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1. The nurse completes a focused assessment on a client who reports migraine headaches.
Which items identified in the assessment would the nurse recommend the client change
in an attempt to decrease the incidence of migraine headaches? Select all that apply.
A) Consumes large quantities of aged cheeses and saltyabirb.com/test
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B) Drinks 3 to 4 glasses of wine in the evening
C) Uses a combined oral contraceptive pill
D) Keeps consistent bedtime and wake-up time abirb.com/test
E) Practices yoga three times a week

2. A 20-year-old client got married and started taking combined oral contraceptives 6
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months ago. Three months ago, the client started experiencing migraine headache
immediately before her menstrual period. The client noted that she never had these
headaches prior to marriage. Her mother told her that theabirb.com/test
headaches were from the stress
of her new husband, new home, and new job. What response by the nurse is most
appropriate in this situation?
A) "Let's talk about other methods of birth control that might work for you."
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B) "Let's find a medication that will help to decrease the distress caused by the
headaches."
C) "Your mother is probably right; hopefully the stress will decrease over time."
D) "You should try yoga and relaxation exercises to restore your emotional balance."
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3. The nurse is counseling a client who has a history of migraine headaches with auditory
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aura about contraception options. Which form of contraception is contraindicated in the
client with migraine headaches?
A) The estrogen patch
B) A female condom abirb.com/test
C) The mini-pill
D) A diaphragm
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4. The client describes headaches that are located on one side of the head with a pulsing
quality. The headaches are accompanied by photophobia, phonophobia, and
nausea/vomiting. They last from 4 hours to several days.abirb.com/test
The nurse recognizes these
symptoms are consistent with which type of headache?
A) Migraine headache
B) Hypnic headache
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C) Cluster headache
D) Stress headache

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5. A client has been experiencing headaches for the past 6 months. The nurse reviews the
client's activity diary from the past 2 months. Which of the client's symptoms are
consistent with the prodrome phase of a migraine headache? Select all that apply.
A) Constipation abirb.com/test
B) Food cravings
C) Neck stiffness
D) Frequent yawning abirb.com/test
E) Visual disturbances

6. A client at 39 weeks' gestation is brought to labor and delivery by ambulance. The EMT
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reports that the client is contracting every 2 minutes and that the contractions are strong
to palpation. The nurse inspects the client's perineum. Which findings would the nurse
communicate to the health care provider as evidence of an imminent birth? Select all
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that apply.
A) Perineum is bulging
B) Fetal head is visible
C) Client has the urge to push abirb.com/test

D) Amniotic membranes have ruptured

E) Client is incontinent
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7. A client experienced the onset of strong, frequent uterine contractions 90 minutes ago.
As the client arrives at the hospital she screams, "I have to push…the baby is
coming…help me!" The nurse takes the client to a room. What equipment will the nurse
ask be brought into the room immediately? abirb.com/test

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A) Birthing kit
B) Postpartum hemorrhage tray
C) Electronic fetal monitor
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D) Birthing ball

8. A patient at 39 weeks' gestation experienced the onset ofabirb.com/test

strong, frequent uterine
contractions 90 minutes ago. As she arrives at the hospital she screams, "I have to
push…the baby is coming…help me!" After the first push the fetus is crowning. The
nurse is aware that this client is at high risk for which complications? Select all that
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apply.
A) Perineal lacerations
B) Cervical lacerations
C) Postpartum hemorrhage abirb.com/test
D) Hypertonic contractions
E) Fecal incontinence
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9. At the beginning of a prenatal visit the nurse asks the client, "Do you feel safe at home
and safe in your relationship?" What is the purpose of this question as a routine part of
the client visit?
A) To let the client know there is help available if she needs it
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B) To identify if the client is at risk for domestic violence
C) To identify if the client needs a referral to social services
D) To let the client know the nurse suspects she is being abused
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10. During the nurse's assessment the above findings are recorded. Which findings from this
assessment are signs of depression? Select all that apply.abirb.com/test
A) Feelings of worthlessness
B) Withdrawal from activities
C) Mismatch between words and expression abirb.com/test
D) Increased fetal activity in the evening
E) Husband buying baby supplies

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11. The nurse observes that a client in her third trimester is unhappy and withdrawn. The
nurse suggests the client attend a newborn class at the community center. The client
refuses. Which statement made by the client would be most indicative that the client is
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depressed?
A) "I am too tired."
B) "I am going to have my mother's help with the baby."
C) "I have experience caring for newborns." abirb.com/test

D) "I don't like group classes."

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12. The nurse is giving a transition-of-care report to the nurse coming on duty. Based on the
above report, what would cause the nurse to be prepared for shoulder dystocia during
the delivery? Select all that apply.
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A) Maternal obesity
B) Female gender
C) Gestational diabetes
D) Previously delivered a 9 lb (4.1 kg) infant abirb.com/test
E) Prolonged second stage

13. Which actions should the nurse take when asked to applyabirb.com/test
suprapubic pressure during a
birth with shoulder dystocia? Select all that apply.
A) Apply downward pressure just above the pubic bone.
B) Apply pressure between contractions. abirb.com/test
C) Apply pressure at an angle toward the face of the fetus.
D) Apply pressure with the contractions.
E) Apply downward pressure on the fundus of the uterus.
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14. A shoulder dystocia situation is called in room 4. The nurse enters the room to help and
the health care provider says to the nurse, "McRoberts maneuver." What does the nurse
do next? abirb.com/test
A) Bring the client's knees back toward the shoulders, causing hyperflexion of the hips
and rotation of the pubic symphysis
B) Move the client into a hands-and-knees position, to abirb.com/test
straighten the sacral curve and
release the posterior shoulder
C) Apply downward pressure above the pubic bone of the client, in an attempt to
rotate the anterior shoulder
D) Push the fetal head back into the uterus and prepareabirb.com/test
the client for cesarean birth

15. The client pushes and the baby's head emerges. External abirb.com/test
rotation begins, but the baby's
chin is drawn back just inside the vagina. The nurse recognizes that additional providers
are needed in the delivery room. What emergency protocol does the nurse call?
A) Shoulder dystocia
B) Fetal macrosomia abirb.com/test

C) Nuchal cord
D) Cephalopelvic disproportion
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16. At birth, a neonate is diagnosed with brachial plexus palsy. The parent asks how the
nurse knows the baby's positioning of the arm is a result of the palsy and not just a
preferred position. The nurse would show the parent thatabirb.com/test
the neonate has asymmetry of
which neonatal reflex?
A) Moro reflex
B) Stepping reflex abirb.com/test
C) Rooting reflex
D) Babinski reflex
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17. A neonate has an injury to the brachial plexus. Which of the following conditions is a
result of a brachial plexus injury?
A) Erb palsy abirb.com/test
B) Bulbar palsy
C) Cerebral palsy
D) Bell palsy
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18. A neonate is diagnosed with Erb's palsy after birth. The parents are concerned about
their baby's limp arm. The nurse explains the baby will be scheduled to receive what
recommended treatment for this condition?
A) Physical therapy to the joint and extremity abirb.com/test
B) Nothing but time and let nature take its course
C) Surgery to correct the joint and muscle alignment
D) Immobilization of the shoulder and arm abirb.com/test

19. The nurse inspects the client's perineum and finds it is red, swollen, and tender. The
nurse explains to the client that she needs to be monitored for blood loss, especially
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because of bleeding into the tissue of the perineum because of the third degree
laceration sustained while giving birth. What parameters will the nurse assess to detect
signs of additional blood loss? Select all that apply. abirb.com/test
A) Urine output
B) Blood pressure
C) Pulse rate
D) Uterine fundus abirb.com/test

E) Amount of lochia

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20. Eight hours after delivery, the client is found to have a perineal hematoma. The health
care provider prescribes insertion of a Foley catheter. The client does not understand
why she needs a catheter, because she has voided twice since giving birth. Which
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responses by the nurse explains the need for a Foley catheter? Select all that apply.
A) "If you are bleeding into the tissue, the hematoma may put pressure on the urethra,
making it impossible for you to void."
B) "As the hematoma gets larger or if it extends into the vagina, it will be much harder
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to place the catheter later."
C) "The hematoma can get larger and place pressure on your kidneys and decrease the
amount of urine produced."
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D) "The Foley catheter is necessary to keep the blood out of your bladder and from
contaminating your urine."
E) "A Foley catheter will decrease the risk of developing a urinary infection while we
are monitoring the condition of the perineum." abirb.com/test

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Answer Key
1. A, B, C
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2. A
3. A
4. A
5. A, B, C, D abirb.com/test
6. A, B
7. A
8. A, B, C
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9. A
10. A, B, C
11. A
12. A, E abirb.com/test
13. A, B, C
14. A
15. A
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16. A
17. A
18. A
19. A, B, C abirb.com/test
20. A, B

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