PRACTICE TEST II Maternal and Child Health

PRACTICE TEST II Maternal and Child Health

1. For the client who is using oral contraceptives,

the nurse informs the client about the need to

take the pill at the same time each day to

accomplish which of the following?

a. Decrease the incidence of nausea

b. Maintain hormonal levels

c. Reduce side effects

d. Prevent drug interactions

2. When teaching a client about contraception.

Which of the following would the nurse include

as the most effective method for preventing

sexually transmitted infections?

a. Spermicides

b. Diaphragm

c. Condoms

d. Vasectomy

3. When preparing a woman who is 2 days

postpartum for discharge, recommendations for

which of the following contraceptive methods

would be avoided?

a. Diaphragm

b. Female condom

c. Oral contraceptives

d. Rhythm method

4. For which of the following clients would the

nurse expect that an intrauterine device would

not be recommended?

a. Woman over age 35

b. Nulliparous woman

c. Promiscuous young adult

d. Postpartum client

5. A client in her third trimester tells the nurse,

“I’m constipated all the time!” Which of the

following should the nurse recommend?

a. Daily enemas

b. Laxatives

c. Increased fiber intake

d. Decreased fluid intake

6. Which of the following would the nurse use as

the basis for the teaching plan when caring for a

pregnant teenager concerned about gaining too

much weight during pregnancy?

a. 10 pounds per trimester

b. 1 pound per week for 40 weeks

c. ½ pound per week for 40 weeks

d. A total gain of 25 to 30 pounds

7. The client tells the nurse that her last menstrual

period started on January 14 and ended on

January 20. Using Nagele’s rule, the nurse

determines her EDD to be which of the

following?

a. September 27

b. October 21

c. November 7

d. December 27

8. When taking an obstetrical history on a pregnant

client who states, “I had a son born at 38 weeks

gestation, a daughter born at 30 weeks gestation

and I lost a baby at about 8 weeks,” the nurse

should record her obstetrical history as which of

the following?

a. G2 T2 P0 A0 L2

b. G3 T1 P1 A0 L2

c. G3 T2 P0 A0 L2

d. G4 T1 P1 A1 L2

9. When preparing to listen to the fetal heart rate

at 12 weeks’ gestation, the nurse would use

which of the following?

a. Stethoscope placed midline at the

umbilicus

b. Doppler placed midline at the

suprapubic region

c. Fetoscope placed midway between the

umbilicus and the xiphoid process

d. External electronic fetal monitor placed

at the umbilicus

10. When developing a plan of care for a client

newly diagnosed with gestational diabetes,

which of the following instructions would be the

priority?

a. Dietary intake

b. Medication

c. Exercise

d. Glucose monitoring

11. A client at 24 weeks gestation has gained 6

pounds in 4 weeks. Which of the following would

be the priority when assessing the client?

a. Glucosuria

b. Depression

c. Hand/face edema

d. Dietary intake

12. A client 12 weeks’ pregnant come to the

emergency department with abdominal

cramping and moderate vaginal bleeding.

Speculum examination reveals 2 to 3 cms

cervical dilation. The nurse would document

these findings as which of the following?

a. Threatened abortion

b. Imminent abortion

c. Complete abortion

d. Missed abortion

13. Which of the following would be the priority

nursing diagnosis for a client with an ectopic

pregnancy?

a. Risk for infection

b. Pain

c. Knowledge Deficit

d. Anticipatory Grieving

14. Before assessing the postpartum client’s uterus

for firmness and position in relation to the

umbilicus and midline, which of the following

should the nurse do first?

a. Assess the vital signs

b. Administer analgesia

c. Ambulate her in the hall

d. Assist her to urinate

15. Which of the following should the nurse do

when a primipara who is lactating tells the nurse

that she has sore nipples?

a. Tell her to breast feed more frequently

b. Administer a narcotic before breast

feeding

c. Encourage her to wear a nursing

brassiere

d. Use soap and water to clean the nipples

16. The nurse assesses the vital signs of a client, 4

hours’ postpartum that are as follows: BP 90/60;

temperature 100.4ºF; pulse 100 weak, thready;

R 20 per minute. Which of the following should

the nurse do first?

a. Report the temperature to the physician

b. Recheck the blood pressure with

another cuff

c. Assess the uterus for firmness and

position

d. Determine the amount of lochia

17. The nurse assesses the postpartum vaginal

discharge (lochia) on four clients. Which of the

following assessments would warrant

notification of the physician?

a. A dark red discharge on a 2-day

postpartum client

b. A pink to brownish discharge on a client

who is 5 days postpartum

c. Almost colorless to creamy discharge on

a client 2 weeks after delivery

d. A bright red discharge 5 days after

delivery

18. A postpartum client has a temperature of

101.4ºF, with a uterus that is tender when

palpated, remains unusually large, and not

descending as normally expected. Which of the

following should the nurse assess next?

a. Lochia

b. Breasts

c. Incision

d. Urine

19. Which of the following is the priority focus of

nursing practice with the current early

postpartum discharge?

a. Promoting comfort and restoration of

health

b. Exploring the emotional status of the

family

c. Facilitating safe and effective self-and

newborn care

d. Teaching about the importance of family

planning

20. Which of the following actions would be least

effective in maintaining a neutral thermal

environment for the newborn?

a. Placing infant under radiant warmer

after bathing

b. Covering the scale with a warmed

blanket prior to weighing

c. Placing crib close to nursery window for

family viewing

d. Covering the infant’s head with a knit

stockinette

21. A newborn who has an asymmetrical Moro

reflex response should be further assessed for

which of the following?

a. Talipes equinovarus

b. Fractured clavicle

c. Congenital hypothyroidism

d. Increased intracranial pressure

22. During the first 4 hours after a male

circumcision, assessing for which of the

following is the priority?

a. Infection

b. Hemorrhage

c. Discomfort

d. Dehydration

23. The mother asks the nurse. “What’s wrong with

my son’s breasts? Why are they so enlarged?”

Whish of the following would be the best

response by the nurse?

a. “The breast tissue is inflamed from the

trauma experienced with birth”

b. “A decrease in material hormones

present before birth causes

enlargement,”

c. “You should discuss this with your

doctor. It could be a malignancy”

d. “The tissue has hypertrophied while the

baby was in the uterus”

24. Immediately after birth the nurse notes the

following on a male newborn: respirations 78;

apical hearth rate 160 BPM, nostril flaring; mild

intercostal retractions; and grunting at the end

of expiration. Which of the following should the

nurse do?

a. Call the assessment data to the

physician’s attention

b. Start oxygen per nasal cannula at 2

L/min.

c. Suction the infant’s mouth and nares

d. Recognize this as normal first period of

reactivity

25. The nurse hears a mother telling a friend on the

telephone about umbilical cord care. Which of

the following statements by the mother

indicates effective teaching?

a. “Daily soap and water cleansing is best”

b. ‘Alcohol helps it dry and kills germs”

c. “An antibiotic ointment applied daily

prevents infection”

d. “He can have a tub bath each day”

26. A newborn weighing 3000 grams and feeding

every 4 hours needs 120 calories/kg of body

weight every 24 hours for proper growth and

development. How many ounces of 20 cal/oz

formula should this newborn receive at each

feeding to meet nutritional needs?

a. 2 ounces

b. 3 ounces

c. 4 ounces

d. 6 ounces

27. The postterm neonate with meconium-stained

amniotic fluid needs care designed to especially

monitor for which of the following?

a. Respiratory problems

b. Gastrointestinal problems

c. Integumentary problems

d. Elimination problems

28. When measuring a client’s fundal height, which

of the following techniques denotes the correct

method of measurement used by the nurse?

a. From the xiphoid process to the

umbilicus

b. From the symphysis pubis to the xiphoid

process

c. From the symphysis pubis to the fundus

d. From the fundus to the umbilicus

29. A client with severe preeclampsia is admitted

with of BP 160/110, proteinuria, and severe

pitting edema. Which of the following would be

most important to include in the client’s plan of

care?

a. Daily weights

b. Seizure precautions

c. Right lateral positioning

d. Stress reduction

30. A postpartum primipara asks the nurse, “When

can we have sexual intercourse again?” Which of

the following would be the nurse’s best

response?

a. “Anytime you both want to.”

b. “As soon as choose a contraceptive

method.”

c. “When the discharge has stopped and

the incision is healed.”

d. “After your 6 weeks examination.”

31. When preparing to administer the vitamin K

injection to a neonate, the nurse would select

which of the following sites as appropriate for

the injection?

a. Deltoid muscle

b. Anterior femoris muscle

c. Vastus lateralis muscle

d. Gluteus maximus muscle

32. When performing a pelvic examination, the

nurse observes a red swollen area on the right

side of the vaginal orifice. The nurse would

document this as enlargement of which of the

following?

a. Clitoris

b. Parotid gland

c. Skene’s gland

d. Bartholin’s gland

33. To differentiate as a female, the hormonal

stimulation of the embryo that must occur

involves which of the following?

a. Increase in maternal estrogen secretion

b. Decrease in maternal androgen

secretion

c. Secretion of androgen by the fetal gonad

d. Secretion of estrogen by the fetal gonad

34. A client at 8 weeks’ gestation calls complaining

of slight nausea in the morning hours. Which of

the following client interventions should the

nurse question?

a. Taking 1 teaspoon of bicarbonate of

soda in an 8-ounce glass of water

b. Eating a few low-sodium crackers before

getting out of bed

c. Avoiding the intake of liquids in the

morning hours

d. Eating six small meals a day instead of

thee large meals

35. The nurse documents positive ballottement in

the client’s prenatal record. The nurse

understands that this indicates which of the

following?

a. Palpable contractions on the abdomen

b. Passive movement of the unengaged

fetus

c. Fetal kicking felt by the client

d. Enlargement and softening of the uterus

36. During a pelvic exam the nurse notes a purpleblue

tinge of the cervix. The nurse documents

this as which of the following?

a. Braxton-Hicks sign

b. Chadwick’s sign

c. Goodell’s sign

d. McDonald’s sign

37. During a prenatal class, the nurse explains the

rationale for breathing techniques during

preparation for labor based on the

understanding that breathing techniques are

most important in achieving which of the

following?

a. Eliminate pain and give the expectant

parents something to do

b. Reduce the risk of fetal distress by

increasing uteroplacental perfusion

c. Facilitate relaxation, possibly reducing

the perception of pain

d. Eliminate pain so that less analgesia and

anesthesia are needed

38. After 4 hours of active labor, the nurse notes

that the contractions of a primigravida client are

not strong enough to dilate the cervix. Which of

the following would the nurse anticipate doing?

a. Obtaining an order to begin IV oxytocin

infusion

b. Administering a light sedative to allow

the patient to rest for several hour

c. Preparing for a cesarean section for

failure to progress

d. Increasing the encouragement to the

patient when pushing begins

39. A multigravida at 38 weeks’ gestation is

admitted with painless, bright red bleeding and

mild contractions every 7 to 10 minutes. Which

of the following assessments should be avoided?

a. Maternal vital sign

b. Fetal heart rate

c. Contraction monitoring

d. Cervical dilation

40. Which of the following would be the nurse’s

most appropriate response to a client who asks

why she must have a cesarean delivery if she has

a complete placenta previa?

a. “You will have to ask your physician

when he returns.”

b. “You need a cesarean to prevent

hemorrhage.”

c. “The placenta is covering most of your

cervix.”

d. “The placenta is covering the opening of

the uterus and blocking your baby.”

41. The nurse understands that the fetal head is in

which of the following positions with a face

presentation?

a. Completely flexed

b. Completely extended

c. Partially extended

d. Partially flexed

42. With a fetus in the left-anterior breech

presentation, the nurse would expect the fetal

heart rate would be most audible in which of the

following areas?

a. Above the maternal umbilicus and to the

right of midline

b. In the lower-left maternal abdominal

quadrant

c. In the lower-right maternal abdominal

quadrant

d. Above the maternal umbilicus and to the

left of midline

43. The amniotic fluid of a client has a greenish tint.

The nurse interprets this to be the result of

which of the following?

a. Lanugo

b. Hydramnio

c. Meconium

d. Vernix

44. A patient is in labor and has just been told she

has a breech presentation. The nurse should be

particularly alert for which of the following?

a. Quickening

b. Ophthalmia neonatorum

c. Pica

d. Prolapsed umbilical cord

45. When describing dizygotic twins to a couple, on

which of the following would the nurse base the

explanation?

a. Two ova fertilized by separate sperm

b. Sharing of a common placenta

c. Each ova with the same genotype

d. Sharing of a common chorion

46. Which of the following refers to the single cell

that reproduces itself after conception?

a. Chromosome

b. Blastocyst

c. Zygote

d. Trophoblast

47. In the late 1950s, consumers and health care

professionals began challenging the routine use

of analgesics and anesthetics during childbirth.

Which of the following was an outgrowth of this

concept?

a. Labor, delivery, recovery, postpartum

(LDRP)

b. Nurse-midwifery

c. Clinical nurse specialist

d. Prepared childbirth

48. A client has a midpelvic contracture from a

previous pelvic injury due to a motor vehicle

accident as a teenager. The nurse is aware that

this could prevent a fetus from passing through

or around which structure during childbirth?

a. Symphysis pubis

b. Sacral promontory

c. Ischial spines

d. Pubic arch

49. When teaching a group of adolescents about

variations in the length of the menstrual cycle,

the nurse understands that the underlying

mechanism is due to variations in which of the

following phases?

a. Menstrual phase

b. Proliferative phase

c. Secretory phase

d. Ischemic phase

50. When teaching a group of adolescents about

male hormone production, which of the

following would the nurse include as being

produced by the Leydig cells?

a. Follicle-stimulating hormone

b. Testosterone

c. Leuteinizing hormone

d. Gonadotropin releasing hormone