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Instructions: SELECT THE BEST ANSWER FOR EACH OF THE FOLLOWING QUESTIONS. READ THE QUESTIONS WELL.

STRICTLY NO ERASURES. 1. A client that has had pelvic inflammatory disease (PID) caused by Chlamydia trachomatis is at risk for which of the following: A. B. Anovulatory menstrual cycles C. Ectopic pregnancy D. Multifetal pregnancy E. Cervical dysplasia 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). The client is pregnant and reports that her last menstrual period began July 10. Her expected date of birth is: A. B. April 3. C. April 17. D. October 3. E. October 17. The pregnant client 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 within 24 hours. In the prenatal record, the nurse should record: A. B. Gravida 2, para 1. C. Gravida 3, para 3. D. Gravida 4, para 2. E. Gravida 5, para 4. Following confirmation of pregnancy, the client has come into the clinic for her first prenatal visit. She reports having a 5-year-old child who was born at 40 weeks gestation, a set of 3-year-old triplets who were born at 34 weeks gestation, and a first trimester abortion when she was in college. On her medical record, the nurse would make which of the following entries? A. B. Gravida 4, Para 1114 C. Gravida 3, Para 1314 D. Gravida 4, Para 4014 E. Gravida 3, Para 3112 During her first prenatal visit, a woman tells the nurse she was born with cleft lip and palate and is concerned that her infant will inherit the anomaly. The nurse's best response is: A. "I will tell the doctor of your concern." B. "There are many reasons for cleft lip and palate; it is not directly inherited." C. "I will contact your parents to check for other family members who may have a birth defect." D. "I know you are concerned, but there is no way to know if your baby will have this After delivery the nurse examines the umbilical cord. She expects to find a cord with: A. B. One artery and two veins. C. Two arteries and one vein. D. Two arteries and two veins. E. One artery and one vein. A nurse discusses teratogens with a client during pre-conceptual counseling. The client demonstrates understanding by stating: A. "I should stop taking all my medications while I am pregnant." B. "The fetus is at greatest risk for developing anomalies during the first 16 weeks of pregnancy." C. "After 12 weeks the placenta protects the fetus from teratogens." D. "Exposure to teratogens poses the greatest risk during the first eight weeks." A client at 36 weeks’ gestation is schedule for a routine ultrasound prior to an amniocentesis. After teaching the client about the purpose for the ultrasound, which of the following client statements would indicate to the nurse in charge that the client needs further instruction? A. The ultrasound will help to locate the placenta B. The ultrasound identifies blood flow through the umbilical cord C. The test will determine where to insert the needle D. The ultrasound locates a pool of amniotic fluid While the postpartum client is receiving herapin for thrombophlebitis, which of the following drugs would the nurse Mica expect to administer if the client develops complications related to heparin therapy? A. B. Calcium gluconate C. Methylegonovine (Methergine) D. Protamine sulfate

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Nitrofurantoin (Macrodantin)

When caring for a 3-day-old neonate who is receiving phototherapy to treat jaundice, the nurse in charge would expect to do which of the following? A. Turn the neonate every 6 hours B. Encourage the mother to discontinue breast-feeding C. Notify the physician if the skin becomes bronze in color D. Check the vital signs every 2 to 4 hours The nurse is caring for a primigravida at about 2 months and 1 week gestation. After explaining self-care measures for common discomforts of pregnancy, the nurse determines that the client understands the instructions when she says: A. “Nausea and vomiting can be decreased if I eat a few crackers before arising” B. “If I start to leak colostrum, I should cleanse my nipples with soap and water” C. “If I have a vaginal discharge, I should wear nylon underwear” D. “Leg cramps can be alleviated if I put an ice pack on the area” When the nurse on duty accidentally bumps the bassinet, the neonate throws out its arms, hands opened, and begins to cry. The nurse interprets this reaction as indicative of which of the following reflexes? A. B. Babinski reflex C. Startle reflex D. Grasping reflex E. Tonic neck reflex A primigravida client at 25 weeks’ gestation visits the clinic and tells the nurse that her lower back aches when she arrives home from work. The nurse should suggest that the client perform: A. B. Leg lifting C. Shoulder circling D. Squatting exercises E. Tailor sitting Which of the following would the nurse in charge do first after observing a 2-cm circle of bright red bleeding on the diaper of a neonate who just had a circumcision? A. Notify the neonate’s pediatrician immediately B. Check the diaper and circumcision again in 30 minutes C. Secure the diaper tightly to apply pressure on the site D. Apply gently pressure to the site with a sterile gauze pad The nurse is reviewing results from the client's initial prenatal visit and notes that the urine contained an increased number of white blood cells, nitrites, and greater than 10,000 bacteria/mL of urine. These findings lead the nurse to suspect which of the following? A. Renal failure B. Contamination of the urine with amniotic fluid C. Urinary tract infection D. Nothing unusual, this is a normal finding in pregnancy In explaining to the client who has come in for her initial prenatal exam why it is important to test pregnant women for gonorrhea, the nurse should tell the client that gonorrhea can cause neonatal: A. B. Vaginal discharge. C. Eye infections. D. Liver damage. E. Congenital anomalies. A primigravida patient is admitted to the labor delivery area. Assessment reveals that she is in early part of the first stage of labor. Her pain is likely to be most intense: A. Around the pelvic girdle B. Around the pelvic girdle and in the upper arms C. Around the pelvic girdle and at the perineum D. At the perineum Normal A. B. C. D. lochial findings in the first 24 hours post-delivery include: Bright red blood Large clots or tissue fragments A foul odor The complete absence of lochia

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A patient is in the second stage of labor. During this stage, how frequently should the nurse in charge assess her uterine contractions? A. B. Every 5 minutes C. Every 15 minutes D. Every 30 minutes E. Every 60 minutes The nurse in charge is reviewing a patient’s prenatal history. Which finding indicates a genetic risk factor? A. The patient is 25 years old B. The patient has a child with cystic fibrosis C. The patient was exposed to rubella at 36 weeks’ gestation D. The patient has a history of preterm labor at 32 weeks’ gestation

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When evaluating a client’s knowledge of symptoms to report during her pregnancy, which statement would indicate to the nurse in charge that the client understands the information given to her? A. “I’ll report increased frequency of urination.” B. “If I have blurred or double vision, I should call the clinic immediately.” C. “If I feel tired after resting, I should report it immediately.” D. “Nausea should be reported immediately.” A client makes a routine visit to the prenatal clinic. Although she’s 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Diaz diagnoses gestational trophoblastic disease and orders ultrasonography. The nurse expects ultrasonography to reveal: A. An empty gestational sac. B. Grapelike clusters. C. A severely malformed fetus. D. An extrauterine pregnancy. After completing a second vaginal examination of a client in labor, the nurse-midwife determines that the fetus is in the right occiput anterior position and at –1 station. Based on these findings, the nurse-midwife knows that the fetal presenting part is: A. 1 cm below the ischial spines. B. Directly in line with the ischial spines. C. 1 cm above the ischial spines. D. In no relationship to the ischial spines. Which of the following would be inappropriate to assess in a mother who’s breast-feeding? A. The attachment of the baby to the breast. B. The mother’s comfort level with positioning the baby. C. Audible swallowing. D. The baby’s lips smacking A client who’s 36 weeks pregnant comes to the clinic for a prenatal checkup. To assess the client’s preparation for parenting, the nurse might ask which question? A. “Are you planning to have epidural anesthesia?” B. “Have you begun prenatal classes?” C. “What changes have you made at home to get ready for the baby?” D. “Can you tell me about the meals you typically eat each day?” The multigravida mother with a history of rapid labor who us in active labor calls out to the nurse, “The baby is coming!” which of the following would be the nurse’s first action? A. Inspect the perineum B. Time the contractions C. Auscultate the fetal heart rate D. Contact the birth attendant A client’s gestational diabetes is poorly controlled throughout her pregnancy. She goes into labor at 38 weeks and delivers a baby boy. Which priority intervention should be included in the care plan for the neonate during his first 24 hours? A. Administer insulin subcutaneously. B. Administer a bolus of glucose I.V. C. Provide frequent early feedings with formula. D. Avoid oral feeding. Early detection of an ectopic pregnancy is paramount in preventing a life-threatening rupture. Which symptoms should alert the nurse to the possibility of an ectopic pregnancy? A. Abdominal pain, vaginal bleeding, and a positive pregnancy test. B. Hyperemesis and weight loss. C. Amenorrhea and a negative pregnancy test. D. Copious discharge of clear mucus and prolonged epigastric pain.

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10. A client who tells the nurse that she would like to use the basal body temperature method of family planning receives instructions about the method. Which of the following client statements indicates to the nurse that the teaching has been successful? A. “When my temperature remains elevated for 7 days, ovulation has occurred. B. “Taking my temperature in the evening just after dinner or before I go to bed is best.” C. “Because this method is not very effective, I should use other forms of contraception too.” D. “It’s important to take my temperature at about the same time every morning before rising.” 11. A 20-year-old client, having missed one menstrual period, visits the prenatal clinic because she suspects that she is pregnant. Besides amenorrhea, the client tells the nurse that she has experienced nausea and vomiting, urinary frequency, and fatigue. The nurse determines that the client has been experiencing signs of pregnancy categorized as which of the following: A. Presumptive B. Probable C. Positive D. Predictive 12. The nurse is assessing a client who gave birth yesterday. Where should the nurse expect to find the top of the client’s fundus? A. One fingerbreadth above the umbilicus B. One fingerbreadth below the umbilicus C. At the level of the umbilicus D. Below the symphysis pubis 13. A client asks, “Can my partner and I still engage in sexual intercourse while I’m pregnant?” The nurse response is based on which of the following? A. Throughout the pregnancy, coitus interruptus is the preferred of sexual activity.

B. Although sexual desire may change, intercourse is safe during an uncomplicated pregnancy. C. Engaging in intercourse must be avoided until the client is at least 16 weeks pregnant. D. The couple should refrain from engaging in sexual intercourse during the last semester. 14. The nurse is planning care for a 16-year-old client in the prenatal clinic. Adolescents are prone to which complication during pregnancy? A. Iron deficiency anemia B. Varicosities C. Nausea and vomiting D. Gestational diabetes 15. A client asks the nurse why Vitamin C intake is so important during pregnancy. Which of the following would be the nurse’s best response? A. “Vitamin C is required to promote blood clot and collagen formation.” B. “Supplemental Vitamin C in large doses can prevent neural tube defects.” C. “Eating moderate amounts of foods high in Vitamin C helps metabolize fats and carbohydrates.” D. “Studies have shown that Vitamin C helps the growth of fetal bones.” 16. Which of the following would the nurse most likely to expect to find when assessing a pregnant client with abruption placenta? A. Excessive vaginal bleeding. B. Rigid, boardlike abdomen. C. Tetanic uterine contractions. D. Premature rupture of membranes. 17. The nurse is assessing a client on the second postpartum day. Under normal circumstances, the tone and location of the client’s fundus is: A. Soft and one fingerbreadth below the umbilicus. B. Firm and to the right or left of midline. C. Firm and two fingerbreadths below the umbilicus. D. Soft and at the level of the umbilicus. 18. Which of the following would the nurse use to assess a client for possible uterine atony after a cesarean delivery? A. Check the abdominal dressing every 15 minutes for the first hour. B. Palpate the fundus every 15 minutes for at least 1 hour. C. Observe the amount of lochia immediately after delivery. D. Assess blood pressure and pulse every 15 minutes for 1 hour. 19. The nurse is caring for a client after evacuation of a hydatidiform molar pregnancy. The nurse should instruct the client to: A. Wait 1 month before trying to become pregnant again. B. Make an appointment for follow-up human chorionic gonadotrophin (hCG) level monitoring at the end of 1 year. C. Discuss options for sterilization with the physician. D. Use birth control for at least 1 year. 20. What’s A. B. C. D. the best way to teach new parents about the care of neonate? Focus on the behavior of their neonate. Relate stories of other parents’ experiences. Show videotapes about neonate care. Distribute literature with photographs of neonate-care skills.

21. Fourth-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 birth D. Instructions to avoid intercourse for at least 12 weeks 22. Following 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 tones. D. Observe the color and consistency of the amniotic fluid. 23. During A. B. C. D. the second stage of labor, nursing actions should include: Withholding oral fluids. Administering an analgesic. Conducting an APGAR assessment. Positioning the woman comfortably for birth. who deliver vaginally are most likely to have what shaped pelvis? Android Anthropoid Gynecoid Platypelloid

24. Women A. B. C. D. E.

25. A client with pre-eclampsia is receiving magnesium sulfate and oxytocin (Pitocin) IV to induce labor at 38 weeks. What is the main indication of the magnesium sulfate for this client? A. Lower blood pressure B. Prevent convulsions C. Provide sedation D. Soften stools

26. Which of the following laboratory tests is least important related to the current condition of a newborn of an HIV-positive mother? A. B. Bilirubin level C. Blood glucose level D. ELISA testing E. Hematocrit 27. The client, who is 11 weeks gestation, has come to the office complaining of flu-like symptoms. Laboratory work indicates that the woman has contracted toxoplasmosis. From which of the following was the infection probably contracted? A. Poor handwashing after handling infected cat litter B. Sexual contact with a heterosexual male C. Contact with toxoplasmosis contaminated droplets in the air D. Exposure to infected saliva 28. A 20-year-old gravida 2 para 0 at 37 weeks gestation calls the nurse because she is experiencing contractions every 7 to 8 minutes. Her first pregnancy ended with a spontaneous abortion at 18 weeks and the client had a MacDonald cerclage placed early in the current pregnancy. Which of the following instructions by the nurse are the most appropriate? A. Try a warm bath and relaxation techniques to see if the contractions will go away." B. "You must wait until your contractions are every 5 minutes before going to the hospital." C. "You need to go to the hospital so we can stop your premature labor this time." D. "You should go to the hospital to be evaluated and have the cerclage removed." 29. The client's prenatal laboratory findings have been returned. Which of the following would indicate a need for further follow-up related to potential development of erythroblastosis fetalis? A. Blood type O B. Rh negative C. Blood type A D. Rh positive 30. When an insulin-dependent diabetic client gives birth, the nurse expects the client's insulin requirements in the first 24 hours after delivery to: A. Drop significantly. B. Gradually return to normal. C. Increase slightly. D. Stay the same as before. 31. 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 glucose B. Glycosylated hemoglobin C. Oral glucose tolerance test D. Post-prandial test 32. A client with a known placenta previa is admitted at 30 weeks with painless vaginal bleeding. The nurse weighs the client's peri-pads to monitor blood loss. An increased weight of 50 g would indicate approximately how much blood loss? A. B. 0.5 mL C. 5 mL D. 50 mL E. 500 mL 33. Thirty hours after delivery, the nurse in charge plans discharge teaching for the client about infant care. By this time, the nurse expects that the phase of postpartal psychological adaptation that the client would be in would be termed which of the following? A. Taking in B. Letting go C. Taking hold D. Resolution 34. A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following? A. Activity limited to bed rest B. Platelet infusion C. Immediate cesarean delivery D. Labor induction with oxytocin 35. A client tells the nurse, “I think my baby likes to hear me talk to him.” When discussing neonates and stimulation with sound, which of the following would the nurse include as a means to elicit the best response? A. Low-pitched speech with a sameness of tone B. Cooing sounds rather than words C. Repeated stimulation with loud sounds D. High-pitched speech with tonal variations 36. A patient with pregnancy-induced hypertension probably exhibits which of the following symptoms? A. Proteinuria, headaches, vaginal bleeding B. Headaches, double vision, vaginal bleeding C. Proteinuria, headaches, double vision D. Proteinuria, double vision, uterine contractions

37. Five hours after birth, a neonate is transferred to the nursery, where the nurse intervenes to prevent hypothermia. What is a common source of radiant heat loss? A. Low room humidity B. Cold weight scale C. Cools incubator walls D. Cool room temperature 38. The nurse in charge is caring for a patient who is in the first stage of labor. What is the shortest but most difficult part of this stage? A. Active phase B. Complete phase C. Latent phase D. Transitional phase 39. After 3 days of breast-feeding, a postpartal patient reports nipple soreness. To relieve her discomfort, the nurse should suggest that she: A. Apply warm compresses to her nipples just before feedings B. Lubricate her nipples with expressed milk before feeding C. Dry her nipples with a soft towel after feedings D. Apply soap directly to her nipples, and then rinse 40. During a prenatal visit at 4 months gestation, a pregnant client asks whether tests can be done to identify fetal abnormalities. Between 18 and 40 weeks’ gestation, which procedure is used to detect fetal anomalies? A. Ultrasound B. Amniocentesis. C. Chorionic villi sampling. D. Fetoscopy. 41. Which change would the nurse identify as a progressive physiological change in postpartum period? A. Lochia B. Uterine involution C. Diuresis D. Lactation 42. When administering magnesium sulfate to a client with preeclampsia, the nurse understands that this drug is given to: A. Prevent seizures B. Reduce blood pressure C. Slow the process of labor D. Increase diuresis 43. What’s A. B. C. D. the approximate time that the blastocyst spends traveling to the uterus for implantation? 2 days 7 days 10 days 14 weeks with eclampsia begins to experience a seizure. Which of the following would the nurse in charge do Pad the side rails Place a pillow under the left buttock Insert a padded tongue blade into the mouth Maintain a patent airway

44. A client first? A. B. C. D.

45. While assessing a primipara during the immediate postpartum period, the nurse in charge plans to use both hands to assess the client’s fundus to: A. Prevent uterine inversion B. Promote uterine involution C. Hasten the puerperium period D. Determine the size of the fundus 46. The hormone responsible for the maturation of the Graafian follicle is: A. Follicle stimulating hormone B. Progesterone C. Estrogen D. Luteinizing hormone 47. What event occurring in the second trimester helps the expectant mother to accept the pregnancy? A. B. Lightening C. Ballotment D. Pseudocyesis E. Quickening 48. While assessing a newborn with cleft lip, the nurse would be alert that which of the following will most likely be compromised? A. Sucking ability B. Respiratory status C. Locomotion D. GI function 49. The following are ways of determining expected date of delivery (EDD) when the LMP is unknown EXCEPT: A. Naegele’s rule B. Quickening C. Mc Donald’s Rule

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Batholomew’s Rule of 4

50. The diet that is appropriate in normal pregnancy should be high in: A. Carbohydrates and vitamins B. Proteins, carbohydrates and fats C. Fats and minerals D. Protein, minerals and vitamins 51. 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 52. The following are skin changes in pregnancy EXCEPT: A. Chloasma B. Striae gravidarum C. Linea negra D. Chadwick's sign 53. Smoking is contraindicated in pregnancy because A. Nicotine causes vasodilation of the mother’s blood vessels B. Carbon monoxide binds with the hemoglobin of 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

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54. A pregnant mother
weeks, A. B. C. D.

is admitted to the hospital with the chief complaint of profuse vaginal bleeding, AOG 36 not in labor. The nurse must always consider which of the following precautions: The internal exam is done only at the delivery under strict asepsis with a double set-up The preferred manner of delivering the baby is vaginal An emergency delivery set for vaginal delivery must be made ready before examining the patient Internal exam must be done following routine procedure

55. 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 56. 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 57. Papanicolaou smear is usually done to determine cancer of A. Cervix B. Ovaries C. Fallopian tubes D. Breast 58. Which of the following causes of infertility in the female is primarily psychological in origin? A. Dyspareunia B. Endometriosis C. Vaginismus D. Impotence 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. 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 61. 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 62. The peak point of a uterine contraction is called the A. B. Acceleration C. Acme D. Deceleration E. Axiom

63. 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 64. When the bag of waters ruptures, the nurse should check the characteristic of the amniotic fluid. The normal color of amniotic fluid is A. B. Clear as water C. Bluish D. Greenish E. Yellowish 65. 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 66. When the shiny portion of the placenta comes out first, this is called the ______________ mechanism. A. B. Schultze C. Ritgens D. Duncan E. Marmets 67. When delivering the baby’s head the nurse supports the mother’s perineum to prevent tear. This technique is called A. B. Marmet’s technique C. Duncan maneuver D. Ritgen’s technique E. Schultze maneuver 68. 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 69. The following are types of breech presentation EXCEPT: A. B. Footling C. Frank D. Complete E. Incomplete 70. 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. B. Engaged C. Descended D. Floating E. Internal Rotation 71. The placenta should be delivered normally within ___ minutes after the delivery of the baby. A. B. 5 minutes C. 30 minutes D. 45 minutes E. 60 minutes 72. After an Rh(-) mother has delivered her Rh (+) baby, the mother is given RhoGam. This is done in order to: A. Prevent the mother from producing antibodies against the Rh(+) antigen that she may have gotten when she delivered to her Rh(+) baby B. Prevent the recurrence of Rh(+) baby in future pregnancies C. Ensure that future pregnancies will not lead to maternal illness D. To prevent the newborn from having problems of incompatibility when it breastfeeds 73. The nursing intervention to relieve pain in breast engorgement while the mother continues to breastfeed is A. Apply cold compress on the engorged breast B. Apply warm compress on the engorged breast C. Massage the breast D. Apply analgesic ointment 74. Right after birth, when the skin of the baby’s trunk is pinkish but the soles of the feet and palm of the hands are bluish this is called: A.

B. C. D. E.

Syndactyly Peripheral cyanosis Cephalo-caudal cyanosis Acrocyanosis

75. A client with heart disease has been prescribed digoxin (Lanoxin) during her pregnancy. The nurse evaluates that client teaching has been effective when the client states: A. "I will avoid eating foods high in potassium while taking this medication." B. "I will check my pulse and not take the medication if it is less than 60." C. "I will not take antibiotics at the same time as this medication." D. "I will take this medication with a full glass of water before breakfast." 76. Which of the following factors found in a prenatal client's history would place her at increased risk for ectopic pregnancy? A. Android pelvis B. Endometriosis C. Late menarche D. Previous cesarean 77. During her first prenatal visit, a woman tells the nurse she was born with cleft lip and palate and is concerned that her infant will inherit the anomaly. The nurse's best response is: A. "I will tell the doctor of your concern." B. "There are many reasons for cleft lip and palate; it is not directly inherited." C. "I will contact your parents to check for other family members who may have a birth defect." D. "I know you are concerned, but there is no way to know if your baby will have this 78. The client, who is 32 weeks gestation, complains of severe heartburn, especially at night. Following instruction by the nurse, which of the following statements by the client indicates that she understands the best course of management? A. "I should eat small, frequent meals." B. "I should try to lay down and rest after eating." C. "I should avoid using of antacids because medication can hurt the baby." D. "Heartburn is a common discomfort in pregnancy, there is really nothing to do about it." 79. A client at 8 months gestation is diagnosed with oligohydramnios. She asks the nurse if this can harm the fetus. The nurse's best response is: A. "Yes, oligohydramnios 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." 80. Within the Florence Nightingale Pledge is the statement "...and will hold in confidence all personal matters committed to my keeping, and all family affairs coming to my knowledge in the practice of my calling." To which ethical principle is this statement referring? A. Autonomy B. Confidentiality C. Informed consent D. Non-maleficence