parts) are signs that the birth of the baby imminent.

Question 28

In stage 1 of labor, during the active phase, the cervix dilates?
A. 1-3 cm 
B. 7-10 cm
C. 4-7 cm
D. 8-10 cm

Answer 28

4-7 cm

Question 29

You’re performing a routine assessment on a mother post-delivery. The uterus is soft and displaced to the left of the umbilicus. What is your next nursing action?
A. Perform fundal massage and assist the patient to the bathroom.
B. Continue to monitor the mother. This is a normal finding post-delivery.
C. Notify the physician.
D. Administer PRN dose of Pitocin as ordered by the physician.

Answer 29

The answer is A. This is not a normal finding. The fundus of the uterus should be firm, mid-line, and near or at the umbilicus. If the fundus is soft, boggy, and displaced, the nurse should perform fundal massage and assist the patient to the bathroom to void. A full bladder can cause the fundus to become displaced and soft/boggy.

Question 30

Stage 1 of labor includes which phases in the correct order?
A. Transition, Latent, Active
B. Active, Latent, Transition
C. Active, Transition, Latent
D. Latent, Active, Transition

Answer 30

Latent (early labor), Active, Transition

Question 31

The nurse teaches a pregnant woman to avoid lying on her back. The nurse has based this statement on the knowledge that the supine position can:
A) Unduly prolong labor
B) Cause decreased placental perfusion
C) Lead to transient episodes of hypotension
D) Interfere with free movement of the coccyx

Answer 31

B)This is because impedance of venous return by the gravid uterus, which causes hypotension and decreased systemic perfusion.

Question 32

A 26-year old multigravida is 14 weeks’ pregnant and is scheduled for an alpha-fetoprotein test. She asks the nurse, “What does the alpha-fetoprotein test indicate?” The nurse bases a response on the knowledge that this test can detect:
A) Kidney defects
B) Cardiac defects
C) Neural tube defects
D) Urinary tract defects

Answer 32

C) The alpha-fetoprotein test detects neural tube defects and Down syndrome.

Question 33

A pregnant client is making her first Antepartum visit. She has a two year old son born at 40 weeks, a 5 year old daughter born at 38 weeks, and 7 year old twin daughters born at 35 weeks. She had a spontaneous abortion 3 years ago at 10 weeks. Using the GTPAL format, the nurse should identify that the client is:
A) G4 T3 P2 A1 L4
B) G5 T2 P2 A1 L4
C) G5 T2 P1 A1 L4
D) G4 T3 P1 A1 L4

Answer 33

5 pregnancies; 2 term births; twins count as 1; one abortion; 4 living children.

Question 34

The nurse recognizes that an expected change in the hematologic system that occurs during the 2nd trimester of pregnancy is:
A) decrease in WBC’s
B) In increase in hematocrit
C) An increase in blood volume
D) A decrease in sedimentation rate

Answer 34

C) The blood volume increases by approximately 40-50% during pregnancy. The peak blood volume occurs between 30 and 34 weeks of gestation. The hematocrit decreases as a result of the increased blood volume.

Question 35

After the first four months of pregnancy, the chief source of estrogen and progesterone is the:
A) Placenta
B) Adrenal cortex
C) Corpus luteum
D) Anterior hypophysis

Answer 35

A) When placental formation is complete, around the 16th week of pregnancy; it produces estrogen and progesterone.

Question 36

The chief function of progesterone is the:
A) Development of the female reproductive system
B) Stimulation of the follicles for ovulation to occur
C) Preparation of the uterus to receive a fertilized egg
D) Establishment of secondary male sex characteristics

Answer 36

C) Progesterone stimulates differentiation of the endometrium into a secretory type of tissue.

Question 37

In a lecture on sexual functioning, the nurse plans to include the fact that ovulation occurs when the:
A) Oxytocin is too high
B) Blood level of LH is too high
C) Progesterone level is high
D) Endometrial wall is sloughed off.

Answer 37

B) It is the surge of LH secretion in mid cycle that is responsible for ovulation.

Question 38

A primigravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension (PIH). The nurse who is caring for the client is performing assessments every 30 minutes. Which assessment finding would be of most concern to the nurse?
A) Urinary output of 20 ml since the previous assessment
B) Deep tendon reflexes of 2+
C) Respiratory rate of 10 BPM
D) Fetal heart rate of 120 BPM

Answer 38

C) Magnesium sulfate depresses the respiratory rate. If the respiratory rate is less than 12 breaths per minute, the physician or other health care provider needs to be notified, and continuation of the medication needs to be reassessed. A urinary output of 20 ml in a 30 minute period is adequate; less than 30 ml in one hour needs to be reported. Deep tendon reflexes of 2+ are normal. The fetal heart rate is WNL for a resting fetus.