61. Which of the ff. problems does not typically result from uncontrolled gestational diabetes?
a. maternal hyperglycemia
b. fetal demise
c. insufficient amniotic fluid
d. maternal hypertension
62. When measuring fundal height in a primiparous client during the 24 weeks check up, which measurement should the nurse expect?
a. 30 cm b. 20 cm c. 24 cm d. 16 cm
63. Which of the ff. fetal positions is most favorable for birth?
a. vertex presentation
b. transverse lie
c. frank breech presentation
d. posterior position of the fetal head
64. Which of the ff. stages of labor is one in which birth occurs?
a. 1st stage c. 3rd stage
b. 2nd stage d. 4th stage
65. Which of the ff. nursing actions is required before a client in labor receives an epidural?
a. give a fluid bolus of 500 ml
b. check pupil dilation
c. assess maternal reflexes
d. assess maternal gait
66. Which of the ff. complications is possible in episiotomy?
a. blood loss
b. uterine disfigurement
c. prolonged dyspareunia
d. hormonal fluctuation postpartum
67. Which of the ff. positions increases cardiac output and stroke volume of a client in labor?
a. supine c. side lying
b. sitting d. semi-Fowler’s
68. Which of the ff. Leopold’s maneuver assesses the descent of the part into the pelvis?
a. 1st b. 2nd c. 3rd d. 4th
69. During which of the ff. stages of labor does crowning take place?
a. 1st b. 2nd c. 3rd d. 4th
70. Which of the ff. assessment requires fetal monitoring?
a. fetal heart rate
b. long term variability
c. short term variability
d. periodic changes in the heart rate
71. Which of the ff. symptoms is not usually observed in laboring clients with PIH?
a. elevated BP c. facial & hand edema
b. polyuria d. epigastric discomfort
72. Which type of contraction s signals true labor? It is a contraction that
a. achieve cervical dilation
b. are felt abdominally
c. maybe irregular
d. disappear w/ ambulation
73. Which characteristic best describes spontaneous accelerations?
a. occur with contraction
b. reflect the shape of contractions
c. associated with decelerations
d. indicate fetal well being and are not associated with contractions
74. A client in labor is using the Lamaze method of prepared childbirth. Her cervix is 5 cm dilated with contractions occurring 2-3 minutes apart. The nurse should instruct the client to breath at which level?
a. level 1 c. level 3
b. level 2 d. level 4
75. The 1st stage of labor is divided into the latent and active states. Each is characterized by which of the ff. events.
a. progressive cervical dilation and fetal descent
b. progressive maternal anxiety
c. progressive fetal descent
d. progressive cervical dilation.
76. Labor length is determined by multiple factors, including the number of previous labors. In primiparous clients, labor lasts an average of 13 to 15 hrs. Which is the average length of labor for multiparous client?
a. 6 to 7 hrs c. 10 to 11 hrs
b. 8 to 9 hrs. d. 12 to 15 hrs
77. Which of the ff. interventions would be helpful to a breast feeding mother who is experiencing engorged breast?
a. applying ice
b. applying breast binder
c. teaching how to express her breast in a warm shower
d. administering Parlodel
78. Which of the ff. factors might result in a decreased supply of breast milk in a post partum mother?
a. supplemental feedings with formula
b. maternal diet high in Vit. C
c. an alcoholic drink
d. frequent feedings
79. Which of the ff. assessment should be performed routinely in the post partum client?
a. antibody screen c. Homan’s sign
b. Babinski reflex d. Patellar reflex
80. A client is complaining of painful contractions on the 2ndpostpartum day Which of the ff. conditions could increase the severity of after pains?
a. bottle feeding c. multiple gestation
b. diabetes d. primiparily
81. When giving a postpartum client self care instructions, the nurse instruct her to report heavy bleeding. Which of the ff. would indicate heavy bleeding? It is saturating a pad in
a. 15 minutes c. 4 to 6 hrs.
b. 1 hour d. 8 hrs.
82. On which of the ff. post partum days can the client expect lochia serousa?
a. 3RD to 4th day c. 10th to 14th day
b. 3rd to 10th day d. 14th to 42nd day
83. Which of the ff. behaviors characterizes the postpartum mother in the taking in phase?
a. passive and dependent
b. striving for independence and autonomy
c. curious and interested in the care of the baby
d. exhibiting maximum readiness for new learning
84. What type of milk is present in the breast 7 to 10 days post partum?
a. colostrums c. mature milk
b. hind milk d. transitional milk
85. An RH positive client delivers a 6 lb, 10 oz neonate vaginally after 17 hrs of labor. Which of the ff. conditions puts this client at risk of infection
a. length of labor c. method of delivery
b. maternal RH status d. size of the baby
86. Which of the ff. Conditions is a post partum client may cause fever not caused by infection?
a. breast engorgement c. mastitis
b. endometritis d. uterine involution
87. Which of the ff. complications is most likely responsible for delayed post partum hemorrhage?
a. cervical lacerations
b. clotting deficiencies
c. perineal lacerations
d. uterine subinvolution
88. Which of the ff. complications is associated with magnesium sulfate therapy?
a. hypotension
b. post partum depression
c. post partum hemorrhage
d. uterine infection
89. Which of the ff. physiological responses is considered normal in the early postpartum period?
a. urinary urgency & dysuria c. ↓ in BP
b. rapid diuresis d. ↑ GI motility
90. Which percentage of postpartum clients experiences postpartum blues?
a. 20 to 25% c. 30 to 45 %
b. 50 to 80% d. 100 %
91. Before teaching clients about nutritional needs during pregnancy, the nurse should be aware that:
a. Carbohydrate needs are decreased during pregnancy
b. Calorie needs increase by a maximum of 100 calories per day
c. The need for protein increases gradually throughout pregnancy
d. Calcium and phosphorus needs decrease gradually during pregnancy
92. At 40 weeks gestation a client is admitted to the birthing unit in early labor. She asks the nurse. “What is the best position to assume during labor?” The nurse should tell her that the side-lying position:
a. Prevents fetal hyperactivity
b. Encourages descent of the presenting part
c. Enhances uterine perfusion and contractions
d. Decreases incidence of nausea and vomiting
93. A 36-year-old primigravida accompanied by her husband is admitted to the birthing unit and fetal monitoring is instituted. When a fetus is being monitored, the nurse must realize that
a. Internal monitoring will be used in the latter part of labor
b. The machinery can be very frightening to the laboring couple
c. The mother may need a mild sedative every 4 hours fro comfort
d. Older primigravida have more complications than younger woman
94. 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
95. A client is breastfeeding her infant and complains that her breast breasts are swollen and painful. When teaching her about breastfeeding, the nurse should assist her in preventing engorgement in the future by telling her
a. “Use a bottle for feeding when you are experiencing discomfort.”
b. “Limit nursing to 4 to 6 minutes on each breast, four times a day.”
c. “Nurse the baby frequently and for at least 10 to 15 minutes on each breast.”
d. “Feed the baby four times a day. This will prevent rapid filling of the breast.”
96. At the end of the first trimester of pregnancy, a client complains of feeling tired. The nurse recognizes that this probably related to cardiovascular changes that
a. Decrease BP
b. Increase hematocrit
c. Increased blood volume
d. Decrease cardiac output
97. During a prenatal class the nurse can help participants understand an advantage of breastfeeding by explaining that:
a. Breastfed infant have fewer infections
b. Breastfeeding inhibits ovulation in the mother
c. Breastfed infants adhere more easily to a 4-hour schedule
d. Breast milk has a larger concentration of protein than does cow’s milk
98. During the first visit to the prenatal clinic by a pregnant woman, a pelvic examination will be performed. Teaching about this examination should include telling the client that:
a. She must relax during the examination to prevent discomfort
b. A douche prior to the examination is necessary for cleanliness
c. A rectal examination may be included after the pelvic examination
d. After the examination she should direct any questions
99. The fetus of a woman in labor is at +1 station. This indicates that the fetus’ head is:
a. Not yet engaged
b. Entering the pelvic inlet
c. Below the ischial spine
d. Visible at the vaginal opening
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