OBSTETRIC NURSING

By: Alfred Raymund C. Panopio, RN, MAN, LPT

Situation1: Cora, 9months pregnant, is admitted to the hospital with bleeding caused by possible placenta
previa. The laboratory technician takes blood samples and IV fluids are begun.

1. A client with placenta previa is likely to present with:

a. Hard, tender uterus
b. Painless, bright-red vaginal bleeding after the 20th week of gestation
c. A sluggish fetus with weak heart sounds on auscultation
d. Bleeding during the first trimester

2. Nursing care for Cora includes:

a. Withholding foods and fluids
b. Encouraging ambulation and supervision
c. Inspecting the hemorrhage
d. Avoiding all extraneous stimuli

3. The nurse following the physician’s order, begins administering oxygen by mask. The client’s
apprehension is increasing and she asked the nurse what is happening. The nurse tells her not to worry,
that she is going to be all right and everything is under control. The nurse statements are:
a. Correct, since only the physician should explain why treatment are being done
b. Proper, since the client’s anxieties would be increased if she knew the dangers
c. Adequate, since all preparations are routine and need no explanation
d. Questionable, since the client has the right to know what treatment is being given and why

4. If a vaginal examination is to be performed on Cora, the nurse should be prepared for an immediate:
a. Induction of labor c. Forceps delivery
b. Cesarean delivery d. X-ray examination

5. The care of a client with placenta previa includes:

a. Vital signs at least once per shift
b. A tap-water enema before delivery
c. Observation and recording of the bleeding
d. Limited ambulation until the bleeding stops
Situation 2: Helen, age20, is 37 weeks pregnant. She is admitted to the hospital with preeclampsia, moderate
vaginal bleeding, and sudden abdominal pain. The results of the ultrasound indicate that abruptio placenta is
present.
6. Based on these findings, the nurse would prepare the client for:
a. Complete bed rest for the remainder of the pregnancy
b. Delivery of the fetus
c. Strict monitoring of intake and output
d. The need for weekly monitoring of coagulation studies until the time of delivery

7. On Helen’s admission to the unit the nurse should observe for:

a. Decrease in size of uterus, cessation of contractions, visible or concealed hemorrhage
b. Firm and tender uterus, concealed or external hemorrhage, shock
c. Increase in size uterus, visible bleeding, no associated pain
d. Shock, decrease in size uterus, absence of external bleeding
 8. The nurse realizes that the abdominal pain associated with abruption placenta is caused by:
a. Hemorrhagic shock
b. Inflammatory reactions
c. Blood in the uterine muscle
d. Concealed hemorrhage

9. Helen is given a unit of blood. The realizes that this is necessary, since the bleeding following severe
abruptio placenta is usually caused by:
a. Hypofibrinogenemia c. Thrombocytopenia
b. Hyperglobulinemia d. Polycythemia

10. A nurse is monitoring Helen for Disseminated Intravascular Coagulopathy. Which assessment finding is
least likely to be associated with DIC?
a. Swelling of the calf on one leg
b. Prolonged clotting times
c. Decreased platelet count
d. Petechiae, oozing from injection sites, and hematuria
Situation 3: Anne delivered a child two days ago. She is breastfeeding her child.

11. To show Anne how to help her have good attachment of the infant during breast feeding. Which of the
following statements should NOT be included?
a. Place the infant in your most convenient position
b. Touch the infant’s lips with her nipples
c. Wait until the infant’s mouth is widely open
d. Move the infant quickly onto her breast, aiming the infant’s lips well below the nipple

12. Which of the following signs of good attachment should the nurse teach Anne?
a. The chin should touch the breast, the mouth is wide open while the lower lip is turned inward, and
more areola is visible above than below
b. The chin should touch the breast, the mouth is wide open while the lower lip turned outward, and
more areola visible above than below
c. The chin should touch the breast, the mouth is wide open while the lower lip turned outward, and
more areola visible below than above
d. The chin should touch the breast, the mouth is wide open while the lower lip turned inward, and
more areola is visible below than above
13. Which of the following instructions can the nurse give to Anne?
a. Wear a good, well-supporting bra
b. Apply warm compresses to breast if too full
c. Apply cold compresses to breast if too full
d. Do not apply any soap to your nipples

14. Anne is visited by the home health nurse two weeks after delivery. The woman is febrile with flu-like
symptoms. On assessment, the nurse notes a warm, reddened painful area of the right breast. The best
initial action of the nurse is to:

a. Contact the physician for an order of antibiotics

b. Advise the mother to stop breastfeeding and pumping
 c. Assess the mother's feeding technique and knowledge of breast care
d. Obtain a sample of the breast milk for culture

15. Anne has received treatment for a warm, reddened, painful area in the breast as well as cracked and
fissured nipples. The client expresses the desire to continue breastfeeding. The following are instructions
that the nurse should include to prevent recurrence of this condition EXCEPT:
a. Change the breast pads frequently
b. Expose the nipples to air for part of each day
c. Wash hands before handling the breast and breastfeeding
d. Make sure that the baby grasps the nipple only
Situation 4: Rita, 27 years old, is a gravida 1 in the active phase of labor. Fetal position is LOA, and cervix is 4
cm dilated.

16. Rita wants to walk about in the labor room. Which of the following criteria will help the nurse determine
whether she should walk?
a. Whether membranes are intact
b. Frequency of contraction
c. Fetal position
d. Fetal station

17. When planning comfort measures to help Rita in active labor to tolerate her pain, the nurse must
consider which of the following?
a. Early labor contractions are usually regular, coordinated, and very painful
b. If women are properly prepared, they will require no pain medication to manage their pain
c. Pain medication given during the latent phase of labor is not likely to impair contractions
d. The acceleration phase of labor can be a time of true discomfort and high anxiety
18. When her membranes rupture, the nurse should expect to see:
a. A large amount of bloody fluid
b. A moderate amount of clear to straw-colored fluid
c. A small amount of greenish fluid
d. A small segment of the umbilical cord

19. When her membranes rupture, the nurse's first action should be to:
a. Notify the physician because delivery is imminent
b. Measure the amount of fluid
c. Count the fetal heart rate
d. Perform a vaginal exam

20. During the third stage of labor, the nurse may have which of the following responsibilities?
a. Administer intramuscular Oxytocin to facilitate uterine contractility
b. Monitor for blood loss greater than 100 cc, which would indicate gross hemorrhage
c. Note if the placenta makes a Schultz presentation, which is a sign of gross complication
d. Push down on the relaxed uterus to aid in the removal of the placenta
Situation 5: A pregnant client has delayed her first prenatal visit. She visits the prenatal clinic only after
she starts to experience edema of the feet and hands. The nurse takes a history and physical assessment to
begin Mrs. Barton's care.

21. The client's response to one of the nurse's questions is, “This is my third pregnancy. I miscarried twice,
the first time I was 8 weeks pregnant, and the last time I was 26 weeks pregnant.” The nurse correctly
records Mrs. Barton's pregnancy status as:
 a. G2, P0, A1 c. G3, P0, A2
b. G2, P1, A1 d. G3, P1, A1

22. During the examination, while client is lying in a lithotomy position, the client complains of dizziness and
nausea. What would be an appropriate nursing action to relieve the client's discomfort?
a. Administering an antiemetic ordered by the physician
b. Offering small sips of ginger ale
c. Assisting to a side-lying position temporarily
d. Discontinuing the examination

23. Diplopia was noted during the assessment of Mrs. Barton. This condition is described as:
a. Elevated pigmentation of the skin
b. Double vision
c. Facial edema
d. Gingivitis

24. The physician asks the nurse to make sure his pregnant patient's next appointment is scheduled
correctly. The patient is in her 33rd week. Her next appointment should be in:
a. 1-month c. 2 weeks
b. 3 weeks d. 1 week

25. Mrs. Barton reports that the last day of her last menstrual period was May 11, 2009. Her menstruation
lasted for 5 days. Her expected date of delivery will be:
a. February 14, 2010 c. August 4, 2010
b. February 18, 2010 d. August 18, 2010
Situation 6: Nene is a 26 – year – old woman you admit to a birthing room. She’s been having contractions 45
seconds long and 3 minutes apart for the last 6 hours. She tells you she wants to have her baby natural without
analgesia or anesthesia. Her husband is in the army assigned overseas, so he is not with her. Although her
sister lives only two blocks from the birthing center, Nene doesn’t want her called. She asks if she can talk to
her mother on the telephone. As you finish assessing contractions, she screams with pain and shouts,
“Ginagawa ko na ang lahat ng makakaya ko! Kailan ba matatapos ang paghihirap kong ito?”

26. Nene did not recognize for over an hour that she was in labor. A sign of true labor is:
a. Sudden increased energy from epinephrine release
b. “Nagging” but constant pain in the lower back
c. Urinary urgency from increased bladder pressure
d. “Show” or release of the cervical mucus plug

27. Nene asks which fetal position and presentation are ideal. Your best answer would be:
a. Right occiput anterior full flexion
b. Left transverse anterior in moderate flexion
c. Right occiput posterior with no flexion
d. Left Sacro anterior with flexion
28. Nene is having long and hard uterine contraction. What length of contraction would you report as
abnormal?
a. Any length over 30 seconds
b. A contraction over 70 seconds in length
c. A contraction that peaks at 20 seconds
d. A contraction shorter than 60 seconds
29. You assess Nene’s uterine contractions. In relation to the contraction, when does a late deceleration
 begin?
a. 45 seconds after the contraction is over
b. 30 seconds after the start of a contraction
c. After every tenth or more contraction
d. After a typical contraction ends
30. Immediately after the membranes rupture, which of the following should the nurse check?
a. Check the presence of infection
b. Assess for prolapsed umbilical cord
c. Check for maternal heart rate
d. Assess the color of the amniotic fluid
Situation 7: Sexually Transmitted Diseases are important to identify during pregnancy because of its potential
effect on the pregnancy, fetus, or newborn. The following questions pertain to STDs.
31. Frankie, a promiscuous woman in Manila, submits herself to the clinic for check-up. She complains of
vaginal irritation, redness and a thick cream cheese-like vaginal discharge. As a nurse, you will suspect
that Frankie is having a vaginal infection caused by:
a. Gardnerella vaginalis
b. Candida albicans
c. Treponema pallidum
d. Herpes simplex virus type 2
32. Cecil comes to the health center. Her doctor examines Cecil’s vaginal secretions and finds out that she
has Trichomoniasis infection. Trichomoniasis is diagnosed through which of the following methods?
a. Vaginal secretions are examined in a wet slide that has been treated with potassium hydroxide
b. Vaginal speculum is used to obtain secretions from the cervix
c. A litmus paper is used to test if the vaginal secretions are infected with Trichomoniasis
d. Vaginal secretions are examined on a wet slide treated with zephiram solution
33. The drug of choice for a client with Trichomoniasis is:
a. Flagyl c. Monistat
b. Clotrimazole d. Zovira
34. Jarisch-Herxheimer reaction maybe experienced by the client with syphilis after therapy with benzathine
penicillin G. The characteristic manifestation of Jarisch-Herxheimer reaction are:
a. Rashes, itchiness, hives and pruritus
b. Confusion, drowsiness, and numbness of extremities
c. Sudden episode of hypotension, fever, tachycardia, and muscle aches
d. Episodes of nausea and vomiting, with bradypnea and bradycardia
35. Cryocautery may be used in removing the lesions of a client with venereal warts. The healing period after
Cryocautery may be completed in 4-6 weeks but may cause some discomforts to the woman. What
measures can alleviate these discomforts?
a. Kegel’s exercise
b. Cool air
c. Topical steroids
d. Seitz bath and lidocaine cream
Situation 8: Nurse Gwen is an Independent Nurse Practitioner following preferred clients in their respective
homes. She handles Leah's case, a post partial mother.
36. Leah is developing constipation from being on bed rest. What measures would you suggest she take to
help prevent this?
a. Eat more frequent small meals instead of three large one daily
b. Walk for at least half an hour daily to stimulate peristalsis
 c. Drink more milk, increased calcium intake prevents constipation
d. Drink eight full glasses of fluid such as water daily

37. Which of the following actions would alert Nurse Gwen that Leah is entering a postpartum taking-hold
phase?
a. She urges the baby to stay awake so that she can breast-feed him or her
b. She tells you she was in a lot of pain all during labor
c. She says that she has not selected a name for the baby as yet
d. She sleeps as if exhausted from the effort of labor

38. At 6-week postpartum visit, what should Leah's fundic height be?
a. Inverted and palpable at the cervix
b. Six finger breadths below umbilicus
c. No longer palpable on her abdomen
d. One centimeter above the symphysis pubis

39. Leah wants to lose the weight she gained in pregnancy, so she is reluctant to increase her caloric intake
for breast-feeding. By how much should a lactating mother increase her caloric intake during the first 6
months after birth?
a. 350 kcal/day c. 200 kcal/day
b. 500 kcal/day d. 1000 kcal/day
40. When preparing recommendations for Leah, which of the following contraceptive methods would be
avoided?
a. Diaphragm c. Oral contraceptives
b. Female condom d. Rhythm method
Situation 9: Nette, a nurse palpates the abdomen of Mrs. Medina, a primigravida. She is unsure of the date of
her last menstrual period. Leopold’s Maneuver is done. The obstetrician said that she appears to be 20 weeks
pregnant.
41. Nette explains this because the fundus is:
a. At the level of the umbilicus, and the fetal heart can be heard with a fetoscope
b. 18 cm, and the baby is just about to move
c. Is just over the symphysis, and fetal heart cannot be heard
d. 28 cm, and fetal heart can be heard with a Doppler

42. In doing Leopold’s Maneuver palpation which among the following is NOT considered a good
preparation:
a. The woman should lie in a supine position with her knees flexed slightly
b. The hands of the nurse should be cold so that abdominal muscles would contract and tighten
c. Be certain that your hands are warm (by washing them in warm water first if necessary)
d. The woman empties her bladder before palpation

43. In her pregnancy, she experienced fatigue and drowsiness. This probably occurs because:
a. Of high blood pressure
b. She is expressing pressure
c. The fetus utilizes her glucose stores and leaves her with a low blood glucose
d. Of the rapid growth of the fetus
44. The nurse assesses the woman at 20 weeks gestation and expects the woman to report:
a. Spotting related to fetal implantation
b. Symptoms of diabetes as human placental lactogen is released
c. Feeling fetal kicks
 d. Nausea and vomiting related HCG production

45. Mrs. Medina comes to you for check-up on June 2, her EDC is June 11. What do you expect during
assessment?
a. Fundic height of 2 fingers below xyphoid process, engaged
b. Cervix close, uneffaced, FH-midway between the umbilicus and symphysis pubis
c. Cervix open, fundic height 2 fingers below xyphoid process, floating
d. Fundic height at least at the level of the xyphoid process, engaged
Situation 10: A professional nurse should know how to respond in these varied health situations.
46. RhoGAM is given to Rh-negative women to prevent maternal sensitization from occurring. The nurse is
aware that in addition to pregnancy, Rh-negative women would also receive this medication after which
of the following?
a. Unsuccessful artificial insemination procedure
b. Blood transfusion after hemorrhage
c. Therapeutic or spontaneous abortion
d. Head injury from a car accident

47. The breathing technique that the mother should be instructed to use as the fetus' head is crowning is:
a. Blowing c. Shallow
b. Slow chest d. Accelerated-decelerated

48. When providing prenatal education to a pregnant woman with asthma, which of the following would be
important for the nurse to do?
a. Demonstrate how to assess her blood glucose levels
b. Teach correct administration of subcutaneous bronchodilators
c. Ensure she seeks treatment for any acute exacerbation
d. Explain that she should avoid steroids during her pregnancy

49. Which of the following conditions would cause an insulin- dependent diabetic client the most difficulty
during her pregnancy?
a. Rh incompatibility
b. Placenta Previa
c. Hyperemesis Gravidarum
d. Abruptio Placenta

50. Which of the following would the nurse use as the basis for the teaching plan when caring for a pregnant
teenager concerned about gaining too much weight during pregnancy?
a. 10 pounds per trimester
b. 1 pound per week for 40 weeks
c. ½ pound per week for 40 weeks
d. A total gain of 25 to 30 pounds
Situation 11: Angel, 25 years old, is a 2-day postpartum client. She delivered a 6 lb. 4 oz baby boy.
51. Angel verbalizes her labor and delivery experience, does not appear confident about holding the baby or
changing diapers. The nurse identifies the client is in which phase of the postpartum period?
a. Letting go c. Holding out
b. Taking in d. Taking hold
 52. When checking Angel's fundus, the nurse observes that the fundus is above the umbilicus and displaced
to the right. The nurse evaluates that the client probably has:
a. A slow rate of involution
b. A full, overdistended bladder
c. Retained placental fragments
d. Over stretched uterine ligaments

53. During the postpartum period, Angel tells the nurse she is having leg cramps. The nurse should suggest
that she should increase her intake of:
a. Eggs and bacon c. Juices and water
b. Liver and onions d. Cheese and broccoli

54. When performing discharge teaching for Angel, the nurse should inform her that:
a. The episiotomy sutures will be removed at the first postpartum checkup
b. She may not have any bowel movements for up to a week after the birth
c. She has to schedule a postpartum checkup as soon as her menses returns
d. The perineal tightening exercises started during pregnancy should be continued indefinitely

55. Which of the following statements would indicate to the nurse that Angel has begun to integrate her new
baby into the family structure?
a. All the baby does is cry. He's not liked my other child.
b. I wish he had curly hair like my husband
c. My parents wanted a granddaughter
d. When he yawns, he looks like just his brother
Situation 12: Awareness of the complications that may accompany pregnancy is essential in order to
render a patient nursing management.
56. In which of the following clients would the nurse suspect anemia?
a. Client in her first trimester with a hemoglobin level of 12 g/dL
b. Client in her second trimester with a hemoglobin level of 11 g/dL
c. Client in her third trimester with a hemoglobin level of 8 g/dL
d. Client in her first trimester with a hemoglobin level of 10.5 g/dL

57. Which of the following would the nurse identify as a classic sign of PIH?
a. Edema of the feet and ankles
b. Edema of the hands and face
c. Weight gain of 1 lb/week
d. Early morning headache

58. Which of the following may happen if the uterus becomes overstimulated by oxytocin during the
induction of labor?
a. Weak contractions prolonged to more than 70 seconds
b. Tetanic contractions prolonged to more than 90 seconds
c. Increased pain with bright red vaginal bleeding
d. Increased restlessness and anxiety

59. Which of the following best describes preterm labor?

a. Labor that begins after 20 weeks’ gestation and before 37 weeks’ gestation
 b. Labor that begins after 15 weeks’ gestation and before 37 weeks’ gestation
c. Labor that begins after 24 weeks’ gestation and before 28 weeks’ gestation
d. Labor that begins after 28 weeks’ gestation and before 40 weeks’ gestation
60. The nurse evaluates that the danger of a seizure in a woman with eclampsia subsides:
a. After labor begins
b. After delivery occurs
c. 24 hours post-partum
d. 48 hours postpartum

Situation13: You are the nurse taking care of a client moving into the active phase of labor.
61. The nurse should include which of the following as priority care?
a. Offer support by reviewing the short-pant form of breathing
b. Administer a narcotic analgesia
c. Allow the mother to walk around the unit
d. Watch for the rupture of the membrane

62. A client is progressing through the 1st stage of labor. Which finding signals the 2nd stage of labor?
a. Passage of the mucus plug
b. Bearing down reflex
c. Change in uterine shape
d. Gush of dark blood

63. As the nurse assigned to a laboring woman, you are observing the FHR. Which of the following findings
would you consider abnormal for a client in active labor?
a. A rate of 160 with no significant changes through a contraction
b. A rate of 130 with accelerations to 150 with fetal movement
c. A rate that varies between 120 and 130
d. A rate of 170 with a drop to 140 during a contraction.

64. The client is now 8 cm dilated. To support her during this phase of labor, you should:
a. Leave her alone most of the time
b. Offer her a back rub during contraction
c. Offer her sips of oral fluids
d. Provide her with warm blanket

65. During the 4th stage of labor, the client should be carefully assessed for:
a. Uterine atony
b. Complete cervical dilatation
c. Placental expulsion
d. Umbilical cord prolapses

Situation 14: As the fetus grows and hormone shift during pregnancy, physiologic adaptations occur in
everybody system to accommodate the fetus.
66. The nurse suggests breast pumping to relieve client’s breast engorgement. Which instruction should the
nurse provide?
a. Pump each breast 5 to 10 minutes every 3 to 4 hours round the clock
b. Pump each breast for at least 10 minutes every 3 to 4 hours, pump at night only if awake
c. Pump each breast for no more than 10 minutes every 2 hours round the clock
d. Pump each breast for 10 minutes every 2 hours, skip one pumping at night
 67. Weng complains of constipation. The nurse should explain that constipation frequently occurs during
pregnancy because of:
a. Pressure of the growing uterus on the anus
b. Increased intake of milk as recommended during pregnancy
c. The slowing of peristalsis in the GIT
d. Changes in the metabolic rate

68. Jane is concerned about the mask of pregnancy, the dark nipples and the dark line from her navel to her
pubis. The nurse explains that these adaptations are caused by the hyperactivity of the:
a. Adrenal gland c. Ovaries
b. Thyroid gland d. Pituitary gland

69. Jane complains of morning sickness. The nurse realizes that a predisposing factor that causes morning
sickness during the first trimester of pregnancy is the adaptation to increased level of:
a. Estrogen c. Luteinizing hormone
b. Progesterone d. Chorionic gonadotropin

70. During pregnancy, what happens to the heart from displacement of the diaphragm? It moves:
a. Upward and to the left
b. Upward and to the right
c. Downward and to the left
d. Downward and to the right
Situation 15: The process of data gathering and analysis is ongoing. The nurse, therefore, should focus on
trimester-specific issues.
71. Fetal heart rate can be auscultated with a fetoscope as early as which of the following?
a. 5 weeks’ gestation
b. 10 weeks’ gestation
c. 15 weeks’ gestation
d. 20 weeks’ gestation

72. An ultrasound is typically performed during the third trimester for which of the following reasons?
a. To evaluate the fetus for possible congenital anomalies
b. To determine the fetal position and estimate fetal size
c. To confirm the suspicion of possible multiple gestation
d. To enhance prenatal testing and evaluation of pelvic mass

73. Quickening in primigravida’s usually can be detected during which of the following weeks of gestation?
a. 10 to 14 weeks
b. 15 to 17 weeks
c. 18 to 20 weeks
d. 20 to 22 weeks

74. At 12 weeks’ gestation, what fetal development would you expect to find?
a. Eyelids are open
b. Insulin is present in the pancreas
c. Vernix caseosa is copious
d. Subcutaneous fat increases
 75. During prenatal development, fetal weight gain is greatest in the:
a. First trimester
b. Third trimester
c. Second trimester
d. Implantation period
Situation 16: The nurse bears responsibilities during the postpartum stage, wherein the mother undergoes
physical and psychological adjustment to the process of child bearing.
76. While bottle feeding her neonate, a post-partum client asks the nurse when she can expect her
menstrual period to return. How should the nurse respond?
a. In 1-2 weeks, c. In 7-9 weeks
b. In 3-4 weeks, d. In 10-12 weeks

77. When assessing lochia serosa, which of the following would the nurse expect?
a. Creamy yellow color
b. Characteristic odor
c. Serosanguineous appearance
d. White to colorless

78. Which behavior would the postpartum client demonstrate during the taking-in phase?
a. Passive dependent role
b. Increased energy
c. Receptiveness to self-care education
d. Increased responsibility for neonate

79. Which statement about nutrition in the postpartum period is true?

a. The client should maintain a high-carbohydrate diet
b. The client should expect a decrease in thirst
c. The client should eat low-fiber food
d. The client should increase protein and caloric intake

80. The nurse working on the postpartum unit should encourage clients to ambulate early to:
a. Promote respirations
b. Increase the tone of the bladder
c. Maintain tone of abdominal muscles
d. Increase peripheral vasomotor activity
Situation 17: Nutrition is an important aspect during pregnancy. It has a direct bearing on her health and
on the fetal growth and development. Nurses can help guide pregnant women in planning a good diet.
81. The nurse in the prenatal clinic should provide nutritional counseling to all newly pregnant women
because:
a. Most weight gain during pregnancy is fluid retention
b. Dietary allowances should not increase during pregnancy
c. Pregnant women must adhere to a specific pregnancy diet
d. Different sources of essential nutrients are favored by different cultural groups

82. Nutritional planning for a newly pregnant woman of average height weighing 145 pounds should include:
 a. A decrease of 200 calories per day
b. An increase of 300 calories per day
c. An increase of 500 calories per day
d. A maintenance of her present caloric intake

83. A primigravida woman in her 10th week of gestation is concerned because she has read that nutrition
during pregnancy is important for the growth and development of the fetus. She wants to know something
about the food she should eat. The nurse should:
a. Instruct her to continue eating a normal diet
b. Assess what she eats by taking a diet history
c. Give her a list of food to help her better plan her meals
d. Emphasize the importance of limiting salt and highly seasoned food
84. A client is concerned about gaining weight during pregnancy. The nurse explains that the largest part of
weight gain during pregnancy is because of:
a. The fetus
b. Fluid retention
c. Metabolic alterations
d. Increased blood volume

85. A patient who is 20 weeks pregnant tells the nurse that her prenatal vitamin makes her sick. Which is
the best suggestion?
a. Take the vitamin with breakfast
b. Stop taking the vitamin for a few days and then resume
c. Take the vitamin at bedtime
d. Take the vitamin with milk between meals
Situation 18: A nurse is taking care of a client who is scheduled for cesarean delivery.
86. Which assessment finding would indicate a need to contact the physician?
a. Fetal heart rate of 180 bpm
b. WBC count of 12,000 cells/mm3
c. Maternal pulse rate of 85 bpm
d. Hemoglobin of 11.0 g/dL

87. A client in labor is transported to the delivery room and is prepared for a cesarean delivery. The nurse
places the client in the:
a. Trendelenburg’s position with the legs in stirrups
b. Semi-fowler position with a pillow under the knees
c. Prone position with the legs separated and elevated
d. Supine position with a wedge under the right hip

88. A nurse prepares to auscultate the fetal heart rate by using a Doppler ultrasound device. The nurse
most accurately determines that the fetal heart sound are heard by:
a. Noting if the heart rate is greater than 140 bpm
b. Placing the diaphragm of the Doppler on the mother’s abdomen
c. Performing Leopold’s maneuver first to determine the location of the fetal heart
d. Palpating the maternal radial pulse while listening to the fetal heart rate

89. After delivery, the nurse is assessing the mother for signs and symptoms of superficial venous
thrombosis. Which of the following signs and symptoms would the nurse note if superficial venous
 thrombosis were present?
a. Paleness of the calf area
b. Enlarged, hardened veins
c. Coolness of the calf area
d. Palpable dorsalis pedis pulses

90. A nurse has provided discharge instructions to a client who delivered healthy newborn infant by cesarean
delivery. Which statement if made by the client indicates a need for further instructions?
a. “I will notify the physician if I develop a fever.”
b. “I will lift nothing heavier than the newborn infant for at least 2 weeks.”
c. “I will begin abdominal exercises immediately.”
d. “I will turn on my side and push up with my arms to get out of bed.”
Situation 19: The following questions pertain to care of women’s reproductive health.
91. For women aged 19-39 years, recommended health screening diagnostic testing includes which of the
following?
a. Pap smear
b. Mammography
c. Cholesterol and lipid profile
d. Bone mineral density testing

92. The nurse teaches the female patient who is premenopausal to perform breast self-examination (BSE):
a. Any time during the month
b. With the onset of menstruation
c. On day 5 to day 7, counting the first day of menses as day 1
d. On day 2 to day 4, counting the first day of menses as day 1

93. The nurse is caring for a 38-year-old unmarried woman. She is 38 weeks pregnant and has two school-
age children at home. She has gained 4 pounds in the last week and she states her “rings are tight and
won’t come off.” Her significant other, who is not the father of this baby or the other children, attends
prenatal clinic with her to provide support and share information. Based on the philosophy of family-
centered maternal-newborn nursing, the following principles apply to the care of this family EXCEPT:
a. Pregnancy and childbirth are usually normal, healthy events in the family
b. Pregnancy and childbirth affect the entire family
c. Families are able to make decisions about care if given the proper information
d. Personal and cultural attitudes influence the meaning of pregnancy and birth in the family

94. Stage 3 of breast development, according to Tanner, occurs when:

a. Breast budding begins
b. The breast develops into a single contour
c. The areola (a darker tissue ring around the nipple) develops
d. The areola and nipple form a secondary mound on top of breast tissue

95. In counseling the couple about the various Family Planning Methods, the nurse identifies that the most
important factor in choosing a contraceptive method is:
a. Financial expense
b. Compliance with cultural expectations
c. Non-contraceptive benefits
d. Correct and consistent use
Situation 20: All maternal body systems are altered by pregnancy. The following questions pertain to the
signs and symptoms of pregnancy.
96. Cervical softening and uterine soufflé are classified as which of the following?
a. Diagnostic signs c. Probable signs
b. Presumptive signs d. Positive signs

97.Which of the following would the nurse identify as a presumptive sign of pregnancy?
a. Hegar’s sign
b. Nausea and vomiting
c. Skin pigmentation changes
d. Positive serum pregnancy test

98.The nurse documents positive ballottement in the client's prenatal record. The nurse understands that
this indicates which of the following?
a. Contractions palpable on the abdomen
b. Passive movement of the unengaged fetus
c. Fetal kicking felt by the client
d. Enlargement and softening of the uterus

99.The client has completed an at-home pregnancy test with positive results. Which of the following
indicates the client understands the meaning of the test results?
a. “I understand that this means I have ovulated in the past 24 hours.”
b. “I understand that this means I am not pregnant.”
c. “I understand that this means I might be pregnant.”
d. “I understand that this means I am pregnant.”

100. The client has come to the clinic because she suspects that she is pregnant. Which of the following
would be the most definitive way to confirm the diagnosis?
a. Client's report of amenorrhea for 3 months
b. Positive Hegar's sign
c. Pigmentation changes of the breast
d. Palpation of fetal movement by the care provider