Questions:

1. A nurse is conducting a prenatal teaching class and is reviewing the functions of the
female reproductive system. A client in the class asks the nurse about the function of
the fallopian tubes. The nurse tells the client that
a. Estrogen and progesterone are secreted from the fallopian tubes
b. The fallopian tubes are the passageway for the fetus
c. The fetus develops in the fallopian tubes
d. Fertilization occurs in the fallopian tubes

2. A client arrives at a prenatal clinic for the first prenatal assessment. The client tells a
nurse that the first day of her last menstrual period was September 19, 2005. Using
Nagele’s Rule, the nurse determines the estimated date of confinement as
a. July 26, 2006
b. June 12, 2007
c. June 26, 2006
d. June 12, 2007

3. A pregnant client in the last trimester has been admitted to the hospital with a diagnosis
of severe preeclampsia. A nurse monitors for complications associated with the
diagnosis and assesses the client for
a. Any bleeding such as in the gums, petechiae, and purpura
b. Enlargement of the breasts
c. Periods of fetal movement followed by quiet periods
d. Complaints of feeling hot when the room is cool

4. A client in the first trimester of pregnancy arrives at the health care clinic and reports
that she has been experiencing vaginal bleeding. A threatened abortion is suspected,
and a nurse instructs the client regarding management of care. Which statement if
made by the client indicates a need for further education?
a. “I will maintain strict bed rest throughout the remainder of the pregnancy.”
b. “I will avoid sexual intercourse until the bleeding has stopped, and for 2
weeks following the last evidence of bleeding.”
c. “I will count the number of perineal pads used on a daily basis and note the
amount and color of blood on the pad.”
d. “I will watch for the evidence of the passage of tissue.”
5. A nurse assists in the vaginal delivery of a newborn infant. After the delivery, the nurse
observes the umbilical cord lengthen and a spurt of blood from the vagina. The nurse
documents these observations as a signs of
a. Hematoma
b. Placenta previa
c. Uterine atony
d. Placental separation

6. A nurse is preparing a plan of care for a client who just delivered a dead fetus. The most
appropriate initial intervention in planning to meet the emotional needs of the client
and her spouse is which of the following?
a. Encourage the client to talk about the dead fetus
b. Allow the client and the spouse to hold the baby
c. Allow the family members to name the baby
d. Assess the client and the spouse’s perception of the event

7. A nurse in a labor room performing a vaginal assessment on a pregnant client in labor.

The nurse notes the presence of the umbilical cord protruding from the vagina. Which
of the following would be the initial nursing action?
a. Place the client in Trendelenburg’s position
b. Call the delivery room to notify the staff that client will be transported
immediately
c. Gently push the cord into the vagina
d. Find the closest telephone and stat page the physician

8. A clinic nurse has provided home care instructions to a client with a history of cardiac
disease who has just been told that she is pregnant. Which statement if made by the
client indicates a need for further education?
a. “During the pregnancy, I need to avoid contact with other individuals as
much as possible to prevent infection.”
b. “I need to avoid excessive weight gain to prevent increased demands on my
heart.”
c. “It is best that I rest on my left side to promote blood return to the heart
d. “I need to try to avoid stressful situations because stress increases the
workload on the heart.”
9. A nonstress test is prescribed for a pregnant client, and the client asks the nurse about
the procedure. The nurse tells the client that
a. The test is an invasive procedure and requires that an informed consent be
signed
b. The test will take about 2 hours and will require close monitoring for 2 hours
after the procedure is completed
c. An ultrasound transducer that records fetal heart activity is secured over the
abdomen when the fetal heart is heard most clearly
d. The fetus is challenged or stressed by uterine contractions to obtain the
necessary information

10. A nursing instructor asks a nursing student who is preparing to assist with the
assessment of a pregnant client to describe the process of quickening. Which of the
following statements if made by the student indicates an understanding of this term?
a. “It is the irregular, painless, contractions that occur throughout pregnancy.”
b. “It is the soft blowing sound that can be heard when the uterus is
auscultated.”
c. “It is the fetal movement that is felt by the mother.”
d. “It is the thinning of the lower uterine segment.”
Answers:

1. D
Rationale: Each fallopian tube is a hallow, muscular tube that transports a mature
oocyte for final maturation and fertilization. Fertilizations typically occurs near the
boundary between the ampulla and isthmus of the tube. Estrogen is a hormone
produced by the ovarian follicles, corpus luteum, adrenal cortex, and placenta
during pregnancy. Progesterone is a hormone secreted by the corpus luteum of the
ovary, adrenal glands, and placenta during pregnancy. The vagina is the passageway
for the fetus, and the fetus develops in the uterus.

2. C
Rationale: Use of Nagele’s Rule (3 + 7 +1)

3. A
Rationale: Severe preeclampsia can trigger disseminated intravascular coagulation
(DIC) because of the widespread damage to vascular integrity. Bleeding is an early
sign of DIC and should be reported to the health care provider if noted on
assessment. Options B, C and D are normal occurrences in the last trimester of
pregnancy.

4. A
Rationale: Strict bed rest throughout the remainder of the pregnancy is not
required. The woman is advised to curtail sexual activities until bleeding has ceased,
and for 2 weeks following the last evidence of bleeding or as recommended by the
physician or other health care provider. The woman is instructed to count the
number of perineal pads used daily and to note the quantity and color of blood on
the pad. The woman also should watch for the evidence of the passage of tissue.

5. D
Rationale: As the placenta separates, it settles downward into the lower uterine
segment. The umbilical cord lengthens, and a sudden trickle or spurt of blood
appears. Options A, B and C are incorrect interpretations.

6. D
Rationale: The most appropriate initial intervention in planning to meet the
emotional needs of the client and her spouse is to assess their perception of the
event. Although options A, B,and C are likely to be components of the plan of care,
the initial intervention in planning is to assess the perception of the event.
7. A
Rationale: When cord prolapsed occurs, prompt action are taken to relieve cord
compression and increase fetal oxygenation. The mother should be positioned with
the hips higher than the head to shift the fetal presenting part toward the
diaphragm.

8. A
Rationale: To avoid infections, visitors with active infections should not be allowed
to visit the client; otherwise restrictions are not required. Stress causes increased
heart workload, and the client should be instructed to avoid stress. Too much
weight gain can place further demands on the heart. Resting should be on the left
side to promote blood return.

9. C
Rationale: The nonstress test takers about 20 to 30 minutes. The test is termed
nonstress because it consists of monitoring only; the fetus is not challenged or
stressed by uterine contractions to obtain the necessary data. The testis
noninvasive, and an ultrasound transducer that records fetal heart activity is secured
over the maternal abdomen where the fetal heart is heard most clearly.

10. C
Rationale: Quickening is the fetal movement and may occur as early as the sixteenth
to eighteenth week of gestation, and the expectant mother first notices subtle fetal
movement that gradually increase in intensity.