OB/PEDIA WORKBOOK b. Explain the surgery 1-2 hours before it is carried out. b.
ours before it is carried out. b. Button the child’s coat and blouse.
1. The nurse expects a well-developing 3-month-old infant to be
able to perform which of the following motor skill? *
a. Bangs objects held in hand
b. Looks and plays with own fingers
c. Begins to grab objects using pincer grasp
d. Grabs objects using a palmar grasp
2. A mother complains that her 3-year-old toddler is acting out.
She asks the nurse what a good form of discipline would be for
her son, to which the nurse replied a “time-out” for the child.
Which statement regarding a time-out is most accurate? *
a. Children should not be expected to sit still until they are in
school
b. The child should sit still for as many minutes as he
misbehaved
c. The child should sit still at a time-out for as many minutes as
his age in years
d. The child should be able to read a book during time-out
3. To be able to provide tactile stimulation to a 10-month-old
child, the nurse should: *
a. Swaddle the child at nap time
b. Let the child squash and mash food while sitting in a high
chair
c. Caress the child while diaper changing
d. Give the child a soft squeeze toy
4. A first-time mother asks the clinic nurse when the best time
their 2-year-old child should be toilet trained. What will be the
most appropriate response of the nurse? *
a. “Children need sphincter control, cognitive understanding of
the task, and the ability to delay immediate gratification.”
b. “Children should be placed on the potty chair often so they
get used to the task and should be rewarded immediately for
staying on the potty chair.”
c. “Children should be ready to toilet train at about 2 years
old.”
d. “First put training pants on your child so the child gets used
to not wearing a diaper.”
5. Daniel Joshua is scheduled for surgery to repair a cleft palate.
The parents ask the nurse manager when they could talk about
the surgery with Daniel Joshua. Based on the child’s
developmental age, the nurse manager’s best response is: *
a. Explain the surgery immediately before it is carried out.
c. Explain the surgery several days before it is carried out.
d. Explain the surgery only when you feel like doing it.
6. A nurse is preparing a 4-year-old boy for surgery. Which
nursing action is appropriate for preoperative teaching based on
Erikson’s developmental stages? *
a. Asking the child how he feels about surgery
b. Allowing the child to listen to music without further
instructions
c. Allowing the child to make a project related to the surgery
d. Having the child put a surgical mask on a doll
7. Which result should a nurse expect if a 4-year-old child’s
visual acuity test is normal for the child’s developmental age? *
a. 10/10
b. 20/20
c. 20/40
d. 40/40
8. When taking an infant’s blood pressure, the nurse should
consider which of the following points? SELECT ALL THAT
APPLY. I. It is best to use an infant cuff on an infant.II. The
cuff used can be a Doppler ultrasound device.III. The reading of
the upper arm should be higher than the thigh.IV. The cuff used
should be no more than two-thirds of the length of the upper
arm.V. A similar reading on the arm and the thigh could
indicate coarctation of the aorta. *
a. I, II, IV, V
b. I, II, III
c. I, II, IV
d. I, II
9. How should a nurse weight a 22-month-old child who can
walk independently? *
a. All infants until the age of 2 years should be weighed using
an infant scale.
b. Ask the mother which would be best for the child.
c. A standing scale should be used because the toddler is able
to stand independently.
d. Have the mother weigh herself and then weigh herself
holding her child. Then subtract the mother’s weight from the
combined child and mother’s weight.
10. How can a mother promote autonomy in a 4-year-old
child? *
a. Praise the child’s attempts to dress herself.
c. Discourage the child’s choice of clothing.
d. Tell the child when the combination of clothes is not
appropriate
11. The mother of a preschooler reports that her child creates a
scene every night at bedtime. The nurse and the mother decide
that the best course of action would be to do which of the
following? *
a. Encourage active play before bedtime.
b. Allow the child to stay up later one or two nights a week.
c. Establish a set bedtime and follow a routine.
d. Give the child a cookie if bedtime is pleasant.
12.. The mother tells the nurse that her 8-year-old child is
continually telling jokes and riddles to the point of driving the
other family members crazy. The nurse should explain this
behavior is a sign of: *
a. Excessive television watching
b. Inadequate parental attention.
c. Inappropriate peer influence.
d. Mastery of language ambiguities.
13. Parents of a 15-year-old state that he is moody and rude.
The nurse should advise his parents to: *
a. Talk to other parents of adolescents
b. Obtain family counseling
c. Restrict his activities
d. Discuss their feelings with their child
14. Which actions by the parents of an 8-month-old child would
alarm the nurse that further teaching is needed for prevention of
childhood accidents? *
a. Inspecting toys for loose parts.
b. Placing a fire screen in front of the fireplace.
c. Placing a car seat in a front-seat, front-facing position.
d. Placing toxic substances out of reach or in a locked cabinet
MATERNAL HEALTH 1
1. Which client should the postpartum nurse assess first after
receiving the a.m. shift report? *
a. The client who is complaining of perineal pain when
urinating.
b. The client who saturated multiple peri-pads during the night.
c. The client who is refusing to have the newborn in the room.
d. The client who is crying because the baby will not nurse.
2. Which newborn infant would warrant immediate intervention
by the nursery nurse? *
a. The 1-hour-old newborn who has abundant lanugo.
b. The 6-hour-old newborn whose respirations are 52.
c. The 12-hour-old newborn who is turning red and crying.
d. The 24-hour-old newborn who has not passed meconium.
3. The nurse working in a women’s health clinic is returning
telephone calls. Which client should the nurse contact first? *
a. The 16-year-old client who is complaining of severe lower
abdominal cramping.
b. The 27-year-old primigravida client who is complaining of
blurred vision.
c. The 48-year-old perimenopausal client who is expelling
dark-red blood clots.
d. The 68-year-old client who thinks her uterus is falling out of
her vagina.
4. The postpartum unit nurse should immediately attend to
which client? *
a. The client whose white blood cell count is 18,000 mm3.
b. The client whose serum creatinine level is 0.8 mg/dL.
c. The client whose platelet count is 410,000 mm3.
d. The client whose serum glucose level is 280 mg/dL.
5. The nursery nurse needs to immediately attend to which
newborn infant? *
a. The 3-hour-old newborn who weighs 6 pounds and 2 ounces.
b. The 4-hour-old newborn delivered at 44 weeks’ gestation.
c. The 6-hour-old newborn who is 22 inches long.
d. The 8-hour-old newborn who was born at 40 weeks’
gestation.
6. The nurse instructed the unlicensed assistive personnel
(UAP) to provide a sitz bath to the postpartum client with
hemorrhoids. Which priority intervention should the nurse
implement? *
a. Document the sitz bath in the client’s nurse’s notes.
b. Follow-up to ensure the UAP gave the sitz bath.
c. Assess the client’s hemorrhoids every 4 hours.
d. Discuss the importance of not getting constipated
7. The 36-week gestational client has just delivered a stillborn
infant. Which intervention should the nurse implement? *
a. Call the sudden infant death syndrome (SIDS) support group.
b. Refer the client to the maternal child case manager.
c. Notify the hospital chaplain of the fetal demise.
d. Contact Child Protective Services.
8. Which primigravida client would warrant immediate
intervention by the nurse? *
a. The 12-week gestation client complaining of nausea and
vomiting.
b. The 24-week gestation client complaining of ankle edema.
c. The 32-week gestation client reporting of facial edema.
d. The 38-week gestation client reporting urinary frequency.
9. After AM endorsements, the nurse in the labor and delivery
unit will prioritize which client? *
a. The client who is 10 cm dilated and 100% effaced.
b. The client who is exhibiting early decelerations on the fetal
monitor.
c. The client who is vacillating about whether or not to have an
epidural.
d. The client who is upset because her obstetrician is on
vacation.
10. The nurse is caring for clients in a women’s health clinic.
Which client warrants intervention by the nurse? *
a. The pregnant client who has hematocrit and hemoglobin
levels of 40% and 13 g/dl respectively.
b. The pregnant client who has a fasting blood glucose level of
110 mg/dL.
c. The pregnant client who has 3+ proteins in her urine.
d. The pregnant client who has a white blood cell count of
9,500 mm3
MATERNAL HEALTH 2
1. A nurse is taking the health history of a new, pregnant client.
Which medical conditions are most likely to be risk factors for
complications during pregnancy? SELECT ALL THAT
APPLY. i. Controlled chronic hypertension ii. Diabetes iii.
Anemia iv. Hemorrhage with a previous pregnancy v. Previous
pregnancy  a. Measure the woman’s abdominal girth
a. II, III, IV
b. II, III, V
c. I, II, III, IV
d. I, II, III, IV, V
2. A pregnant woman asks a nurse, who is teaching a prepared
childbirth class, when she should expect to feel fetal movement.
The nurse’s correct response would between: *
a. 22 and 26 weeks of pregnancy
b. 18 and 20 weeks of pregnancy
c. 12 and 16 weeks of pregnancy
d. 8 and 12 weeks of pregnancy
3. A nurse is caring for a 30-year-old client whose pregnancy
history is as follows: elective termination in 2001, spontaneous
abortion in 2005, term vaginal delivery in 2010, and currently
pregnant again. Which documentation by the nurse of the
client’s gravity and parity is correct? *
a. G2P1
b. G3P1
c. G4P1
d. G4P2
4. A client with gravida 3 para 2 (G3P2) at 40 weeks’ gestation
is admitted with spontaneous contractions. The physician
performs an amniotomy to augment her labor. The priority
nursing action is to: *
a. position the client in a lithotomy position to administer
perineal care.
b. explain the rationale for the amniotomy to the client.
c. assess fetal heart tones after the amniotomy.
d. ambulate the client to strengthen the contraction pattern.
5. A 25-year-old woman asks a clinic nurse when her due date
will be. Her last menstrual period was 3 months ago, which
began on 11/21. She has a positive urine pregnancy test. Using
Naegele’s rule, when is the patient’s expected date of
confinement (EDC)? *
a. 1/28
b. 8/28
c. 8/15
d. 1/15
6. A 32-week-pregnant client asks how the nurse will determine
if the baby is “really okay.” Based on evidences, which
assessment during the third trimester should the nurse perform
to evaluate adequate growth and viability of the fetus? *
b. Complete a third-trimester ultrasound
c. Auscultate maternal heart tones
d. Measure fundal height
7. When assessing a pregnant woman is at 20 weeks gestation,
at what level does she expect the client’s uterine height to be? *
a. Two finger-breadths above the symphysis pubis
b. Halfway between the symphysis pubis and the umbilicus
c. At the umbilicus
d. Two finger-breadths above the umbilicus
8. A nurse is assessing the fundal height for multiple pregnant
clients. For which client should the nurse conclude that a fundal
height measurement is most accurate? *
a. A pregnant client who is obese
b. A pregnant client with polyhydramnios
c. A pregnant client with uterine fibroids
d. A pregnant client experiencing fetal movement
9. A client comes in to the clinic to have her first prenatal visit.
Which universal screenings should a nurse be able to complete
at this time? Select all that apply. i. Testing the urine for protein
ii. Taking the blood pressure iii. Screening for domestic
violence iv. Screening for smoking v. Testing the urine for
glucose *
a. I, II, V
b. I,II, III, IV,V
c. II, IV, V
d. I, III, IV
10. A pregnant client visits the hospital for her first prenatal
visit with the following laboratory results. Which among these
would alert the nurse? *
a. Pap smear: Negative; human papillomavirus (HPV) changes
noted
b. White blood cells (WBCs): 7,000/mm3
c. Hematocrit: 36.5%
d. Urine pH: 7.4
11. A 16-week-pregnant client shows to you her positive result
of a quadruple screen for Down’s syndrome. What diagnostic
test do you expect to be ordered to confirm the diagnosis? *
a. Level II ultrasound
b. Chorionic villus sampling (CVS)
c. Amniocentesis
d. Nuchal translucency testing
12. A nurse is reviewing the laboratory results of a pregnant
client. Which among these values is considered abnormal for a
pregnant woman?Laboratory test (Result) Hemoglobin (10.6
g/dL) Indirect Coombs’ test (Negative) 50-gram 1-hour glucose
test (137) Glycosuria (Negative)Proteinuria (Trace)
a. 50-gram 1-hour glucose test
b. Hemoglobin
c. Glycosuria
d. Proteinuria
13. A G1P0 client shows up at a clinic and states that she is
anxious regarding her pregnancy, her prenatal care, and her
labor and birth. What would be then nurse’s priority teaching
during the first trimester? *
a. Fetal growth and development
b. Sexual relations with her spouse
c. Labor and delivery options
d. Completion of preparations for the baby
14. A first-time pregnant client has a jetsetter lifestyle. She
wishes to travel by airplane during the first 36 weeks of her
pregnancy. The client will be at risk for which primary
condition if she wishes to air travel? *
a. Preterm labor
b. Deep vein thrombosis
c. Spontaneous miscarriage
d. Nausea and vomiting
15. Which among these activities are considered safe for a first-
trimester pregnant client? *
a. Sexual activity
b. Sauna use
c. Hair coloring
d. Hot tub use
16. A nurse is assessing a pregnant woman during a prenatal
visit. Several presumptive indicators of pregnancy are
documented. Which of the following are presumptive
indicators? Select all that apply. i. Hegar’s sign ii. Amenorrhea
iii. Nausea and vomiting iv. Quickening v. Ballottement vi.
Palpation of fetal movement by the nurse *
a. I, V
b. II,III, IV
c. II, III, IV, V
d. I, II, V
17. A woman at 30 weeks of gestation assumes a supine
position for a fundal measurement and Leopold’s maneuvers.
She begins to complain about feeling dizzy and nauseated. Her
skin feels damp and cool. The nurse’s first action would be to: *
a. elevate the woman’s legs 20 degrees from her hips.
b. assess the woman’s respiratory rate and effort.
c. turn the woman on her side.
d. provide the woman with an emesis basin.
18. The nurse evaluates a pregnant woman’s knowledge about
prevention of urinary tract infections at the prenatal visit
following a class on infection prevention that the woman
attended. The nurse would recognize that the woman needs
further instruction when she tells the nurse about which one of
the following measures that she now uses to prevent urinary
tract infections? Select all that apply. i. “I should stop having
intercourse with my partner since it increases my risk for
urinary tract infections.” ii. “I have started wearing panty hose
and underpants with a cotton crotch.” iii. “I have yogurt for
lunch or as an evening snack.” iv. “I drink about 1 quart of fluid
a day.” v. “I have stopped using bubble baths and bath oils.” *
a. II, III, V
b. I, III
c. I, IV
d. IV
19. What is the suggested weight gain for a pregnant woman
who had an ideal weight before becoming pregnant? *
a. Less than 15 lb
b. 15–25 lb
c. 25–35 lb
d. 35–45 lb
20. What preconceptal supplement will prevent incidence of
neural tube defects? *
a. Vitamin B9 supplement
b. Iron supplement
c. Vitamin C supplement
d. Vitamin B6 supplement
MATERNAL HEALTH 3
1. When does a nurse consider the fetus head has already
engaged? *
a. the biparietal diameter passes the pelvic inlet
b. the presenting part moves through the pelvis.
c. the fetal head rotates to pass through the ischial spines.
d. the fetal head extends as it passes under the symphysis
pubis.
2. A mother active phase of labor has a reactive fetal monitor
strip and has been encouraged to walk. When she returns to bed
for a monitor check, she complains of an urge to push. The
nurse notes rupture of membranes (ROM) and that she can
visualize the umbilical cord. What would be the appropriate
action of the nurse? *
a. Push down on the uterine fundus.
b. Put the client in a knee-to-chest position.
c. Call the physician or midwife.
d. Arrange for fetal blood sampling to assess for fetal acidosis
3. A client in the 28th week age of gestation (AOG) comes to
the emergency department thinking she’s in labor. To confirm
diagnosis of preterm labor, the nurse would expect the physical
examination to reveal: *
a. irregular uterine contractions with no cervical dilation.
b. painful contractions with no cervical dilation.
c. regular uterine contractions with cervical dilation.
d. regular uterine contractions with no cervical dilation
4. Before starting a titrated infusion of oxytocin, the nurse
FIRST: *
a. sets the infusion pump for the ordered rate.
b. initiates I.V. access.
c. checks the label on the infusion bag for proper
concentration.
d. identifies the client.
5. A mother experiences rupture of membranes while she was in
the second stage of labor. The most appropriate nursing action
to be done is to: *
a. position the client on her left side
b. assess the client’s vital signs immediately.
c. administer oxygen through a face mask at 6 to 10 L/minute.
d. observe for a prolapsed cord and monitor fetal heart rate
(FHR).
6. A nurse determines that a gestationally diabetic client in
preterm labor has a reactive nonstress test (NST) when which
findings are noted? *
a. The absence of decelerations in a 20-minute period
b. Two FHR accelerations of 20 bpm above baseline for at least
20 seconds in a 20-minute period
c. Two fetal heart rate (FHR) accelerations of 15 beats per
minute (bpm) above baseline for at least 15 seconds in a 20-
minute period
d. A FHR acceleration of 15 bpm above baseline for at least 15
seconds in a 20-minute period
7. A client is induced with oxytocin. The fetal heart rate is
showing accelerations lasting 15 seconds and exceeding the
baseline with fetal movement. What action associated with this
finding should the nurse take? *
a. Notify the health care provider of the situation.
b. Turn the client to her left side.
c. Administer oxygen via facemask at 10 to 12 L/min.
d. Document fetal well-being
8. A laboring client is experiencing dyspnea, diaphoresis,
tachycardia, and hypotension. A nurse suspects aortocaval
compression. How should the nurse position the client
immediately? *
a. Turning the client onto her left side
b. Turning the client onto her right side
c. Reverse Trendelenburg’s position
d. Supine position
9. The nurse is managing care of a primigravida at full term
who is in active labor. What should be included in developing
the plan of care for this client? *
a. Anesthesia/pain level assessment every 30 minutes.
b. Oxygen saturation monitoring every half hour.
c. Supine positioning on back, if it is comfortable.
d. Vaginal bleeding, rupture of membrane (ROM) assessment
every shift.
10. A nurse is caring for a woman who is being evaluated for a
suspected malpresentation. The fetus’s long axis is lying across
the maternal abdomen, and the contour of the abdomen is
elongated. Which should be the nurse’s documentation of the lie
of the fetus? *
a. Breech
b. Transverse
c. Vertex
d. Brow
11. A full-term client is admitted for induction of labor. The
initial goal is cervical ripening prior to labor induction. Which
drug will prepare her cervix for induction and cause the
ripening? *
a. Betamethasone
b. Misoprostol
c. Nalbuphine
d. Oxytocin
12. A primigravida client has been pushing for 2 hours when the
head emerges. The fetus fails to deliver, and the physician notes
that the turtle sign has occurred. Which should be a nurse’s
interpretation of this information? *
a. Cephalopelvic disproportion
b. Persistent occiput posterior position
c. Shoulder dystocia
d. Cord prolapse
13. The cervix of a primigravid client in active labor who
received epidural anesthesia 4 hours ago is now completely
dilated, and the client is ready to begin pushing. Before the
client begins to push, the nurse should assess: *
a. Cervical dilation again.
b. Fetal heart rate variability.
c. Status of membranes.
d. Bladder status
14. In response to a pregnant client’s wish to have only minimal
interventions for pain relief, the OBGYN recommends a
procedure of injecting perineal anesthesia into the pudendal
plexus for pain relief during the second stage of labor, birth, and
episiotomy repair. The nurse anticipates which type of
anesthesia to be administered? *
a. Pudendal block
b. Epidural anesthesia
c. Systemic analgesia
d. Local infiltration anesthesia
15. A client on 24th week of gestation presents with regular
contractions that she describes as strong in intensity. Her
cervical exam indicates that she is dilated to 3 cm. This
information should suggest to a nurse that the client is
experiencing: *
a. Lightening
b. Cervical ripening
c. Early labor
d. False labor
16. The nurse is caring for a client in labor and is monitoring
the fetal heart rate patterns. The nurse notes the presence of
episodic accelerations on the electronic fetal monitor tracing.
Which action is most appropriate? *
a. Take the mother’s vital signs and tell the mother that bed rest
is required to conserve oxygen
b. Reposition the mother and check the monitor for changes in
the fetal tracing.
c. Notify the health care provider of the findings.
d. Document the findings and tell the mother that the pattern on
the monitor indicates fetal well-being.
17. After teaching on true and false labor with a multiparous
patient, the nurse evaluates that the patient understands the
signs of true labor if she says which of the following? *
a. “My contractions will be felt in my abdominal area.”
b. “My contractions will not be as painful if I walk around.”
c. “My contractions will increase in duration and intensity.”
d. “I won’t be in labor until my baby drops.”
18. A client on labor has been pushing effectively for an hour
already. What is the client’s priority physiologic need at this
time? *
a. Ambulation
b. Changing positions frequently
c. Rest between contractions
d. Consuming oral food and fluids
19. A client who is in the second stage of labor for the last 12
hours is in the unit. The nurse DOES NOT expect which of the
following cardiovascular change to occur during labor? *
a. A decrease in cardiac output
b. An increase in peripheral vascular resistance
c. An increase in maternal heart rate
d. A decrease in the uterine artery blood flow during
contractions
20. A nurse has been advised by a laboring client that she wants
to avoid an episiotomy if possible. The nurse’s response should
be based on which recommendation related to an episiotomy? *
a. Episiotomies should not be performed in modern clinical
practice.
b. Routine use of episiotomy reduces prolonged pushing and
perineal trauma.
c. Routine episiotomy can prevent pelvic floor damage.
d. Restricted use of episiotomy is preferred.
21. A nurse is about to obtain a fetal heart rate (FHR) of a
pregnant client for possible labor. When preparing to auscultate
the FHR, she uses which information as basis for correct
placement? *
a. Presence of contractions
b. Fetal position
c. Position of the placenta
d. Whether ultrasonic gel should be used
22. A night nurse has admitted multiple maternity clients with
various fetal presentations. Which fetal presentations, if
unchanged, would require the nurse to prepare for cesarean
sections? SELECT ALL THAT APPLY. i. Single footling
breech ii. Double footling breech iii. Frank breech iv. Shoulder
presentation v. Brow presentation vi. Face presentation (with
posterior mentum) *
a. I, II, III, V, VI
b. II, IV, V, VI
c. I, II, IV, V, VI
d. I, II, III, IV, V, VI
23. A patient on preterm labor is given betamethasone to
produce which of the following expected outcome? *
a. The client will give birth to a neonate without infection.
b. The neonate will be born with mature lungs
c. The client will give birth to a full-term neonate.
d. The contractions will end within 24 hours.
24. The nurse is reviewing the record of a client in the labor
room and notes that the health care provider has documented
that the fetal presenting part is at the –1 station. This
documented finding indicates that the fetal presenting part is
located at which area? *
a. 1 inch below the iliac crest
b. 1 inch below the coccyx
c. 1 cm above the ischial spine
d. 1 fingerbreadth below the symphysis pubis
25. The nurse is monitoring a client in labor. The nurse suspects
umbilical cord compression if which is noted on the external
monitor tracing during a contraction? *
a. Variability
b. Variable decelerations
c. Accelerations
d. Early decelerations
26. The primary physician orders an amniocentesis for a
primigravid client at 35 weeks' gestation in early labor to
determine fetal lung maturity. Which of the following is an
indicator of fetal lung maturity? *
a. Barr body determination.
b. Amount of bilirubin present.
c. Lecithin-sphingomyelin (L/S ratio)
d. Presence of red blood cells.
27. How should a nurse position a client for cesarean
delivery? *
a. Trendelenburg’s position with the legs in stirrups
b. Prone position with the legs separated and elevated
c. Supine position with a wedge under the right hip
d. Semi-Fowler’s position with a pillow under the knees
28. Which finding following an amniotomy should be assessed
for first? *
a. Cervical dilation
b. Bladder distention
c. Fetal heart rate pattern
d. Maternal blood pressure
29. Approximately 15 minutes after birth of a viable term
neonate, a multiparous client has chills. Which of the following
should the nurse do next? *
a. Assess the client's pulse rate.
b. Decrease the rate of intravenous fluids.
c. Provide the client with a warm blanket.
d. Assess the amount of blood loss
30. Which of the following signs would indicate to the nurse
that the placenta is about to be delivered? *
a. There is decreased vaginal bleeding.
b. The uterus cannot be palpated.
c. The cord lengthens outside the vagina.
d. Uterus changes to discoid shape.
31. A nurse notices repetitive late decelerations on the fetal
heart monitor. The best initial actions by the nurse would be: *
a. Prepare for birth, reposition patient, and begin pushing.
b. Reposition patient, apply oxygen, and increase IV fluids
c. Perform sterile vaginal exam, increase IV fluids, and apply
oxygen.
d. Notify the provider, explain findings to the patient, and
begin pushing.
POSTPARTAL NURSING CARE
1. A postpartal client looks at the mirror and says, “My stomach
still looks like I’m pregnant!” The nurse explains that the
abdominal muscles, which separate during pregnancy, will do
which of the following? *
a. Regain tone within the first week after birth
b. Regain prepregnancy tone with exercise
c. Remain permanently separated giving the abdomen a slight
bulge
d. Regain tone as the client loses the weight gained during the
pregnancy
2. A postpartum client, who is 24 hours post-vaginal birth and
breastfeeding, asks a nurse when she can begin exercising to
regain her prepregnancy body shape. Which response by the
nurse is correct? *
a. “You will need to wait until after your 6-week postpartum
checkup.”
b. “Once your lochia has stopped you can begin exercising.”
c. “Simple abdominal and pelvic exercises can begin right
now.”
d. “You should not exercise while you are breastfeeding.”
3. Immediately after delivery of the placenta, the nurse palpates
the uterine fundus and finds that it is firm and located halfway
between the client’s umbilicus and symphysis pubis. Based on
the findings, what action would the nurse take? *
a. Monitor the client closely for increased vaginal bleeding
b. Assess for bladder distension
c. Immediately begin to massage the uterus
d. Document the findings
4. It has been 24 hours after a postpartal client had a vaginal
delivery. She complains not having a bowel movement since
before the delivery. The nurse would intervene by doing which
of the following? *
a. Assessing the client’s bowel sounds
b. Notifying the health-care practitioner immediately
c. Administering a laxative that has been ordered on an as
needed basis
d. Documenting the information in the client’s healthcare
records
5. In the process of preparing a client for discharge after
cesarean section, a nurse addresses all of the following areas
during discharge education. Which should be the priority advice
for the client? *
a. Infant care procedures
b. Increased need for rest
c. The need to plan for assistance at home
d. How to manage her incision
6. A postpartum primiparous client is having difficulty breast-
feeding her infant. The infant latches on to the breast, but the
mother's nipples are extremely sore during and after each
feeding. The client needs further instruction about breast-
feeding when she states *
a. “As long as some of my nipple is in the baby's mouth, the
baby will receive enough milk.”
b. “I can put breast milk on my nipples to heal the sore areas.”
c. “The baby needs to have as much of the nipple and areola in
his mouth as possible to prevent sore and cracked nipples.”
d. “Feeding the baby for a half-hour on each side will not make
my breasts sore.”
7. While assisting with the delivery of a term newborn, which
intervention should a nurse anticipate to prevent postpartum
hemorrhage during the third stage of labor? *
a. Application of fundal pressure
b. Clamping the umbilical cord before pulsations stop
c. Administration of intravenous oxytocin
d. Administration of subcutaneous terbutaline sulfate
8. The nurse assesses a swollen ecchymosed area to the right of
an episiotomy on a primiparous client 6 hours after a vaginal
birth. The nurse should next *
a. Apply an ice pack to the perineal area.
b. Assess the client's temperature.
c. Have the client take a warm sitz bath.
d. Contact the physician for prescriptions for an antibiotic.
9. A postpartum client, who delivered a full-term infant 2 days
previously, calls a nurse to her room and states that she is
concerned because her breasts “seem to be growing.” She
reports that the bra she wore during pregnancy is too small. She
asks the nurse what is wrong with her. The nurse’s response
should be based on which of the following statements? *
a. Thrombi may form in veins of the breast and cause increased
breast size.
b. Breast tissue increases in the early postpartum period as milk
forms.
c. Enlarging breasts are a symptom of infection.
d. Increasing breast tissue may be a sign of postpartum fluid
retention.
10. A primiparous client, who is bottle feeding her infant, asks a
nurse when she can expect to start having her menstrual cycle
again. Which response by the nurse is most accurate? *
a. “Your period should return a few days after your lochial
discharge stops.”
b. “You will notice a change in your vaginal discharge from
pink to white; once that happens your period should return
within a week.”
c. “Most women who bottle feed their infants can expect their
periods to return within 6 to 10 weeks after birth.”
d. “Bottle feeding will delay the return of a normal menstrual
cycle until 6 months post-birth.”
11. While assessing a postpartum client who is 10 hours post-
vaginal delivery, a nurse notes a perineal pad that is totally
saturated with lochia. To determine the significance of this
finding, which question should the nurse ask the client first? *
a. “Are you having uterine cramping?”
b. “Are you having any difficulty emptying your bladder?”
c. “When was the last time you changed your peri pad?”
d. “Have you passed any clots?”
12. A grand-multiparous client has just given birth to a large-
for-gestational-age infant. The nurse determines the client's
primary risk is for: *
a. Fluid volume deficit
b. Knowledge deficit
c. Acute pain
d. Ineffective breastfeeding
13. A primiparous client who is beginning to breast-feed her
neonate asks the nurse, “Is it important for my baby to get
colostrum?” When instructing the client, the nurse would
explain that colostrum provides the neonate with *
a. More fat than breast milk.
b. Passive immunity from maternal antibodies
c. Vitamin K, which the neonate lacks.
d. Delayed meconium passage.
14. A client gave birth vaginally 2 hours ago and has a third-
degree laceration. There is ice in place on her perineum.
However, her perineum is slightly edematous, and the client is
having pain rated 6 on a scale of 1 to 10. Which nursing
intervention would be the most appropriate at this time? *
a. Replace ice packs to the perineum.
b. Begin sitz baths.
c. Administer pain medication per prescription.
d. Initiate anesthetic sprays to the perineum
15. In response to the nurse's question about how she is feeling,
a postpartum client states that she is fine. She then begins
talking to the baby, checking the diaper, and asking infant care
questions. The nurse determines the client is in which postpartal
phase of psychological adaptation? *
a. Taking in
b. Taking on
c. Taking hold
d. Letting go
MATERNAL HEALTH 4
1. A client with gestational diabetes entering her third trimester
is learning how to monitor her fetus's movements. After
teaching the client about the kick count, the nurse knows that
further teaching is needed if the client makes which of the
following statements? *
a. “The baby may not move at times because it is asleep.”
b. “The baby should be moving less than 10 times in 2 hours.”
c. “The baby may be more active at different times of the day.”
d. “How I feel my baby move is different than my friend.”
2. When teaching a primigravid client with diabetes about
common causes of hyperglycemia during pregnancy, which of
the following would the nurse include? *
a. Maternal infection
b. Fetal macrosomia
c. Obesity prior to conception
d. Pregnancy-induced hypertension (PIH)
3. At 38 weeks' gestation, a primigravid client with poorly
controlled diabetes and severe preeclampsia is admitted for a
cesarean birth. Ceserean section is necessary to prevent which
complication of the client’s conditions? *
a. Congenital anomalies.
b. Neonatal hyperbilirubinemia.
c. Stillbirth
d. Perinatal asphyxia.
4. A pregnant client with insulin-dependent diabetes asks about
her insulin needs after giving birth. She said she has plans to
breastfeed her child. Which of the following statements about
postpartal insulin requirements for breastfeeding mothers would
the nurse include in her response? *
a. They remain the same as during the labor process.
b. They fall significantly in the immediate postpartum period.
c. They usually increase in the immediate postpartum period.
d. They need constant adjustment during the first 24 hours.
5. A nurse is admitting a full-term pregnant client presenting
with bright red, vaginal bleeding and intense abdominal pain.
Her BP upon admission is 150/96 mm Hg and her pulse is 109
beats per minute. Which problem should the nurse suspect that
the client is likely experiencing? *
a. Placenta previa
b. Abruptio placenta
c. Bloody show
d. Succenturiate placenta
6. When caring for a multigravid client admitted to the hospital d. Dyspepsia
with vaginal bleeding at 38 weeks' gestation, which of the
following would the nurse anticipate administering 11. A 38-year-old pregnant woman has just been told she has
intravenously if the client develops disseminated intravascular hydramnios after undergoing a sonogram for size greater than
coagulation (DIC)? * dates. For which conditions, associated with hydramnios,
a. Warfarin sodium should the nurse assess? SELECT ALL THAT APPLY. i.
b. Dextrose 5% Presence of major congenital anomaly ii. Chronic hypertension
c. Lactated Ringer’s solution iii. Infectioiv. Gestational diabetes v. Preeclampsia *
d. Fresh frozen platelets
7. Another nurse is caring for a 29-weeks-pregnant woman who a. I, II, IV
presents with decreased fetal movement. Her initial blood b. II, IV, V
pressure (BP) reading is 140/90 mm Hg. She states she “doesn’t c. I, II, III
feel well” and her vision is “blurry.” Additional assessment data d. I, III, IV
include +3 reflexes, +2 proteinuria, +2 pedal edema, and puffy
face and hands. What is the most important information that the 12. A pregnant client presents with vaginal bleeding and
nurse should obtain from the client’s prenatal record? * increasing cramping. Her exam reveals that the cervical os is
a. Urine dip stick from last visit open. Which term should the nurse expect to see in the client’s
b. BP at 20 weeks chart notation to most accurately describe the client’s
c. BP at her first prenatal visit condition? *
d. Weight gain pattern
8. A client is attempting to deliver vaginally despite the fact that a. Complete abortion
her previous delivery was by cesarean birth. Her contractions b. Imminent abortion
are 2 to 3 minutes apart, lasting from 75 to 100 seconds. c. Ectopic pregnancy
Suddenly, the client complains of intense abdominal pain, and d. Incomplete abortion
the fetal monitor stops picking up contractions. The nurse
13. A nurse admits a woman with a diagnosis of placenta
recognizes that which of the following has occurred? *
previa. Which symptom is the nurse most likely to assess in a
a. Abruptio placentae
woman with this diagnosis? *
b. Prolapsed cord
a. Painful vaginal bleeding
c. Partial placenta previa
b. Painless vaginal bleeding
d. Complete uterine rupture
c. Contractions
9. A woman presents with vaginal bleeding at 7 weeks. What is d. Absence of fetal movement
the primary nursing intervention for a woman who is bleeding
14. A pregnant client (G7P5) presents after being advised she
during the first trimester? *
has a missed abortion. She tells a nurse that she wants to wait
a. Have oxygen available
and let the pregnancy pass “naturally.” Which length of time
b. Assess family’s response to the situation
should the nurse tell the client is the longest she can wait before
c. Monitor vital signs
having a dilatation and curettage (D&C) after being diagnosed
d. Prepare equipment for examination
with a missed abortion? *
10. A client is receiving magnesium sulfate to help suppress a. 4–6 weeks
preterm labor. The nurse should watch for which sign of b. 72 hours
magnesium toxicity? * c. 6–8 weeks
a. Palpitations d. 24 hours
b. Headache
c. Loss of deep tendon reflexes
15. A pregnant client is concerned because she is now 14 days
over her due date. A nurse should monitor the client for which
most concerning problem for a post-term fetus? *
a. Meconium-stained amniotic fluid
b. Birth trauma
c. Fetal demise
d. Macrosomia
16. A nurse caring for a 30-weeks-pregnant client is having
contraction every 2 minutes with spontaneous rupture of
membranes about 2 hours ago. Her cervix is dilated at 8cm and
100% effaced. The nurse knows that this is an imminent
delivery and should perform which most important action? *
a. Providing teaching information on premature infant care
b. Administering a tocolytic agent
c. Preparing for a cesarean birth
d. Notifying neonatology of the impending birth
17. Which complications should the nurse identify as being
associated with gestational diabetes? SELECT ALL THAT
APPLY. i. Congenital anomalies ii. Seizures iii. Low birth
weight infant iv. Preterm labor v. Large for gestational age
infant *
a. I, II, IV, V
b. I, V
c. I, IV, V
d. I, IV
18. A client who is 20 days postpartum calls the perinatal clinic
nurse to report that she has been having heavy bright red
bleeding since leaving the hospital 18 days ago. What should
the nurse instruct the client to do? *
a. Stop being concerned because this is expected after birth
b. Call again next week if the bleeding has not stopped by then
c. Come to the clinic immediately
d. Decrease physical activity until the bleeding stops
19. A multigravida client with mild preeclampsia should have
which of the following diets? *
a. Low-sodium diet
b. Regular diet
c. High-protein diet
d. High-residue diet
20. After instructing a primigravid client at 38 weeks' gestation
about how preeclampsia can affect the client and the growing
fetus, the nurse realizes that the client needs additional
instruction when she says that preeclampsia can lead to which
of the following? *
a. Abruptio placentae
b. Hydrocephalic infant
c. Intrauterine growth retardation
d. Poor placental transfusion
21. A 18-year-old client at 32 weeks' gestation with mild
preeclampsia is treated as an outpatient. The nurse instructs the
client to contact the health care provider immediately if she
experiences which of the following? *
a. Ankle edema
b. Increased energy levels
c. Blurred vision
d. Mild backache
22. A primigravid client at 38 weeks' gestation diagnosed with
severe preeclampsia is prescribed with magnesium sulfate.
Which of the following medications should the nurse have
readily available at the client's bedside? *
a. Calcium gluconate
b. Phenytoin
c. Diazepam
d. Hydralazine
23. Which of the following should the nurse do FIRST if the
client with sever preeclampsia begins to experience a seizure? *
a. Insert an airway to improve oxygenation
b. Note the time when the seizure begins and ends
c. Call for immediate assistance
d. Turn the client to her left side
24. A nurse has been given a report on a postpartum client that
includes the information that the client suffered a fourth-degree
perineal laceration during her vaginal birth. In response to this
information, which intervention should the nurse add to the
client’s plan of care?
a. Monitor the uterus for firmness every 2 hours.
b. Instruct the client on a high-fiber diet and administer stool
softeners.
c. Limit ambulation to bathroom privileges only.
d. Decrease fluid intake to 1,000 mL every 24 hours.
25. A multigravid client at 34 weeks' gestation visits the
hospital because she suspects that her water has broken. After
testing the leaking fluid with nitrazine paper, the nurse confirms
that the client's membranes have ruptured when the paper turns
which of the following colors? *
a. Yellow
b. Green
c. Blue
d. Red
26. A primigravid client at 34 weeks' gestation is experiencing
contractions every 3 to 4 minutes lasting for 35 seconds. Her
cervix is 2 cm dilated and 50% effaced. While the nurse is
assessing the client's vital signs, the client says, “I think my bag
of water just broke.” Which of the following would the nurse do
first? *
a. Check the status of the fetal heart rate.
b. Turn the client to her right side.
c. Test the leaking fluid with nitrazine paper.
d. Perform a sterile vaginal examination.
27. A client in sickle cell crisis was admitted during her
pregnancy. Which statement by the client requires intervention
from the nurse? *
a. “At the earliest signs of a crisis, I need to seek treatment.”
b. “I have this disease because I don't eat enough food with
iron.”
c. “I will need more frequent appointments during the
remainder of the pregnancy.”
d. “Signs of any type of infection must be reported
immediately.”
28. The nurse assessed a positive Homan sign in a multiparous
client who delivered 24 hours ago. What should the nurse do? *
a. Ask the client to ambulate around the room.
b. Place a cold pack on the client's perineal area.
c. Place the client in semi-Fowler's position.
d. Notify the client's physician immediately.
29. A postpartum client is diagnosed with cystitis. The nurse
should plan for which priority nursing action in the care of the
client? *
a. Placing ice on the perineum
b. Providing sitz baths
c. Encouraging fluid intake
d. Monitoring hemoglobin and hematocrit levels
30. A postpartum client is being discharged to home with a
streptococcal puerperal infection. The client is taking antibiotics
but asks a nurse what precautions she should take at home to
prevent spreading the infection to her husband, newborn, and
toddler. Which is the best response by the nurse? *
a. “No precautions are necessary since you are taking
antibiotics.”
b. “Your husband should provide all of the care for both
children until your infection is gone.”
c. “You should wear a mask when caring for your newborn and
toddler.”
d. “You need to perform hand hygiene before caring for your
children and after toileting and perineal care.”