MATERNITY NURSING

MATERNITY NURSINGA. This test paper contains 200 questions.

B. Write your answer in CAPITAL LETTERS before each number

C. No erasures, superimpositions and alterations allowed in your answer.

1. You performed the leopolds maneuver and found the following: breech presentation, fetal back at the right side of the mother. Based on these findings, you can hear the fetal heart beat (PMI) BEST in which location? A. Left lower quadrant B. Right lower quadrant C. Left upper quadrant D. Right upper quadrant

2. In Leopolds 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.

3. In Leopolds 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

4. The hormone responsible for a positive pregnancy test is:

A. Estrogen B. Progesterone C. Human Chorionic Gonadotropin D. Follicle Stimulating hormone

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

7. The most common normal position of the fetus in utero is: A. Transverse position B. Vertical position C. Oblique position D. None of the above

8. In the later part of the 3rd trimester, the mother may experience shortness of breath. This complaint maybe explained as:

A. A normal occurrence in pregnancy because the fetus is using more oxygen B. The fundus of the uterus is high pushing the diaphragm upwards C. The woman is having allergic reaction to the pregnancy and its hormones D. The woman maybe experiencing complication of pregnancy

9. 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

10. 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

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

12. Shoes with low, broad heels, plus a good posture will prevent which prenatal discomfort? A. Backache B. Vertigo C. Leg cramps D. Nausea

13. When a pregnant woman experiences leg cramps, the correct nursing intervention to relieve the muscle cramps is: A. Allow the woman to exercise B. Let the woman walk for a while C. Let the woman lie down and dorsiflex the foot towards the knees D. Ask the woman to raise her legs

14. From the 33rd week of gestation till full term, a healthy mother should have prenatal check up every: A. week B. 2 weeks C. 3 weeks D. 4 weeks

15. The expected weight gain in a normal pregnancy during the 3rd trimester is A. 1 pound a week B. 2 pounds a week C. 10 lbs a month D. 10 lbs total weight gain in the 3rd trimester

16. In the Batholonews rule of 4, when the level of the fundus is midway between the umbilicus and xyphoid process the estimated age of gestation (AOG) is: A. 5th month B. 6th month C. 7th month D. 8th month

17. The following are ways of determining expected date of delivery (EDD) when the LMP is unknown EXCEPT: A. Naegeles rule B. Quickening C. Mc Donalds rule D. Batholomews rule of 4

18. If the LMP is Jan. 30, the expected date of delivery (EDD) is A. Oct. 7 B. Oct. 24 C. Nov. 7 D. Nov. 8

19. Kegels exercise is done in pregnancy in order to: A. Strengthen perineal muscles B. Relieve backache C. Strengthen abdominal muscles D. Prevent leg varicosities and edema

20. Pelvic rocking is an appropriate exercise in pregnancy to relieve which discomfort? A. Leg cramps B. Urinary frequency C. Orthostatic hypotension D. Backache

21. The main reason for an expected increased need for iron in pregnancy is: A. The mother may have physiologic anemia due to the increased need for red blood cell mass as well as the fetal requires about 350-400 mg of iron to grow B. The mother may suffer anemia because of poor appetite C. The fetus has an increased need for RBC which the mother must supply D. The mother may have a problem of digestion because of pica

22. 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

24. Which of the following signs will require a mother to seek immediate medical attention? A. When the first fetal movement is felt B. No fetal movement is felt on the 6th month C. Mild uterine contraction D. Slight dyspnea on the last month of gestation

25. 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

26. 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

27. 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

28. The common normal site of nidation/implantation in the uterus is A. Upper uterine portion B. Mid-uterine area C. Lower uterine segment D. Lower cervical segment

29. 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

30. The following are skin changes in pregnancy EXCEPT: A. Chloasma B. Striae gravidarum C. Linea negra D. Chadwick's sign

31. 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

32. Which of the following are the functions of amniotic fluid?

1.Cushions the fetus from abdominal trauma 2.Serves as the fluid for the fetus

3.Maintains the internal temperature

4.Facilitates fetal movement A. 1 & 3 B. 1, 3, 4 C. 1, 2, 3 D. All of the above

33. You are performing abdominal exam on a 9th month pregnant woman. While lying supine, she felt breathless, had pallor, tachycardia, and cold clammy skin. The correct assessment of the womans condition is that she is A. Experiencing the beginning of labor B. Having supine hypotension C. Having sudden elevation of BP D. Going into shock

34. Smoking is contraindicated in pregnancy because A. Nicotine causes vasodilation of the mothers 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

35. Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy? A. Large for gestational age (LGA) fetus B. Hemorrhage C. Small for gestational age (SGA) baby D. Erythroblastosis fetalis

36. Which of the following signs and symptoms will most likely make the nurse suspect that the patient is having hydatidiform mole? A. Slight bleeding B. Passage of clear vesicular mass per vagina C. Absence of fetal heart beat D. Enlargement of the uterus

37. Upon assessment the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP) 5 months ago, fetal heart beat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition? A. Hydatidiform mole B. Missed abortion C. Pelvic inflammatory disease D. Ectopic pregnancy

38. When a pregnant woman goes into a convulsive seizure, the MOST immediate action of the nurse to ensure safety of the patient is: A. Apply restraint so that the patient will not fall out of bed B. Put a mouth gag so that the patient will not bite her tongue and the tongue will not fall back C. Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration D. Check if the woman is also having a precipitate labor

39. A gravido-cardiac mother is advised to observe bedrest primarily to A. Allow the fetus to achieve normal intrauterine growth B. Minimize oxygen consumption which can aggravate the condition of the compromised heart of the mother C. Prevent perinatal infection D. Reduce incidence of premature labor

40. A pregnant mother is admitted to the hospital with the chief complaint of profuse vaginal bleeding, AOG 36 wks, not in labor. The nurse must always consider which of the following precautions:

A. The internal exam is done only at the delivery under strict asepsis with a double set-up B. The preferred manner of delivering the baby is vaginal C. An emergency delivery set for vaginal delivery must be made ready before examining the patient D. Internal exam must be done following routine procedure

41. Which of the following signs will distinguish threatened abortion from imminent abortion? A. Severity of bleeding B. Dilation of the cervix C. Nature and location of pain D. Presence of uterine contraction

42. The nursing measure to relieve fetal distress due to maternal supine hypotension is: A. Place the mother on semi-fowlers position B. Put the mother on left side lying position C. Place mother on a knee chest position D. Any of the above

43. 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

44. In placenta praevia marginalis, the placenta is found at the: A. Internal cervical os partly covering the opening B. External cervical os slightly covering the opening C. Lower segment of the uterus with the edges near the internal cervical os D. Lower portion of the uterus completely covering the cervix

45. In which of the following conditions can the causative agent pass through the placenta and affect the fetus in utero? A. Gonorrhea B. Rubella C. Candidiasis D. moniliasis

46. Which of the following can lead to infertility in adult males? A. German measles B. Orchitis C. Chicken pox D. Rubella

47. Papanicolaou smear is usually done to determine cancer of A. Cervix B. Ovaries C. Fallopian tubes D. Breast

48. Which of the following causes of infertility in the female is primarily psychological in origin? A. Vaginismus B. Dyspareunia C. Endometriosis D. Impotence

49. Before giving a repeat dose of magnesium sulfate to a pre-eclamptic patient, the nurse should assess the patients condition. Which of the following conditions will require the nurse to temporarily suspend a repeat dose of magnesium sulfate? A. 100 cc. urine output in 4 hours B. Knee jerk reflex is (+)2 C. Serum magnesium level is 10mEg/L. D. Respiratory rate of 16/min

50. Which of the following is TRUE in Rh incompatibility? A. The condition can occur if the mother is Rh(+) and the fetus is Rh(-) B. Every pregnancy of an Rh(-) mother will result to erythroblastosis fetalis C. On the first pregnancy of the Rh(-) mother, the fetus will not be affected D. RhoGam is given only during the first pregnancy to prevent incompatibility

51. Which of the following conditions will lead to a small-for-gestational age fetus due to less blood supply to the fetus? A. Diabetes in the mother B. Maternal cardiac condition C. Premature labor D. Abruptio placenta

52. The lower limit of viability for infants in terms of age of gestation is: A. 21-24 weeks B. 25-27 weeks C. 28-30 weeks D. 38-40 weeks

114. The uterine fundus right after delivery of placenta is palpable at A. Level of Xyphoid process B. Level of umbilicus C. Level of symphysis pubis D. Midway between umbilicus and symphysis pubis

56. In a woman who is not breastfeeding, menstruation usually occurs after how many weeks? A. 2-4 weeks B. 6-8 weeks C. 6 months D. 12 months

55. The preferred manner of delivering the baby in a gravido-cardiac is vaginal delivery assisted by forceps under epidural anesthesia. The main rationale for this is:A. To allow atraumatic delivery of the baby B. To allow a gradual shifting of the blood into the maternal circulation C. To make the delivery effort free and the mother does not need to push with contractions D. To prevent perineal laceration with the expulsion of the fetal head

56. When giving narcotic analgesics to mother in labor, the special consideration to follow is: A. The progress of labor is well established reaching the transitional stage B. Uterine contraction is progressing well and delivery of the baby is imminent C. Cervical dilatation has already reached at least 8 cm. and the station is at least (+)2 D. Uterine contractions are strong and the baby will not be delivered yet within the next 3 hours.

57. The cervical dilatation taken at 8:00 A.M. in a G1P0 patient was 6 cm. A repeat I.E. done at 10 A.M. showed that cervical dilation was 7 cm. The correct interpretation of this result is: A. Labor is progressing as expected B. The latent phase of Stage 1 is prolonged C. The active phase of Stage 1 is protracted D. The duration of labor is normal

58. Which of the following techniques during labor and delivery can lead to uterine inversion? A. Fundal pressure applied to assist the mother in bearing down during delivery of the fetal head B. Strongly tugging on the umbilical cord to deliver the placenta and hasten placental separation C. Massaging the fundus to encourage the uterus to contract D. Applying light traction when delivering the placenta that has already detached from the uterine wall

59. The fetal heart rate is checked following rupture of the bag of waters in order to: A. Check if the fetus is suffering from head compression B. Determine if cord compression followed the rupture C. Determine if there is utero-placental insufficiency D. Check if fetal presenting part has adequately descended following the rupture

60. Upon assessment, the nurse got the following findings: 2 perineal pads highly saturated with blood within 2 hours post partum, PR= 80 bpm, fundus soft and boundaries not well defined. The appropriate nursing diagnosis is: A. Normal blood loss B. Blood volume deficiency C. Inadequate tissue perfusion related to hemorrhage D. Hemorrhage secondary to uterine atony

61. The following are signs and symptoms of fetal distress EXCEPT: A. Fetal heart rate (FHR) decreased during a contraction and persists even after the uterine contraction ends B. The FHR is less than 120 bpm or over 160 bpm C. The pre-contraction FHR is 130 bpm, FHR during contraction is 118 bpm and FHR after uterine contraction is 126 bpm D. FHR is 160 bpm, weak and irregular

62. If the labor period lasts only for 3 hours, the nurse should suspect that the following conditions may occur:1.Laceration of cervix2.Laceration of perineum3.Cranial hematoma in the fetus4.Fetal anoxia

A. 1 & 2 B. 2 & 4 C. 2,3,4 D. 1,2,3,4

63. The primary power involved in labor and delivery is A. Bearing down ability of mother B. Cervical effacement and dilatation C. Uterine contraction D. Valsalva technique

64. The proper technique to monitor the intensity of a uterine contraction is

A. Place the palm of the hands on the abdomen and time the contraction B. Place the finger tips lightly on the suprapubic area and time the contraction C. Put the tip of the fingers lightly on the fundal area and try to indent the abdominal wall at the height of the contraction D. Put the palm of the hands on the fundal area and feel the contraction at the fundal area

65. To monitor the frequency of the uterine contraction during labor, the right technique is to time the contraction A. From the beginning of one contraction to the end of the same contraction B. From the beginning of one contraction to the beginning of the next contraction C. From the end of one contraction to the beginning of the next contraction D. From the deceleration of one contraction to the acme of the next contraction

66. The peak point of a uterine contraction is called the A. Acceleration B. Acme C. Deceleration D. Axiom

67. When determining the duration of a uterine contraction the right technique is to time it from A. The beginning of one contraction to the end of the same contraction B. The end of one contraction to the beginning of another contraction C. The acme point of one contraction to the acme point of another contraction D. The beginning of one contraction to the end of another contraction

68. When the bag of waters ruptures, the nurse should check the characteristic of the amniotic fluid. The normal color of amniotic fluid is A. Clear as water B. Bluish C. Greenish D. Yellowish

69. When the bag of waters ruptures spontaneously, the nurse should inspect the vaginal introitus for possible cord prolapse. If there is part of the cord that has prolapsed into the vaginal opening the correct nursing intervention is: A. Push back the prolapse cord into the vaginal canal B. Place the mother on semifowlers position to improve circulation C. Cover the prolapse cord with sterile gauze wet with sterile NSS and place the woman on trendellenberg position D. Push back the cord into the vagina and place the woman on sims position

70. The fetal heart beat should be monitored every 15 minutes during the 2nd stage of labor. The characteristic of a normal fetal heart rate is A. The heart rate will decelerate during a contraction and then go back to its pre-contraction rate after the contraction B. The heart rate will accelerate during a contraction and remain slightly above the pre-contraction rate at the end of the contraction C. The rate should not be affected by the uterine contraction. D. The heart rate will decelerate at the middle of a contraction and remain so for about a minute after the contraction

71. The mechanisms involved in fetal delivery is A. Descent, extension, flexion, external rotation B. Descent, flexion, internal rotation, extension, external rotation C. Flexion, internal rotation, external rotation, extension D. Internal rotation, extension, external rotation, flexion 72. The first thing that a nurse must ensure when the babys head comes out is A. The cord is intact B. No part of the cord is encircling the babys neck C. The cord is still attached to the placenta D. The cord is still pulsating

73. To ensure that the baby will breath as soon as the head is delivered, the nurses priority action is to A. Suction the nose and mouth to remove mucous secretions B. Slap the babys buttocks to make the baby cry C. Clamp the cord about 6 inches from the base D. Check the babys color to make sure it is not cyanotic

74. When doing perineal care in preparation for delivery, the nurse should observe the following EXCEPT A. Use up-down technique with one stroke B. Clean from the mons veneris to the anus C. Use mild soap and warm water D. Paint the inner thighs going towards the perineal area

75. What are the important considerations that the nurse must remember after the placenta is delivered?1.Check if the placenta is complete including the membranes2.Check if the cord is long enough for the baby3.Check if the umbilical cord has 3 blood vessels4.Check if the cord has a meaty portion and a shiny portion

A. 1 and 3 B. 2 and 4 C. 1, 3, and 4 D. 2 and 3

76. The following are correct statements about false labor EXCEPT A. The pain is irregular in intensity and frequency. B. The duration of contraction progressively lengthens over time C. There is no vaginal bloody discharge D. The cervix is still closed.

77. The passageway in labor and deliver of the fetus include the following EXCEPT A. Distensibility of lower uterine segment B. Cervical dilatation and effacement C. Distensibility of vaginal canal and introitus D. Flexibility of the pelvis

78. The normal umbilical cord is composed of: A. 2 arteries and 1 vein B. 2 veins and 1 artery C. 2 arteries and 2 veins D. none of the above

79. At what stage of labor and delivery does a primigravida differ mainly from a multigravida? A. Stage 1 B. Stage 2 C. Stage 3 D. Stage 4

80. The second stage of labor begins with ___ and ends with __? A. Begins with full dilatation of cervix and ends with delivery of placenta B. Begins with true labor pains and ends with delivery of baby C. Begins with complete dilatation and effacement of cervix and ends with delivery of baby D. Begins with passage of show and ends with full dilatation and effacement of cervix

81. The following are signs that the placenta has detached EXCEPT: A. Lengthening of the cord B. Uterus becomes more globular C. Sudden gush of blood D. Mother feels like bearing down

82. When the shiny portion of the placenta comes out first, this is called the ___ mechanism. A. Schultze B. Ritgens C. Duncan D. Marmets

83. When the babys head is out, the immediate action of the nurse is A. Cut the umbilical cord B. Wipe the babys face and suction mouth first C. Check if there is cord coiled around the neck D. Deliver the anterior shoulder

84. When delivering the babys head the nurse supports the mothers perineum to prevent tear. This technique is called A. Marmets technique B. Ritgens technique C. Duncan maneuver D. Schultze maneuver

85. The basic delivery set for normal vaginal delivery includes the following instruments/articles EXCEPT: A. 2 clamps B. Pair of scissors C. Kidney basin D. Retractor

86. As soon as the placenta is delivered, the nurse must do which of the following actions? A. Inspect the placenta for completeness including the membranes B. Place the placenta in a receptacle for disposal C. Label the placenta properly D. Leave the placenta in the kidney basin for the nursing aide to dispose properly

87. In vaginal delivery done in the hospital setting, the doctor routinely orders an oxytocin to be given to the mother parenterally. The oxytocin is usually given after the placenta has been delivered and not before because: A. Oxytocin will prevent bleeding B. Oxytocin can make the cervix close and thus trap the placenta inside C. Oxytocin will facilitate placental delivery D. Giving oxytocin will ensure complete delivery of the placenta

88. In a gravido-cardiac mother, the first 2 hours postpartum (4th stage of labor and delivery) particularly in a cesarean section is a critical period because at this stage A. There is a fluid shift from the placental circulation to the maternal circulation which can overload the compromised heart. B. The maternal heart is already weak and the mother can die C. The delivery process is strenuous to the mother D. The mother is tired and weak which can distress the heart

89. The drug usually given parentally to enhance uterine contraction is: A. Terbutalline B. Pitocin C. Magnesium sulfate D. Lidocaine

90. The partograph is a tool used to monitor labor. The maternal parameters measured/monitored are the following EXCEPT: A. Vital signs B. Fluid intake and output C. Uterine contraction D. Cervical dilatation

91. The following are natural childbirth procedures EXCEPT:

A. Lamaze method B. Dick-Read method C. Ritgens maneuver D. Psychoprophylactic method

92. The following are common causes of dysfunctional labor. Which of these can a nurse, on her own manage? A. Pelvic bone contraction B. Full bladder C. Extension rather than flexion of the head D. Cervical rigidity

93. At what stage of labor is the mother is advised to bear down? A. When the mother feels the pressure at the rectal area B. During a uterine contraction C. In between uterine contraction to prevent uterine rupture D. Anytime the mother feels like bearing down

94. The normal dilatation of the cervix during the first stage of labor in a nullipara is A. 1.2 cm./hr B. 1.5 cm./hr. C. 1.8 cm./hr D. 2.0 cm./hr

95. When the fetal head is at the level of the ischial spine, it is said that the station of the head is A. Station 1 B. Station 0 C. Station +1 D. Station +2

96. During an internal examination, the nurse palpated the posterior fontanel to be at the left side of the mother at the upper quadrant. The interpretation is that the position of the fetus is: A. LOA B. ROP C. LOP D. ROA

97. The following are types of breech presentation EXCEPT: A. Footling B. Frank C. Complete D. Incomplete

98. When the nurse palpates the suprapubic area of the mother and found that the presenting part is still movable, the right term for this observation that the fetus is A. Engaged B. Descended C. Floating D. Internal Rotation

99. The placenta should be delivered normally within ___ minutes after the delivery of the baby. A. 5 minutes B. 30 minutes C. 45 minutes D. 60 minutes

100. According to Rubins theory of maternal role adaptation, the mother will go through 3 stages during the post partum period. These stages are: A. Going through, adjustment period, adaptation period B. Taking-in, taking-hold and letting-go C. Attachment phase, adjustment phase, adaptation phase D. Taking-hold, letting-go, attachment phase

EXAM II1. A client who is a brittle diabetic is seeking to get pregnant. Who should she choose as a care provider?

a. a certified nurse-midwife

b. a family nurse practitioner

c. an obstetrician

d. a maternal-fetal medicine specialist

2. A client who is gravida 14, para 10-3-0-16, gave to all her children vaginally. She presents in labor and upon vaginal examination the obstetrician discovers the infant is in footling breech position. The obstetrician plans to do a C.S. immediately but the family dramatically refuses. How can the nurse help resolve the dilemma?

a. follow the physicians order and prepare the client for surgery

b. help identify all the options, taking action on the on the best option for all concerned

c. side with the client and refuse to prepare for the surgery

d. call the supervisor so she can mediate the dispute3. A child bearing is considered a developmental crisis for a family because:

a. it is an abnormal experience in the process of growth and development

b. it is a period of physical, psychological, in social change causing a sense of disorganization

c. it is a stressful, unexpected event caused by external factors

d. the family has already mastered the tasks of this maturational age.

4. A nurse is a defendant in a suit brought by a client who had a post partum hemorrhage requiring transfusion of 20 units of blood and a hysterectomy after the delivery of her 3rd child. The client had an epidural before the delivery and immediately after delivery of the placenta the client had persistent uterine atony with heavy bleeding. In the immediate postpartum, the clients uterus continued to get boggy and the client had a heavy, bright rubra lochial flow. The nurse is being sued for not providing appropriate care. Which of the following would be the standard of care for a client experiencing a post partum hemorrhage?

a. palpate the fundus every 10 to 15 minutes and if boggy, massage to expel clots

b. have the client empty her bladder only when she has the urge to void

c. discontinue the pitocin IV when the uterus is firm and 4 cm above the umbilicus

d. do assessment every 30 minutes as indicated in the postpartum flow sheet

5. A client basal. Body temperature (BBT) graph shows a nearly straight line. Which of the following describes the etiology of what the graph means?

a. the client is not ovulating

b. the client is not having intercourse

c. the client is ovulating late in her menstrual cycle

d. the client is not taking her temperature correctly

6. A client who has a pelvic inflammatory disease (PID) caused by Chlamydia trachomatis is at risk for which of the following?

a. anovulatory menstrual cycle

b. ectopic pregnancy

c. multifetal pregnancy

d. cervical dysplasia

7. Which of the following statements tells you that a client needs further teaching? To become pregnant, we should:

a. have intercourse on the 14th day of menstrual cycle

b. have intercourse when my basal body temperature rises

c. have intercourse every other day during the week before and after ovulation

d. abstain from intercourse for the month prior to the month I want to conceive.

8. An infertile couple will likely have which of the following tests ordered?

a. Semen analysis and hystersalpingogram

b. Hystersalpingogram and Pap smear

c. Colposcopy with endocervical biopsy

d. Sexually transmitted infection testing and artificial insemination

9. Nursing care of the infertile couple would include which of the following?

a. assistance in dealing with feelings of guilt and shame

b. facilitation of verbalizing which partner is to blame

c. History and vital sign analysis only

d. discussing the advantages of adoption instead of infertility treatment10. A client with fallopian tube blockage would be a candidate for which of the following methods of achieving pregnancy?

a. natural family planning c. tubal ligation

b. vitro fertilization

d. sperm washing11. The client has been scheduled to have a hysterosalpingogram. Which of the following questions does the nurse need to ask?

a. Do you have any metal implants?

b. When was the last time you had intercourse?

c. When was the first day of your last menstrual cycle?

d. What was your age at menarche?

12. A couple visits the genetic counseling clinic regarding a family history of cystic fibrosis, an autosomal recessive disorder. They ask the nurse, What are the chances that we will have a child with cystic fibrosis if we are both carriers?

a. They should not have children because they will all have cystic fibrosis

b. the disorder occurs at random, and there is no way to calculate the risk

c. there is 50% chance that they will have a child with cystic fibrosis

d. there is a 25% chance that they will have a child with cystic fibrosis

13. A nurse is counseling a couple about fertility awareness. The nurse determines they understand the ideal time for conception when the client states:

a. ovulation usually occurs 14 days after the beginning of the menstrual cycle

b. the ovum survives for 24 hours after ovulation

c. it is best to have intercourse 24 to 48 hrs. after ovulation

d. the ovum must be in contact with sperm for 48 hours in order for fertilization to occur.

14. After completing a health history in a prenatal clinic, the nurse recognizes which client as having the greatest risk for potential birth anomalies?

a. a 23 y.o. pregnant woman at 7 months gestation with a urinary tract infection

b. a 15 y.o. primigravida with a sister who has Down syndrome

c. a 35 y.o. multigravida at 16 weeks gestation with a yeast infection

d. a 42 y.o. multigravida at 5 months gestation with a colds

15. A 30 y.o. woman is pregnant with twins. She tells the nurse that twins run in her family. She has a twin brother, her mother is a twin, and many relatives have twins. The nurse explains that this type of twinning is most likely:

a. identical

c. dizygotic

b. monozygotic

d. monoamniotic16. A client at 8 months gestation is diagnosed with oligohydramnios. She asks the nurse if this can harm the fetus. The nurse best response is

a. yes, it can lead to umbilical cord compression.

b. yes, it means the fetus swallowed too much fluid.

c. No, this commonly occurs toward the end of pregnancy.

d. No, this is a sign that the lungs are maturing.17. At a family planning clinic, the nurse explains how a urine pregnancy test works and tells the client that the test detects an increase in the hormone:

a. Estriol

b. progesterone

c. human chorionic gonadotropin (hCG)

d. human placental lactogen (hPL)

18. Following an ultrasound at 6 weeks gestation the client comments, the embryo doesnt look human. And asks, when will it begin to look like a baby? The nurse best response is:

a. in one week the embryo will take on a human appearance.

b. the embryo looks like a baby already. Let me show you again.

c. the embryo becomes a fetus and looks human after 8 weeks gestation.

d. you are right. The embryo doesnt look human. Is this important to you?

19. Following an amniocentesis, the parents discover that their fetus has Down syndrome. The nurse should:

a. provide information about Down syndrome

b. discuss the possibility of intrauterine surgery

c. refer the parents for karyotyping

d. refer the parents to their local public health surgery.20. During the clients initial prenatal visit, which of the following would indicate a need for further assessment?

a. history of diabetes for 6 years

b. exercises 3 times a week

c. occasional use of over the counter pain relievers

d. maternal age 30 years21. The low-risk client, who is 16 weeks pregnant, should be told to return to the prenatal clinic in:

a. one week

c. 3 weeks

b. two weeks

d. four weeks22. The pregnant woman reports that she has a 3 year old child at home who was born at term, had a miscarriage at 10 weeks gestation, and delivered a set of twins at 28 weeks gestation that died after 24 hours. In the prenatal record, the nurse should record:

a. gravida 2 para 1

c. gravida 4 para 2

b. gravida 3 para 3

d. gravida 5 para 4

23. The clients prenatal education includes danger signs to report, Which of the following, if reported, would indicate that the client understood the teaching?

a. dizziness and blurred vision

b. occasional nausea and vomiting

c. no bowel movement for 3 days

d. ankle edema24. The is planning a childbirth education class for women in their first trimester of pregnancy. Which of the following topics is most appropriate?

a. breathing techniques for pain relief in labor

b. choosing a prenatal care provider

c. postpartum self-care

d. care of the newborn infant

25. Which of the following would be the best indicator of normal fetal growth?

a. maternal weight gain 7 lbs at 22 weeks gestation

b. fundal height 22 cm at 25 weeks gestation

c. maternal waist circumference 41 inches at 36 weeks gestation

d. maternal intake1,500 calories per day

26. The pregnant client is scheduled to have an ultrasound. Which of the following might indicate a need to do the assessment transvaginally?

a. client is 5 ft 1 inc tall and weighs 230 lbs.

b. client is 15 yrs old and easily embarrassed

c. client is 32 weeks gestation

d. client is concerned about ultrasound wave hurting the baby

27. A client with class ll heart disease is being seen for her first prenatal visit. Which of the following teaching points would the nurse stress for this client?

a. avoid all over the counter (OTC) medications during pregnancy

b. regular exercise will help increase the cardiac capacity during pregnancy

c. it is important to take prenatal vitamins and iron as prescribed

d. the clients fetus will probably have a similar congenital heart disease.

28. When an insulin-dependent diabetic client gives birth, the expects the clients insulin requirements in the first 24 hrs. after delivery to:

a. drop significantly

b. gradually return to normal

c. increase slightly

d. stay the same as before

29. Which of the following lab tests would the nurse look at to provide the best information about ongoing control of insulin-dependent diabetes in a pregnant adolescent?

a. fasting blood sugar

b. glycosylated hemoglobin

c. oral glucose tolerance test

d. post-prandial test30. The nurse should be aware that pregnant women who practice substance abuse and present themselves for prenatal care:

a. are ready to kick their habit

b. must be reported to the authorities

c. recognize the need for caring interventions

d. will lack appropriate parenting skills

31. Which of the following actions would take priority when caring for the woman with suspected ectopic pregnancy?

a. administering oxygen

b. monitoring vital signs

c. obtaining surgical consent

d. providing emotional support

32. A client with a known placenta previa is admitted at 30 weeks with painless vaginal bleeding. The nurse weighs the clients peri-pads to monitor blood loss. An increased weight of 50 g would indicate approximately how much blood loss.

a. 0.5 mlb. 5 ml c. 50 ml d. 500 ml

33. A client is hospitalized in the antepartum unit with premature rupture of membranes at 37 weeks gestation. Which of the following routine physician orders would the nurse alter for this client?

a. bed rest with BR

b. diet as tolerated

c. external fetal monitor prn

d. vital signs every shift

34. A client with pre-eclampsia is receiving magnesium sulfate and oxytocin IV to induce labor at 36 weeks. What is the main indication of the magnesium sulfate for this client?

a. lower blood pressure c. provide sedation

b. prevent convulsionsd. soften stools

35. Which of the following complications of pregnancy would be most consistent with development of sinusoidal fetal heart rate pattern during labor?

a. abrutio placenta

b. chorioamnionitis

c. pregnancy-induced hypertension

d. prolapsed cord36. The nurse performs a vaginal exam and determines that the fetus is in a sacrum anterior position. This means:

a. the fetal sacrum is toward the maternal symphysis pubis

b. the fetal sacrum is toward the maternal sacrum

c. the fetal face is toward the maternal sacrum

d. the fetal face is toward the maternal symphysis pubis

37. The client has been having contractions every 5 minutes for 7 hours. Which factor is used to determine if this is a true or false labor?

a. the cervix is effacing and dilating

b. this is the clients 2nd baby

c. the contractions are becoming more intense and lasting longer

d. the membranes have ruptured38. The highest priority in nursing care of the laboring client is:

a. pain relief measures are offered that are acceptable to the client

b. the clients partner is involved with the labor and delivery

c. appropriate fluid intake is monitored

d. fetal response to the labor is assessed39. As labor progresses, the nurse expects to find contractions becoming:

a. more intense, less frequent, and of longer duration

b. more intense, more frequent, and of longer duration

c. constant in intensity, more frequent, and of shorter duration.

d. constant in intensity and frequency, and of shorter duration

40. Which of the following nursing observations would indicate a sign of impending placental separation and expulsion?

a. steady trickle of blood with an unchanged cord length

b. no bleeding with the lengthening of the cord

c. small gush of blood with lengthening of the cord

d. small gush of blood with unchanged length of the cord.

41. The nurse determines a laboring client is anxious and recognizes that may result in:

a. rapid progression in labor

b. increased pain during labor

c. no reliance on support person

d. need for episiotomy

42. Earlier in the day, the fetal heart rate baseline was 140. It is now 170. One explanation for this could be:

a. maternal fever

b. narcotic administration

c. fetal movement

d. utero-placental insufficiency

43. The nurse determines teaching has been effective when a laboring client responds:

a. effacement is the opening of the cervix.

b. my cervix will probably efface before it dilates because this is my first pregnancy.

c. effacement is measured from 0 to 10 cm.

d. my cervix will probably efface and dilate simultaneously because this is my first pregnancy.

44. The clients vaginal examination reveals: 3 cm dilated, 80% effaced, vertex at a -1 station. The woman is talkative and appears excited. The nurse determines the client is to be in which stage and phase of labor?

a. 1st stage, latent phase

b. 1st stage, active phase

c. 2nd stage, latent phase

d. 3rd stage, transition phase

45. The nurse determines that vaginal delivery of a vertex presentation is more likely to occur if the fetus adapts to the passageway (pelvis) in which sequence of movements?

a. flexion, internal rotation, external rotation, extension

b. extension, flexion, descent, external rotation

c. descent, internal rotation, extension, external rotation

d. internal rotation, descent, flexion, extension

46. Assessment of a normal episiotomy immediately post delivery is most likely to reveal:

a. gaping between the sutures

b. slight bruising

c. pus coming from the sutures

d. edema that makes the tissue looks shiny

47. 4th stage nursing care for a client with an episiotomy includes which of the following?

a. application of ice beginning 4 hours after delivery

b. ice pack to the perineum for up to 60 minutes per application

c. inspection every 15 minutes during the first hour after childbirth

d. instruction to avoid intercourse for at least 12 weeks

48. The nurses goal in teaching childbirth education classes is to:

a. provide education to all pregnant client

b. ensure a normal spontaneous vaginal delivery

c. help client know what to expect during labor

d. prepare the couple for all possible complications49. The nurse note on the antepartal history that the client has an android pelvis and recognizes an increased risk for:

a. a prolonged labor

b. occiput posterior position

c. precipitous delivery

d. developing postpartum complications50. The nurse determines teaching has been effective when a client with a fetus in a frank breech position says: My babys hips are:

a. Flexed and the knees are flexed

b. extended and the knees are flexed

c. flexed and the knees are extended

d. extended and the knees are extended

51. If the fetal head is determined to be presenting in a position of complete extension, the nurse should anticipate a:

a. precipitous labor and delivery

b. prolonged labor and possible CS delivery

c. normal labor and spontaneous vaginal delivery

d. forceps assisted vaginal delivery52. The pregnant client is 7 cm, 100% effaced, and at +1 station. The fetus is in a face presentation. You know your teaching has been effective when the clients husband states:

a. our baby will come out face first

b. our baby will come out facing one hip.

c. our baby will come out buttocks first

d. our baby will come out with the back of the head first.

53. Following an amniotomy, the most important nursing action is to:

a. reposition the mother on her left side

b. place a clean underpad on the bed

c. listen to fetal heart tone

d. observe the color and consistency of the amniotic fluid

54. The nurse may help a client with a fetus in the right occiput posterior (ROP) position by avoiding which of the following actions?

a. position her on her left side

b. position her on her right side

c. helping her walk around the room

d. assisting her to knee chest position

55. A nulliparous client has not made any progress in cervical dilatation or station since she was 7 cm and 0 station over 2 hrs. ago. According to the Friedman curve, this is termed:

a. prolonged deceleration phase

b. protracted active phase

c. arrest of descent

d. secondary arrest of dilatation

56. A clients amniotic fluid is greenish-tinged. The fetal presentation is vertex. Fetal heart rate (FHR) and uterine activity have remained within normal limits. At the time of delivery, the nurse should anticipate the need for:

a. an infant laryngoscope and suction catheters

b. forceps

c. a transport isolate

d. emergency CS set-up

57. A client who is 34 weeks gestation has been having contractions every 10 minutes regularly. In addition to instructing her to lie down and rest while continuing to time contractions, the nurse should also tell her to:

a. refrain from eating or drinking anything

b. Take slow deep breaths with each contraction

c. go to the hospital if contractions continue for more than one (1) hour.

d. drink 3 to 4 cups of water

58. The client who has had a previous cesarean birth asks about vaginal birth after cesarean (VBAC). Which of the following factors from her history is a contraindication for VBAC?

a. previous cesarean was for breech presentation

b. the client has a classical uterine incision

c. the abdominal incision was vertical rather than transverse

d. an induction of labor is planned for this delivery

59. A client is undergoing induction of labor with oxytocin. An important observation by the nurse that requires slowing or stopping the infusion is:

a. contractions lasting longer than 60 seconds

b. resting phase interval less than 60 seconds

c. Maternal BP 90/50 mmHg

d. Nausea and vomiting

60. In addition to routine assessment and care, nursing care for a client who is receiving terbutalin to prevent premature labor should include assessing:

a. oral temperature every 2 hrs.

b. fetal hear tone every 30 minutes

c. breath sounds every 4 hrs.

d. deep tendon reflexes every 4 hrs.

61. A multiparous client who has been in labor for almost 3 hrs. suddenly announces that the baby is coming. The nurse sees the infant crowning. Which of the following actions should the nurse do first?

a. Ask the woman to pant while preparing to place gentle counter pressure on the infants head as it is delivered.

b. quickly obtain sterile gloves and towel.

c. retrieve the precipitous delivery tray from the nursing station

d. telephone the physician using the bedside phone

62. The nurse determines that a client does not understand what to expect during cesarean delivery, when the client states:

a. an indwelling Foley catheter will be inserted before surgery

b. my husband can be present during birth

c. I maybe given an antacid before surgery

d. I will receive a blood transfusion during surgery.

63. The nurse concludes that deceleration of the fetal heart rate from 130 to 70 beats per minute with contractions followed by a rapid return to a normal baseline rate is most likely a clients response to:

a. umbilical cord compression

b. fetal head compression

c. severe fetal hypoxia

d. uteroplacental insufficiency

64. The nurse determines that fetal distress is occurring after noting which of the following signs?

a. moderate amount of bloody show

b. pink-tinged amniotic fluid

c. meconium stained amniotic fluid

d. acceleration of FHR with each contraction

65. On performing Leopolds maneuver in multiparous client in early labor, the nurse finds no fetal parts in the fundus or above the symphysis. The fetal head is palpated in the right mid quadrant. The nurse notifies the admitting physician and anticipates:

a. an external version c. a cesarean delivery

b. an internal versiond. prolonged labor

66. The nurse discovers a loop of the umbilical cord protruding through the vagina when preparing to perform a vaginal examination. The most appropriate intervention is to:

a. call the physician immediately

b. place a moist clean towel over the cord to prevent drying

c. immediately turn the client on her side and listen to FHR

d. perform the vaginal examination and apply upward digital pressure to the presenting part while having the mother assume a knee-chest-position

67. The client has refused sedation ordered by the physician for hypertonic contractions and prolonged latent phase labor for fear that her labor will stop. The nurse may help by explaining:

a. Sedation helps to provide needed rest and allows time for uterine contractions to become coordinated so the labor is progressive

b. If the woman is experiencing true labor, contractions will not stop even with sedation

c. If contractions continue without cervical effacement and dilation, the fetus is at risk for hypoxia

d. sedation will stop contractions that are uncoordinated and provide more time to determine if CS is needed68. The client is receiving IV magnesium sulfate at 2 g/h to stop premature labor. The most important nursing assessment to this client include:

a. I & O, LOC, & BP

b. blood pressure, pulse, and uterine activity

c. deep tendon reflexes, hourly I & O, and RR

d. I & O, reflexes, and BP69. During the vaginal examination, the nurse palpates the fetal head and large diamond-shaped fontanel. The fetal presentation is:

a. face

c. vertex

b. transverse

d. brow70. A nurse is assessing a client 24 hrs. after delivery and finds the fundus to be slightly boggy and 2 cm above the umbilicus. What should the priority nursing intervention be?

a. document the expected finding

b. assess the mothers vital signs

c. gently massage the fundus until firm

d. notify the physician

71. A new mother complains of afterpains. The nurse first action should be to

a. administer an analgesic as ordered

b. advise her to stop breast feeding until the pain stops

c. encourage her to empty her bladder

d. assess her vital signs

72. The nurse is preparing to instruct a new mother on resuming sexual intercourse postpartum. The nurse should include which of the following in the teaching plan?

a. use petroleum jelly for lubrication

b. an IUD is an appropriate method of birth control in an early postpartum period

c. wait until the episiotomy has healed and the lochia has stopped before resuming intercourse

d. refrain from intercourse until the first menstrual period after delivery is completed

73. A client is caring for a client who has decided not to brestfeed. Client teaching to promote lactation suppression should include which of the following?

a. applying warm compresses

b. pumping the breast

c. applying ice bags

d. using medication to suppress lactation

74. A client has a temperature of 100.2F four hours after delivery. What is the appropriate action for the nurse to take?

a. encourage increased fluid intake

b. do nothing for this is an expected finding during this time

c. check the physicians order for antibiotics to treat the clients infection

d. medicate the client for pain

75. Which laboratory finding should the nurse assess further on a client 24 hrs. after delivery?

a. hemoglobin 7.2g/dL

b. WBC count 20,000/mm

c. trace to 1+ proteinuria

d. hematocrit 35%76. A client is to be discharge 12 hours after delivery. The nurse should delay the discharge and notify the physician if which of the following is observed?

a. moderate lochia rubra

b. fundus firm at umbilicus

c. pulse 62 beats per minute

d. 3 voiding totaling 240 cc in 12 hours

77. This is the first postoperative day for a client who delivered cesarean. The client asks the nurse why she has to get up and walk when it hurts her incision so much. The nurse responds that:

a. walking decreases the risk of blood clots after surgery

b. walking encourages deep breaths to blow off the anesthetic from surgery

c. early ambulation is important to stimulate milk production

d. walking will decrease the occurrence of after pains78. Which of the following interventions should be omitted when caring for a client with a midline episiotomy with a 3rd degree laceration?

a. increase fiber in the diet

b. administer Dulcolax suppository

c. increase fluid intake

d. administer an oral stool softener

79. You are caring for a client whose baby was sent to the neonatal intensive care unit because of respiratory distress. The client plans to breastfeed her baby. You understand teaching has been effective when the client states: I know I need to continue pumping my breast to:

a. prevent engorgement

b. stimulate my milk supply

c. remove the infected milk

d. keep my uterus contracted

80. A client delivered by cesarean 2 days ago. While assessing the clients incision, The nurse notes that the skin edges around the incision are red, edematous and tender to the touch. A scant amount of purulent drainage is noted. What is the most appropriate initial action by the nurse?

a. cleanse the wound with betadine

b. notify the physician

c. document this expected response

d. observe the incision closely for the next 24 to 48 hrs.

81. On the 3rd post partum day, a client reports that she has voided 5 times that morning. The nurse should initially:

a. Collect the next voiding and measure the amount of urine.

b. call the physician

c. catheterize the client for residual urine

d. insert a foley catheter

82. A clients vital signs following delivery are:

Day 1 BP 116/72, T 98.6F, P 68

Day 2 BP 114/80, T 100.6F, P 76

Day 3 BP114/80, T 101.6F, P 80. The nurse should suspect that the client:

a. is dehydrated

b. may have an infection

c. has normal vital signs

d. is going into shock

83. The client is 36 y.o. woman, grvida 6, para 6, who delivered a baby girl at 36 weeks gestation after 48 hrs. of labor. The baby weighs 7 lbs. 14 ounces. The clients vital signs are stable, and her lochia is bright red, heavy, and contains blood clots. The largest clot is about the size of a grape fruit. The client considered to be high risk for uterine atony because of which of the following?

a. grand multiparity

c. length of labor

b. size of the baby

d. clients age

84. Upon assessment of a postpartal client, the home visit nurse observes symptoms of infection. Which of the following symptoms indicates infection?

a. pinkish lochia

b. bradycardia

c. abdominal tenderness

d. oral temperature of 99.2F

85. A mother with mastitis is concerned about breast feeding while she has an active infection. The nurse should explain that:

a. The child is protected from infection by immunoglobulin in the breast milk

b. the infant is not susceptible to the organisms that cause mastitis

c. the organisms that cause mastitis are not passed in the milk

d. the organisms will be inactivated by gastric acid

86. Which of the following signs of thrombophlebitis must the nurse educate the postpartal client to assess at home after discharge from the hospital?

a. muscle soreness in her legs after exercise

b. varicose veins in the legs

c. local tenderness, heat, and swelling

d. bruising

87. Which of the following instructions should be included in the discharge teaching plan to assist the post partal client in recognizing early signs of complications?

a. the passage of clots as large as an orange is expected

b. report any decrease in the amount of brownish-red lochia

c. palpate the fundus daily to make sure it is softd. notify your health care provider for any increase in the amount of lochia or a return to a bright red bleeding

88. Which of the following items of clothing worn by a post partal client could possibly promote a problem for the woman?

a. pantyhose

c. knee-highs

b. short athletic socksd. colored tights89. Which of the following nursing interventions is appropriate to help a lactating client prevent mastitis?

a. apply vitamin E cream to soften the nipples

b. wear tight, supportive bra

c. when the clients nipple is sore, offer the infant a bottle

d. encourage the client to breast feed her infant frequently.90. What factor in a clients history places the client at greatest risk for post partal endometritis?

a. cesarean delivery after 24 hrs. of labor and failure to progress

b. external monitoring during labor

c. ruptured membranes for 4 hrs. prior to delivery.

d. spontaneous vaginal delivery after 8 hrs. labor

91. After the delivery of a large-for-gestational age infant, a client is noted to have bright red blood continuously trickling from the vagina. Her fundus is firm and located in the midline. What is the most likely cause of this bleeding?

a. lacerations c. uterine atony

b. hematoma d. retained fragments of conception

92. One of the most causes of hypotonic uterine dystocia is:

a. toxemia

c. pelvic contracture

b. maternal anemia

d. twin gestation

93. To determine if the is CPD (cephalopelvic disproportion) the physician should order?a. pelvimetry

c. amniocentesis

b. X-ray exam

d. fetal scalp Ph

94. A 6 months pregnant client is admitted with complaints of painful urination, flank tenderness and hematuria and diagnosis of pyelonephritis is made.. An important nursing intervention during attack is

a. limiting fluid intake

b. observing for signs of premature labor

c. examining the urine for albumin

d. maintaining her on a low salt diet

95. A client with pyelonephritis is to receive antibiotic therapy. The nurse should recognize that the safest antibiotic for administration during pregnancy would be:

a. nitrofurantoin

c. tetracycline

b. gantrisin

d. ampicillin

Situation : A client is a Class l cardiac client with a history of rheumatic fever. She is admitted to the labor room in active labor. Questions 96 through 98 refer to this situation

96. Proper positioning for this client is:

a. semi Fowlers; supine

b. lying on the right side, head elevated 30 degrees

c. left lateral, semi Fowlers

d. supine. High Fowlers

97. A specific nursing intervention during labor for a client with cardiac problem is:

a. auscultating for rales q 30 minutes

b. turning from side to side q 15 minutes

c. monitoring BP every hour

d. encouraging frequent voiding

98. In view of the clients past medical history, the nurse anticipates that after delivery, the client will be prophylactically placed on:

a. digitalis

c. ampicillin

b. lasix

d. heparin

99. A 2 months pregnant client asks the clinic nurse how smoking will affect the baby. The nurses answer reflect the following knowledge:

a. fetal and maternal circulation are separated by the placental barrier

b. the placenta is permeable to specific substances

c. smoking relieves tension and the fetus responds accordingly

d. vasoconstriction will affect both maternal and fetal blood vessels.

100. The nurse encourages continued medical supervision for the pregnant woman with pyelitis because:

a. antibiotic therapy is given until the urine is sterile

b. toxemia frequently occurs following pyelitis

c. PID occurs with untreated pyelitis

d. a low protein diet is given until pregnancy is terminated.PAGE 1Ultimate Review Specialist (URS BAGUIO)