OBSTETRICAL NURSING PRACTICE TEST PART 1

1. Which of the following client statements indicates that the nurse's teaching about oral contraceptive agents has been successful? A. "Despite their effectiveness, about 25% of women stop taking them after 1 year." B. "These agents usually only cause a few minor side effects when you take them." C. "Oral contraceptives inhibit ovulation and change the consistency of cervical mucus." D. "I can make these drugs more effective by monitoring my basal body temperature." 2. A client's gestational diabetes is poorly controlled throughout her pregnancy. She goes into labor at 38 weeks and delivers a boy. Which priority intervention should be included in the care plan for the neonate during his first 24 hours? A. B. C. D. Administer insulin subcutaneously. Administer a bolus of glucose I.V. Provide frequent early feedings with formula. Avoid oral feedings.

3. Which finding is considered normal in a neonate during the first few days after birth? A. B. C. D. Weight loss of 25% Birth weight of 2,000 to 2,500 g Weight loss then return to birth weight Weight gain of 25%

4. The physician prescribes clomiphene citrate (Clomid) for a woman who has been having difficulty getting pregnant. When teaching the client about this drug's potential side effects, which of the following would the nurse include in the teaching plan? A. B. C. D. Multiple pregnancies. Increase in spontaneous abortions. Increase in fibrocystic breast disease. Increase in congenital anomalies.

5. 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. B. C. D. Abdominal pain, vaginal bleeding, and a positive pregnancy test Hyperemesis and weight loss Amenorrhea and a negative pregnancy test Copious discharge of clear mucus and prolonged epigastric pain

urinary frequency. which of the following statements by the client indicates to the nurse that the instructions have been successful? A. visits the prenatal clinic because she suspects that she is pregnant. D." D. B. Which of the following client statements indicates to the nurse that the teaching has been successful? . Wear a loose-fitting bra to avoid constricting the milk ducts. B. The nurse teaching the client how to care for her infected breast should include which information? A. A client who tells the nurse that she would like to use the basal body temperature method for family planning receives instructions about the method. Probable. "I'll need to receive a series of estrogen injections after I have the procedure. D. Take antibiotics until the pain is relieved. redness.6. Positive. and fatigue." B. 9. and swelling of her left breast. a client breast-feeding her neonate experiences pain. Predictive. One fingerbreadth above the umbilicus One fingerbreadth below the umbilicus At the level of the umbilicus Below the symphysis pubis 10. C. 8. On the 9th postpartum day. Besides amenorrhea. B. the client tells the nurse that she has experienced nausea and vomiting. "My risk for a multiple births is less with this procedure than with the GIFT procedure. The nurse is assessing a client who gave birth yesterday. three or four embryos will be transferred through the cervix. Where should the nurse expect to find the top of the client's fundus? A. "I know that the chances of getting pregnant with this procedure are about 50%. Use a warm moist compress over the painful area. "After fertilization." 7. A 20-year-old client. D. C. She's diagnosed with mastitis. The nurse determines that the client has been experiencing signs of pregnancy categorized as which of the following? A. After the nurse instructs a client who is scheduled for in vitro fertilization (IVF) about the procedure. Presumptive. C." C. Stop breast-feeding permanently. having missed one menstrual period.

tells the nurse that she has been vomiting after breakfast nearly every morning. "Because this method is not very effective. C. intercourse is safe during an uncomplicated pregnancy. ovulation has occurred. Throughout the pregnancy. B. C." 11. Although sexual desire may change. "It's important to take my temperature at about the same time every morning before arising. "Can my partner and I still engage in sexual intercourse while I'm pregnant?" The nurse's response is based on which of the following? A. The nurse is using Doppler ultrasound to assess a pregnant woman. The couple should refrain from engaging in sexual intercourse during the last trimester. C. To To To To prevent urine retention relieve lower back pain tone the abdominal muscles strengthen the perineal muscles 12. What's the purpose of these exercises? A. Eating dry. the nurse instructs the client to do Kegel exercises. Drinking a carbonated beverage before bedtime. 11 weeks pregnant. 7 weeks 11 weeks 17 weeks 21 weeks 14." C. The nurse is helping to prepare a client for discharge following childbirth. D." B. A client asks. Engaging in intercourse must be avoided until the client is at least 16 weeks pregnant. D. Increasing her intake of high-fat foods. Limiting fluid intake between meals. B.A. unsalted crackers before arising. When should the nurse expect to hear fetal heart tones? A. D. D. "When my temperature remains elevated for 7 days. 13. The client. I should use other forms of contraception too. During a teaching session. "Taking my temperature in the evening just after dinner or before I go to bed is best. B. Which of the following measures should the nurse suggest to help the client cope with early morning nausea and vomiting? A. coitus interruptus is the preferred method for sexual activity. . B." D. C.

"Vitamin C is required to promote blood clot and collagen formation." C. The nurse is caring for a client who is on ritodrine therapy to halt premature labor. B. D." 19. B. "Eating moderate amounts of foods high in vitamin C helps metabolize fats and carbohydrates. C. "Supplemental vitamin C in large doses can prevent neural tube defects. the nurse would instruct the client to take the iron with which of the following to promote maximum absorption? A. Adolescents are prone to which complication during pregnancy? A. When explaining to a pregnant client about the need to take supplemental vitamins with iron during her pregnancy. C. Tea. C. The nurse is planning care for a 16-year-old client in the prenatal clinic. What condition indicates an adverse reaction to ritodrine therapy? A. 17. Hypoglycemia Crackles Bradycardia Hyperkalemia 20. C. D. B.15. which of the following client . The nurse is caring for a 16-year-old pregnant client. B. Milk. After giving instruction about strategies to decrease the discomfort. "Studies have shown that vitamin C helps the growth of fetal bones. Iron deficiency anemia Varicosities Nausea and vomiting Gestational diabetes 16." D. Hot chocolate. Which of the following would be the nurse's best response? A. A pregnant client tells the nurse that she has been having discomfort from her hemorrhoids." B. D. Orange juice. A A A A glass of milk cup of hot tea liquid antacid glass of orange juice 18. D. What should this client drink to increase the absorption of iron? A. The client is taking an iron supplement. A client asks the nurse why vitamin C intake is so important during pregnancy.

" can take a bath daily but should be careful not to fall." 21." 23." B." D. "I can lie in any comfortable position. What nonpharmacologic intervention should the plan include to halt premature labor? A. "I "I "I "I can continue to swim as long as my membranes aren't ruptured. B." C. The nurse is developing a care plan for a client in her 34th week of gestation who is experiencing premature labor. which of the following client statements indicates that the teaching has been successful? A. "You won't need to come in and check on me while I'm wearing this monitor. C." be sure to change positions frequently during the day. After the nurse instructs a pregnant client about swimming and bathing during pregnancy. When the nurse instructs a pregnant client with a history of varicose veins about strategies to promote comfort. "I'll "I'll "I'll "I'll avoid straining to have a bowel movement. which of the following client statements indicates the need for additional teaching? A. "I know that the external monitor increases my risk of a uterine infection." 22." 25." stop using my prescribed iron supplements. Which instruction should the nurse include in the discharge teaching plan? . C. D. but I should stay off my back. C. Encouraging ambulation Serving a nutritious diet Promoting adequate hydration Performing nipple stimulation 24.statements would alert the nurse to the need for additional instruction? A. D." use warm sitz baths frequently during the day." can relax in a hot tub for about 20 minutes after swimming. B. D." "Restricting milk intake may provide some relief. D. A client treated for premature labor is ready for discharge." should avoid sitting in a sauna for prolonged periods. "I'll need to lie perfectly still. B." "Support hose can be put on just before bedtime. Which statement by the client would indicate an understanding of the nurse's teaching? A. B." "Wearing knee-high stockings is better than pantyhose. C. "Lying down with my feet elevated should help. The nurse is caring for a client in her 34th week of pregnancy who wears an external monitor.

C. D.20 28. A pregnant woman states that she frequently ingests laundry starch. Lack of meconium staining Early decelerations in fetal heart rate during contractions An increase in fetal heart rate with fetal scalp stimulation Fetal blood pH less than 7. When assessing the client. D. for which of the following should the nurse be alert? A. 29. D. B. The nurse determines that the client is most likely experiencing which of the following types of abortion? A. Threatened. exhibits bright red vaginal spotting without cervical dilation. C. C. Call the physician if the fetus moves 10 times in 1 hour. B. A primigravida. Her cervix is dilated 8 cm. C. 27. C. B. Her contractions are occurring every 2 minutes. Muscle spasms. The nurse is assessing a woman in labor. The nurse should instruct the client to do which of the following? . Missed. She's irritable and in considerable pain. admitted to the hospital at 12 weeks' gestation complaining of abdominal cramping. Report a heart rate greater than 120 beats/minute to the physician. Deep breathing Shallow chest breathing Deep. Diabetes mellitus. 26. Anemia. D. cleansing breaths Chest panting 30. Increase activity daily if not fatigued. B. Inevitable. Take terbutaline every 4 hours. The nurse is caring for a client in labor. Lactose intolerance. B. What type of breathing should the nurse instruct the woman to use during the peak of a contraction? A. A 26-year-old primigravida visiting the prenatal clinic for her regular visit at 34 weeks' gestation tells the nurse that she takes mineral oil for occasional constipation.A. Complete. D. during waking hours only. Which assessment finding indicates fetal distress? A.

"My baby is coming right now! I feel like I have to push!" An immediate nursing assessment reveals that the head of the fetus is crowning. D. C. Calcium gluconate. A woman in labor shouts to the nurse. C. which nursing intervention would be most appropriate? . B. Phenytoin (Dilantin). B. D. Phenobarbital. Furosemide (Lasix). Take the mineral oil with fruit juice to increase the action of the mineral oil. Gently pulling at the neonate 's head as it's delivered Holding the neonate 's head back until the physician arrives Applying gentle pressure to the neonate 's head as it's delivered Placing the mother in a Trendelenburg position until the physician arrives 34. B. Which of the following would the nurse expect to administer as the drug of choice to a pregnant client with chronic hypertension? A. Avoid mineral oil because it can lead to vitamin C deficiency in pregnant clients. Ensure adequate hydration before the anesthetic is administered. C. D. B. 33. The nurse is caring for a woman receiving a lumbar epidural anesthetic block to control labor pain. Administer oxygen using a mask. C. 35. 32. After asking another staff member to notify the physician and setting up for delivery. D. The nurse is caring for a client who is in labor. Diazepam (Valium). B. What should the nurse do to prevent hypotension? A. Place the woman flat on her back with her legs raised. Methyldopa (Aldomet). D. which nursing intervention is most appropriate? A. Diazepam (Valium). Avoid mineral oil because it interferes with the absorption of fat-soluble vitamins. Administer ephedrine to raise her blood pressure. Which of the following drugs would the nurse expect to administer to the client receiving intravenous magnesium sulfate for pregnancy-induced hypertension if the client develops magnesium toxicity? A.A. Use the mineral oil regularly on a weekly basis to prevent constipation. C. Magnesium sulfate. After the neonate's head is delivered. 31. The physician still isn't present.

B. the nurse tells the client that the usual treatment for partial placenta previa is which of the following? A. C. Tetanic uterine contractions. Perform perineal care after voiding or a bowel movement. Assess blood pressure and pulse every 15 minutes for 1 hour. D. D. boardlike abdomen. B. C. B. D. the tone and location of the client's fundus is: A. C. Checking for the umbilical cord around the neonate 's neck Placing antibiotic ointment in the neonate 's eyes Turning the neonate's head to the side. B. Apply an ice pack to her perineum. C. C. 39. Activity limited to bed rest. Drink plenty of fluids. firm and to the right or left of midline. Which of the following would the nurse most likely expect to find when assessing a pregnant client with abruptio placenta? A. D. D. The nurse is assessing a client on the second postpartum day. Platelet infusion. What should the nurse instruct the woman to do? A. Take a Sitz bath. D. Excessive vaginal bleeding. The client asks the nurse how to relieve pain from her episiotomy.A. B. Premature rupture of membranes. soft and at the level of the umbilicus. C. Immediate cesarean delivery. soft and one fingerbreadth below the umbilicus. Under normal circumstances. Palpate the fundus every 15 minutes for at least 1 hour. 37. 38. Which of the following would the nurse use to assess a client for possible uterine atony after a cesarean delivery? A. B. Rigid. The nurse is caring for a client during the first postpartum day. In explaining the diagnosis. to drain secretions Assessing the neonate for respirations 36. Check the abdominal dressing every 15 minutes for the first hour. firm and two fingerbreadths below the umbilicus. 40. Observe the amount of lochia immediately after delivery. Labor induction with oxytocin. A pregnant client is diagnosed with partial placenta previa. .

use birth control for at least 1 year. make an appointment for follow-up human chorionic gonadotropin (hCG) level monitoring at the end of 1 year. D. the nurse is examining her lower extremities for signs and symptoms of thrombophlebitis. C. During an assessment the next day. C. B. The nurse is caring for a client on her second postpartum day. B. D. decaffeinated coffee and scrambled eggs. Which of the following signs should be assessed? A. D. The nurse should serve this client: A. Increased serum calcium levels. Glycosuria. apple juice and oatmeal. Hyperkalemia. Show videotapes about neonate care. 43. wait 1 month before trying to become pregnant again. red and moderate. 46. D. discuss options for sterilization with the physician. Decreased hematocrit level. tea and gelatin dessert. Distribute literature with photographs of neonate-care skills. B. The nurse should instruct the client to: A.41. B. Chadwick's sign Hegar's sign Homans' sign Goodell's sign 42. 44. D. The nurse is caring for a client after evacuation of a hydatidiform molar pregnancy. When monitoring the laboratory studies of a pregnant client receiving terbutaline (Brethine) therapy. which of the following would lead the nurse to suspect that the client's blood plasma volume has increased? A. A 23-year-old primigravida delivers a healthy 3090. Focus on the behavior of their own neonate. 45. A client with hyperemesis gravidarum is on a clear liquid diet. C. The nurse should expect the client's lochia to be: A. milk and ice pops. What's the best way to teach new parents about the care of their neonate? A. Relate stories of other parents' experiences. B.1-g boy by vaginal delivery. B. continuous with red clots. C. . C.

B." vary the times of day when I exercise. 47." END OF OBSTETRICAL NURSING PRACTICE EXAM PART 1 COMPLETE VERSION WITH RATIONALES IS AVAILABLE FOR . "I "I "I "I know know know know I I I I need need need need to to to to walk with a friend or family member. Using a peri bottle to clean the perineum after each voiding or bowel movement B. A woman in her 8th month of pregnancy is having dinner with her husband at their favorite restaurant." exercise before meals. The nurse is responsible for teaching the client about exercise during her pregnancy. brown and scant. B. B. C. What would be the best action by a nurse sitting at the next table? A. thin and white. Which activity indicates that the client understands proper perineal care? A. The woman suddenly chokes on a piece of chicken and appears to lose consciousness.C." drink fluids while I walk. The external fetal monitor shows a pattern of variable decelerations in fetal heart rate. Check for placenta previa. C. Which of the following statements indicates that the client has an appropriate understanding of her exercise needs? A. Reposition the client on her side. D. Apply abdominal thrust. D. 48. Administer oxygen. Begin cardiopulmonary resuscitation (CPR). A client with type 1 diabetes mellitus is pregnant for the second time. Change the client's position. C. The nurse is caring for a client in labor. 50. Changing perineal pads every 8 hours 49. D. Spraying water from peri bottle into the vagina D. Prepare for emergency cesarean delivery. D. Her previous pregnancy ended in spontaneous abortion at 18 weeks' gestation. What should the nurse do first? A. The nurse is teaching a client how to perform perineal care to reduce the risk of puerperal infection. She's now at 22 weeks' gestation. Apply chest thrust. Cleaning the perineum from back to front after a bowel movement C.

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