Directions: Choose the letter of the correct answer. Answer in capital letter only. 1. 2.
The inner membrane that encloses the fluid medium for the embryo is the: a. funis b. amnion c. chorion d. yolk sac The chief function of progesterone is the: a. stimulation of follicles for ovulation to occur b. development of female reproductive organs c. preparation of the uterus to receive a fertilized ovum d. establishment of the secondary male sex characteristics During the process of gametogenesis, the male and female sex divide, and each mature sex cell contains: a. twenty two pairs of autosomes in their nuclei b. forty six pairs of chromosomes in their nuclei c. a diploid number of chromosomes in their nuclei d. a haploid number of chromosomes in their nuclei The placenta does NOT produce: a. somatotropin b. chorionic gonadotropin c. follicle stimulating hormone d. progesterone precursor substances
The developing cells are called a fetus from the: a. time the fetal heart is heard c. implantation of the fertilized ovum b. eight week to the time of birth d. end of 2nd week to the onset of labor During a. b. c. d. pregnancy the volume of tidal air increases because there is: an increase in total blood volume increased expansion of the lower ribs upward displacement of the diaphragm a relative increase in the height of the rib cage
The uterus rises out the pelvis an becomes an abdominal organ at about the: a. 10th week of pregnancy c. 12th week of pregnancy th b. 8 week of pregnancy d. 18th week of pregnancy First fetal movements felt by the mother are known as: a. lightening b. quickening c. ballottement In prenatal development, fetal weight gain is greatest in the: a. 1st trimester b. 2nd trimester c. 3rd trimester d. engagement d. implantation
10. After the first three months of pregnancy the chief source of estrogen and progesterone is the: a. placenta b. adrenal cortex c. corpus luteum d. anterior hypophysis
11. In fetal blood vessels the oxygen content is highest in the:
a. umbilical artery b. ductus venosus c. pulmonary artery d. ductus arteriosus 12. A client relates that the first day of her last menstrual period was July 22. The estimated date of birth would be: a. May 5 b. May 14 c. April 15 d. April 29 13. A client visits the prenatal clinic to confirm her suspicions that she is pregnant and, if so, to begin prenatal care. The client states her last menstrual period began June 10. According to Nageles Rule, her expected date of delivery (EDD) would be: a. March 17 b. April 17 c. March 10 d. April 10 14. Anticipatory guidance during the first trimester of pregnancy is primarily directed toward increasing the pregnant woman’s knowledge of: a. labor and delivery c. role transition into parenthood b. signs of complications d. physical changes resulting from pregnancy 15. The anterior/posterior diameter of the pelvic inlet is an important measurement of the pelvis and is known as the: a. conjugate vera c. transverse diameter b. diagonal conjugate d. transverse conjugate 16. During pregnancy, the uterine musculature hypertrophies and is greatly stretched as the fetus grows. This stretching: a. By itself inhibits uterine contraction until oxytocin stimulates the birth process b. Is prevented from stimulating uterine contraction by high levels of estrogen during late pregnancy c. Inhibits uterine contraction along with the combined inhibitory effects of estrogen and progesterone d. Would ordinarily stimulate uterine contraction but is prevented by high levels of progesterone during pregnancy. 17. The nurse recognizes that a normal, expected change in hematologic system that occurs during the second trimester of pregnancy is: a. a decrease in WBCs c. an increase in blood volume b. an increase in hematocrit d. a decrease in sedimentation rate
adrenal gland d. A normal cardiopulmonary system experienced by most pregnant women is:
a. Most weight gain during pregnancy is fluid retention b. “Yes. pituitary gland
30. The nurse explains to the client that urinary frequency often occurs because the capacity of the bladder during pregnancy is diminished by: a.”
21. the nurse should suggest: a. Physiological anemia during pregnancy is a result of: a. “Reduction in the secretion of hormones by the ovaries. drinking more high carbohydrate fluid with her meals
29. The nurse should: a. Dietary sources of essential nutrients are favored by different cultural groups
26. in her eight week of pregnancy complaints of having to go to the bathroom often to urinate. The nurse explains that these adaptations are due to the hyperactivity of the: a. Goodell’s sign d. The nurse is aware that a normal adaptation of pregnancy is an increased blood supply to the pelvic region that results in purplish discoloration of the vaginal mucosa. Hegar’s sign c. which is known as: a. increased plasma volume of the mother c. tachycardia b. Ask for time in the morning and afternoon to elevate her legs c. Pregnant women must adhere to a specific pregnancy diet d. “Production of estrogen and progesterone by the ovaries. The nurse should recommend that the client: a. This would necessarily have implications for her plan of care during pregnancy. The nurse in the prenatal clinic should provide nutritional counseling to all newly pregnant women because: a. thyroid gland c. having her first child. progressive dependent enema d.” d.18. When
attending the prenatal clinic. Ask for time in the morning and afternoon to obtain nourishment 25. compromise of the autonomic reflexes d. an internal is done on all mothers. decreased erythropoiesis after the first trimester d. an internal is done on all mothers on the first visit. progesterone c.”
23. eat nothing until the nausea subsides b. Dietary allowances should not increase during pregnancy c. A pregnant client works as a keypunch operator. increased detoxification demands on the mother’s liver 20. The nurse can try to help a pregnant client overcome first trimester morning sickness by suggesting that the client: a. constriction of the urethral entrance at the trigone 28. request her nurse to prescribe and antiemetic
. Assess what she eats by taking a diet history c. “Secretion of follicle stimulating hormone produced by the pituitary. Give her a list of foods so she can better plan her meals d.” c. On a first prenatal visit. dyspnea at rest c. Ladin’s sign b. Have you ever had an internal examination done before?” d. having two small meals daily and a snack at noon d. increasing her fat intake before bed time c.” b. “Secretion of luteinizing hormone produced by the by the pituitary.” b. but it is slightly uncomfortable. Tell her employer she cannot walk beyond the second trimester d. The nurse is aware that the nausea and vomiting commonly experienced by many women during the first trimester of pregnancy is an adaptation to the increased level of: a. take an antacid before bedtime d. estrogen b. “Are you fearful of having an internal examination done?” c. To promote relief. A
primigravida in her tenth week of gestation is concerned because she had read that nutrition during pregnancy is important for proper growth and development of the baby. luteinizing hormone d. chorionic gonadotropin 24. Chadwick’s sign 19. “Yes. decreased dietary intake of iron b. “Yes. eat protein before sleeping c. a client asks thenurse. Try to walk about every few hours during the workday b. ovaries b. shortness of breath on exertion
22. Emphasize the importance of limiting salt and highly seasoned foods
27. “Is it true the doctor will do an internal examination today?” The nurse should respond: a. A client who is 10 weeks pregnant calls the clinic and complains of morning sickness. a newly pregnant client. The nurse’s best response would be that this occurs because of the: a. A client. eating dry crackers before arising b. Instruct her to continue eating a normal diet b. She wants to know something about the foods she should eat. atony of the detrusor muscle b. compression by the enlarging uterus c. expresses concern about her “dark nipples” and a “dark line” from her navel to the pubis. A
client asks the nurse why menstruation ceases once pregnancy occurs.
response is based on the knowledge that coitus during pregnancy would be contraindicated in the presence of: a. “I’m worried about gaining too much weight because I have heard that it is bad for me. “It is far better that the heart rate is rapid. metabolic alterations d. In this instance: a. “A 25 –pound weight gain is recommended. an increase in caloric intake to 2800 cal per day 32. The woman. increased fetal heart rate d. commenting on how rapid it is. A client. During a prenatal examination the nurse draws blood from a young client and explains that the determination of Rh is routinely performed on expectant mothers to predict whether the fetus is at risk for developing: a. Besides advising rest with the legs elevated. A client is in her 4th month of pregnancy. The nurse explains that this is because the fundus: a. A client who is pregnant for the first time attends the prenatal clinic. “Perhaps you might ask the nurse midwife about it. The best response for the nurse to make is: a. a decrease in fat and protein consumption d. When involved in prenatal teaching. supply of NaCl to the cells of the vagina
41. “If you gain over 15 pounds. weight gain causes complications during pregnancy. acute hemolytic anemia c. and the baby has just started to move b. is at the umbilicus. an increase to 1800 to 2000 calories per day b. d. 7 weeks pregnant.” b. leukorrhea c. “The baby’s heart rate is usually twice the mother’s pulse rate.” c. “Can you tell me how you feel in the morning?” c. “The baby’s heartbeat is rapid to accommodate the nutritional needs. metabolic rates c. is told by the obstetrician that she appears to be about 20 weeks pregnant. A client who is pregnant is being prepared for a pelvic examination.31. and do not take any aspirin Take only prescription drugs.” c. The nurse explains that the large part of weight gain during pregnancy is because of: a. “Let’s discuss some ways to deal with these common problems. “This is common. The nurse should respond: a.” b. when it is slow.” b. increased blood volume 33. the pattern of your weight gain will be of more importance than the total amount. you’ll have to follow a low caloric diet. physiologic hyperbilirubinemia b. especially in the second and third trimesters
38. We are more concerned if you don’t gain enough weight to ensure proper growth of your baby. and the fetal heart can be heard with a fetoscope
42. The nutritionist should be brought in to plan and diet
. 5th month b. and the fetal heart can be heard with a Doppler c. production of estrogen d. A primigravida. the nurse discusses and gives instructions concerning the diet. is 18cm. and your baby’s is within the normal range. Nutritional planning for a newly pregnant woman on average height weighing 130 pounds should include: a. a decrease to 1000 calories per day c. She tells the nurse. 2nd month 35. is 28cm. c. appears frightened and asks if this is normal. The best advice the nurse can give to a pregnant woman in her first trimester is to:
a. the fetus b. confides to the nurse in the prenatal clinic that she is very sick every
morning with nausea and vomiting and is sure that she is being punished for having initially thought of aborting the pregnancy. There is no need to worry.” The nurse’s best response would be: a. unsure of the date of her last menstrual period. is just over the symphysis. however. limit alcohol consumption.”
39. the nurse
asks if she would like to listen to the baby’s heartbeat. Cut down on drugs. When she comes for her monthly examination. and the fetal heart cannot be heard d. b. protein metabolism deficiency d. “A baby’s heart rate is rapid. A client is concerned about gaining weight during pregnancy. respiratory distress syndrome
37.” 36. especially in the morning. The nurse assures her that this is not punishment but a common occurrence in early pregnancy and will probably disappear by the end of the: a. A client who is pregnant asks the nurse if she can continue to have sexual relations. 4th month c. 3rd month d.”
34. premature rupture of membranes 40. the nurse should inform clients that an increase in vaginal secretions during pregnancy is called leucorrhea caused by increased: a. alcohol and cigarettes Avoid all drugs and refrain from smoking and ingesting alcohol Avoid smoking. “Don’t worry about gaining weight. there is no need to worry.” d. “Yes. functioning of the Bartholin’s glands b. gestation of 30 weeks of more b.” d. The client complaints of feeling very tired and sick to her stomach. A 21-year old client who is 6 months into her second pregnancy is experiencing increasing edema
in the lower extremities. fluid retention c.” d.
The nurse explains the treatment for fluid retention during pregnancy. she has a bloody show and back pressure c. below the umbilicus on the right side b. the nurse should tell her to come to the hospital when: a. Energy is needed to push during the first stage of labor d. bring about progressive cervical dilation b. “I cannot stand this a minute longer. asking the client when she ate last b. To best auscultate the fetal heart tones. after explaining the procedure. not yet engaged c. The nurse. contractions will: a. d. the Doppler is placed: a.” 45. below the umbilicus near the left groin 54. In the thirty seventh week of gestation a client is scheduled for a nonstress test.
c. “I hope that this test does not cause my labor to begin early. Her fetus is at a +1 station. After doing Leopold’s maneuvers on a laboring client.
Adequate fluid and low salt diet A low salt diet and elevation of the lower extremities Adequate fluid and elevation of the lower extremities Judicious use of directions and elevaion of the lower extremities
44. below the ischial spines b.
c. becomes very tense with contractions and is quite irritable. visible at the vaginal opening 53. Be given an enema before the night of examination b. but now I understand why it is necessary. A client in active labor begins to tremble. The nurse assesses the client’s contractions by timing from the beginning of one contraction:
. Membranes rupture or contractions are 5 to 8 minutes apart d. lead to transient episodes of hypertension 50. At a prenatal visit at 36 weeks’ gestation. he should do okay during the delivery.
The foods selected should have a normal salt content Dietary preferences must influence the food that is eaten The client should be advised to see the physician at the prenatal clinic
43. The nurse explains the procedure and informs the client that for this test she will have to: a. Energy helps to increase the progesterone level c. which is:
a. entering the pelvic inlet d. A client is admitted to the labor room in early active labor. “I hate having needles in my arm. She frequently states. “I hope the baby doesn’t get too restless after this procedure. Refrain from voiding for at least 3 hours before the test c. has been very poorly prepared for labor in the parents’ classes d. a client complaints of discomfort with Braxton Hicks contractions. The nurse should teach pregnant women importance of conserving the “Spurt of Energy” before labor because: a. Walk around until they subside d. taking an obstetric history d. Contractions are 2 to 3 minutes apart and she cannot walk about 48. occur immediately after membranes rupture c. The nurse instructs the client to: a. interfere with free movement of the coccyx b. “If my baby’s heart reacts normally during the test. Her cervix is 100% effaced and she is dilated 3 cm. Fatigue may influence need for pain medication b. ascertaining if the membranes are ruptured 52. True labor can be differentiated from false labor because in true labor. is entering the transition phase of labor b. A client who is gravida 1.” d. b. The physician asks the nurse the frequency of a laboring client’s contractions. is developing some abnormality in terms of uterine contractions 55. cause decreased placental perfusion d. para 0. A nurse teaches a pregnant woman to avoid lying on her back during labor.” b. evaluates that the client understands the teaching when she says: a.” This kind of behavior . Be monitored closely afterward for signs of precipitate labor d.b. is admitted in labor. unduly prolong labor c. auscultating the fetal heart c.
d. above the umbilicus in the midline c. A client in the thirty second week of pregnancy is scheduled for ultrasonography. Time the contraction for ½ hour b. The energy will decrease the intensity of uterine contractions 51. The priority nursing intervention on admission of this laboring client would be: a. contractions are 10-15 minutes apart b. When teaching a young primigravida about labor. Be kept NPO for 12hours to minimize the possibility of vomiting 46. Take 10 grains of aspirin for the discomfort 47. The nurse is aware that the fetus’ head is: a. Lie down until they stop c. be less uncomfortable if client is in a side lying position 49. The nurse has based this statement on the knowledge that supine position can: a. above the umbilicus on the left side d.” c. the nurse determines that the fetus is in ROP position.maybe indicative of the fact that the client: a. stop when the client is encouraged to walk around d. needs immediate administration of an analgesic or anesthetic c.
a. the nurse should expect an order for: a. Place the client in a knee-chest position to avoid cord compression c. She comes to the hospital accompanied by her husband. greenish yellow. Walking may interfere with proper uterine contractions. transition phase of labor b. almost colorless. After an amniotomy. comes to the labor suite with a bloody show and no contractions. Put the client in a dorsal recumbent position to prevent compression of the vena cava
60. “I can’t make a decision on that. The membranes of a client who is 39 weeks pregnant have ruptured spontaneously. administration of prostaglandins 65. the nurse would expect: a. The nurse notes that the fetal heart decelerates in a uniform wave shape reflecting the shape of contraction. Her membranes ruptured 30 minutes before arrival. “It is quite all right for you to be up and about as long as you feel comfortable and your membranes are intact. Vaginal examination reveals 3cm dilation and 75% effacement. and the head is at +1 station. diminished bloody show c. review Lamaze breathing techniques with the client c. just below the xiphoid process d. containing shreds of mucus c. Five minutes after delivery of the infant. clear. A client. introduce the staff nurses to the couple and try to make them feel welcome d. A client in active labor spontaneously ruptures membranes. place the mother in bed and attach an external fetal monitor b. A vaginal examination reveals 1cm dilation and presenting part at -1 station. A primigravida at term is admitted with contractions q5 to 8 minutes and a bloody show. When
examining the fetal monitor strip following rupture of the membranes in a laboring client. The nurse should: a. The nurse should first: a. active phase of labor d. change the client’s position d.” b. A primigravida. restriction of movement c. the client is in the: a. difficulty to find c. Notify the physician because there maybe head compression b. A
laboring client is placed on an external fetal monitor. the nurse could best respond: a. milky. A client is admitted at the hospital in active labor. latent phase of labor c. to the end of a second contraction
c. let the mother undress while the nurse takes history from the father c. The nurse should: a. The nurse observes the client’s amniotic fluid and decides that it appears normal. 41 weeks gestation. and intact membranes. A primigravida. until the time the uterus becomes very firm
56. have them wait in the examining room while the nurse notifies the physician that theyhave arrived 63. After obtaining the fetal heart rate and maternal vital signs. check bp and pulse b. monitor the FHR c. at the umbilicus in the upper right quadrant b. +1 station with occiput anterior and intact membranes.”
. an iM injection of oxytocin d. stop the oxytocin infusion c. Her cervix is 4 cm dilated and 75% effaced. to the beginning of the next contraction d. prepare to type and cross-match the client’s blood for a possible transfusion 67. less discomforts with contractions b. containing little white specks 57. the nurse should: a. call the physician d. teach the client how to push b. arrives at the birthing center with abdominal cramping and bloody show. is admitted with q3 to 5mins contractions. the placenta is expressed. The fetal heart rate is 136. increased fetal heart rate d. containing little white specks d. halfway between symphysis pubis and umbilicus 58. The nurse is aware that according to these data. the nurse notes decelerations in the fetal heart rate. A multigravida has a normal spontaneous vaginal delivery of a healthy infant. She and her husband attended childbirth preparation classes. interference with Lamaze techniques b. The nurse upon assessing the fundus at this time would expect the fundus to be: a. artificial rupture of membranes b. accelerated phase of labor 64. “Please stay in ed. progressive dilation and effacement 66. To induce labor. One problem that confronts the client when an external fetal monitor is being used is the: a. A vaginal exam reveals that the baby’s head is at +1 station. greenish-yellow. The nurse should: a. clear and dark amber in color b. provide the client with comfort measures used for women in labor d. because it is: a. increased frequency of vaginal examinations
59.” c. inability to take sedatives d. Vaginal examination reveals that the cervix is fully effaced. 40 weeks gestation. a bloody show. 6 cm dilated. The client is cheerful and relaxed and asks the nurse if it is all right for her to walk around. time the contractions 62. cloudy. prepare for immediate delivery b. Based on the observations of the client’s contractions and knowledge of the physiology and mechanism of labor. take the client’s blood pressure
61. Continue to observe for return of fetal heart rate to baseline when contraction ends d. 40 weeks’ gestation. you will have to ask the doctor. a tap water enema c. until the time it is completely over b.
station +1 indicates that the presenting part is: a. Undigested food and fluid may cause nausea and vomiting and limit the choice of anesthesia c. Transfer her immediately by stretcher to the delivery room b. pant to prevent cervical edema 79. The breathing technique that the mother should be instructed to use during delivery of the fetus’ head is crowning is: a. place her in the supine position d. which is already increased because of the stress of labor d. totally effaced and the head is at +2. The management of a client in the transition phase of labor is primarily directed toward: a. To alleviate discomfort during contactions. A laboring primapara should be prepared for delivery when the nurse observes: a. breech b. During labor. When a client is positioned for delivery. Support the perineum with the hand to prevent tearing and tell the client to pant
. severe pain c. shallow breaths d.d. on the perineum c. transverse c. the nurse teaches the client to avoid the: a. The
nurse withholds foods and limits fluids as a laboring client approaches the second stage of labor because: a. During each contraction the nurse should encourage her to: a. pressure on the perineum d. occiput anterior d. slightly below the ischial spines b. apply back pressure during contractions b. occiput posterior 70. having the client breathe simple breathing patterns during contractions 74. both legs should be positioned simultaneously to prevent: a. Tell her to breathe through her mouth and not to bear down c. To promote comfort during back labor. The client is now 7cm dilated and the presenting part is low in the midpelvis. blowing b. A laboring client complaints of low back pain. supine position c. An increase in the amount of bloody discharge from the vagina d. uterine tetany d. excessive pull on the fascia b. Food will further aggravate gastric peristalsis. The nurse should: a. Instruct the client to pant during contractions and to breathe through her mouth d. sitting position b. help her perform neuromuscular control exercises 71. instruct her to flex her knees c. A
client is admitted in active labor. a client should be observed carefully for signs of: a. During the period of induction of labor. slightly above the ischial spines
80. push with glottis open c. decreasing the intravenous fluid intake c. That the perineum is beginning to bulge with each contraction c. the nurse should recommend that the client’s husband: a. high in the false pelvis d. the nurse should instruct the husband to encourage his wife to: a. A client and her husband are working together during the wife’s labor. side lying position d. blow as not to grunt d. athletic chest breathe 69. To increase the client’s comfort. the baby’s head is crowning. helping the client maintain control b. pelvic rock c. Otherwise your contractions cannot be timed and no one can listen to the fetal heart. position knee chest
72. deep breathe slowly d. The nurse replies that this pain occurs most when the position of the fetus is: a. A client in labor is fully ditaled. trauma to the uterine ligaments 76. The contractions are occurring every 2 to 3 minutes and lasting 60 seconds 77.accelerated decelerated 75. slow chest c. the client is bearing down and delivery appears imminent. hypoglycemia b. The gastric phase of digestion stimulates the release of hydrochloric acid and may cause dyspepsia
“You will have to stay in bed. pant b. The expectant couple asks the nurse about the cause of low back pain in labor. reducing the client’s discomfort with medications d.”
68. relax by closing her eyes b. The mechanical and chemical digestive process requires energy that is needed for labor b. The client becoming irritable and not following instructions b. prolapse of the umbilical cord 78. venous stasis in the legs c.