Maternity/OB Exam1

1. A primigravida is 16 weeks (or 17) gestation and ask the nurse how long it would be until she
feels the baby move. The best response by the nurse is (quickening 18-20 weeks)
a. The baby is moving but you can’t feel it
b. You should have felt the baby move by now
c. Within the next few weeks or so you should feel a fluttering sensation
d. Some baby don’t move until the sixth month of pregnancy
2. A nurse is teaching an 8 weeks client with iron deficiency anemia about the proper
administration of iron supplements. The nurse instructed her to take the supplements with
which of the following beverages?
a. Orange juice
b. Tea or coffee
c. Low fat or whole milk
d. Water
3. You the RN assess a client who is in the 35thweek of pregnancy. She fell and punctured her
leg with a nail. She states she has not had a tetanus immunization. Which action would you
include in her place of care?
a. Administration of tetanus immune globulin now
b. Analyze of her serum for tetanus antibodies.
c. Administration of tetanus immune globulin after delivery.
d. Inducing labor to avoid tetanus in the fetus.
4. You, the RN, assess a client who is in 35th week of pregnancy. She fell and punctured her leg
with a nail. She states she has not had a tetanus immunization since early childhood. Which
action will you include in her plan of care?
a. Delay administration of tetanus immune globulin until after delivery
b. Inducing labor to avoid tetanus in the fetus
c. Give the tetanus, diphtheria, pertussis vaccine now
d. Analysis of her serum for tetanus antibodies
5. A woman arrives at the obstetrician’s office for her first. She does not speak English. What
action=w23ess by the nurse provide the best care? (SATA)
a. Ask her where she is currently working to assess work hazards or teratogens. ?
b. Ask about cultural practices that she would expect to be part of pregnancy,
labor, delivery.
c. Information about potential intimate partner violence should be obtained in
private using open-ended questions.
d. Allow the partner to be interviewed with her partner present to promote-family
centered care. ?
e. Avoid asking her about future use of birth control as her husband will forbid it.
f. Call for a translator to get an accurate history.
6. The nurse is assessing a woman in early labor. While positioning her for a vaginal exam. She
complains of dizziness and nausea and appears pale. Her blood pressure has dropped slightly
. What is the appropriate initial nursing action?
a. Turn her to her left side.
b. Call healthcare provider
c. Elevate the head of the bed.
d. Encourage deep breathing.
7. A pregnant client. Tells the nurse that her Last Menstrual Period was three month ago and
began on April 20th. Using Nagel’s Rule. Calculate the client’s estimated date of delivery? Fill
 in your answer with the month spelled out and date (example: March 10) ANS. January 27
8. 39) A pregnant client tells the nurse that her LMP was 3 months ago and began on August
15. Using Nagel’s rule, calculate the client’s estimate date of delivery? Fill in your answer with
month spelled out and date (example: March 10) ANS. MAY 22 . —-Naegele's rule
involves a simple calculation: Add seven days to the first day of your LMP and then subtract
three months. For example, if your LMP was November 1, 2017: Add seven days (November
8, 2017). Subtract three months (August 8, 2017).
9. A patient was admitted to L&D with a positive GBS status and is about to receive an
antibiotic. Her mother ask the nurse, why does my daughter need an antibiotic? She is
planning to have a natural delivery. What is the best response by the nurse?
a. The baby will be born soon so I will delay giving the antibiotic to your daughter.
b. The antibiotic will treat the infection in your daughter so the
infection is not passed to the baby.
c. This is a sxually transmitted infection and must me treated in your daughter
d. I will get antibiotics discontinued by the doctor because I don't think it is
needed.
10. A nurse is caring for an antepartum client whose laboratory findings indicate a
rubella titer of 1:15. Which of the following is the correct interpretation of the data.
a. The client is immune to the rubella virus
b. The client requires a rubella immunization during delivery
c. The client requires rubella vaccination at this time
d. The client is not experiencing a rubella infection at this time
11. At her first prenatal visit, a woman and a nurse are discussing fetal development.
The client asks when will we be able to hear the fetal heartbeat?
a. The 12th week of gestation (with a doppler)
b. The 7th week of gestation
c. The 6th week of gestation
d. The 4th week of gestation (WITHOUT doppler)
12. A pregnant client asks about the function of the placenta, Which of the following
items should the nurse include in the teaching plan.
a. Fetal respiration, nutrition, and excretion are carried out by the
placenta
b. The placenta filters fetal urine
c. The placenta filters harmful substances from maternal blood
d. Fetal and maternal blood mix
13. The nurse is teaching a pregnant client how to perform daily fetal movement
counts. Which instructions are most important to include in the teaching? (SATA)
a. You can begin counting fetal movement at 28 weeks gestation.
b. You need to come to the office for the procedure
c. Count fetal movement after eating a meal.
d. Lie on back when counting kicks
e. Call a health care provider if at least 3 movements are not felt over an
hour.
14. A nurse is caring for a newborn whose mother is positive for the hepatitis B
surface antigen. Which of the following should the infant receive?
a. Hepatitis B immune globulin and hepatitis B Vaccine within 12 hr of
birth.
 b. Hepatitis B immune globulin given at 1 week followed by hepatitis B
Vaccine monthly for 6 months
c. Hepatitis B vaccine at 24 hr followed by hepatitis B immune globulin every
12 hrs for 3 days
d. Hepatitis B vaccine monthly until the newborn test negative for hepatitis B
surface antigen.
15. Which statement by the pregnant client indicates to the nurse an understanding of TORCH
infections?
a. I need to be immunized against syphilis because there is no cure
b. I will have my husband take care of grooming my cat and the litter box
c. If my RPR is low, I would need a rubella vaccine delivery
d. If I have CMV, I would need to have a c-section to prevent birth defects.
16. The nurse knows that transcervical chorionic villus sampling (CVS) would be considered a
contraindication in which situation.
a. Rh - negative mother
b. Maternal age younger than 35 years
c. Gestation less than 15 weeks early screening between 10-13 weeks
d. Client with active genital herpes
17. A nurse is speaking with a client who is 6 (or 11)weeks’ gestation. The client tells the
nurse that she smokes 1-2 pack per day but is trying to quit. The nurse should explain
that newborns born to women who smoke are at risk for:
a. Intrauterine growth restrictions.
b. Vision loss
c. Congenital heart defects.
d. Gestational diabetes.
18. After having an Ultrasound the fetus heart shows that “normal fetal circulation is
occurring.” The RN is teaching a pregnant client about normal fetal circulation. Which
of the following statement is consistent with the finding?
a. A right to left shunt is seen between the umbilical arteries
b. A right to left shunt is seen between the atria. (arteries?)
c. Blood is returning to the right atrium from the pulmonary system.
d. Blood is returning to the placenta via the umbilical vein. [umbilical arteries]
19. A client report that she and her husband are considering starting a family within the
next year. The nurse should advise the client to increase her intake of folic acid.
a. Immediately.
b. One week before her period
c. When pregnancy is confirmed
d. If she misses her period
20. A pregnant client 35 weeks gest hemoglobin of 11 -blood volume doubled under
11 dangerous
21. A nurse in a prenatal clinic teaching about nutrition to a client who is 12 weeks gestation.
The client states, “I don’t like milk”, which of the following foods should the nurse
recommend as a good source of calcium?
a. Beans and dark green leafy vegetables
b. Whole milk or 2% of milk
c. Hard-boiled egg or scrambled egg
d. Deep red or orange vegetables
22. A lactose intolerant 30-week pregnant woman eats little meat or dairy products, and she
 may be low in calcium and iron. The nurse can help the woman increase her intake of
these foods in pregnancy by:
a. Telling the family that she must increase her intake of fruits and vegetables that are
calcium rich
b. Emphasizing the need for increased milk intake during pregnancy
c. Suggesting she eat more tofu, legumes, and drink leafy green vegetables
d. Suggesting she eats more “hot” food during pregnancy
23. A nurse is providing teaching about nutrition to a client at her first prenatal visit. Which of
the following statements by the nurse should be included in her teaching?
a. You would need to double your intake of iron during pregnancy.
b. Prenatal vitamins would meet your need for increase vitamin D during
pregnancy
c. Vitamin E requirements decline during pregnancy due to increase in body fat
d. You will need to increase your calcium intake during breastfeeding
24. A client who is in her 34th week gestation is concerned about her weight gain of 25
pounds. The nurse best response is
a. You should try to decrease your amount of weight gain for the next 12 weeks
b. You have not gained enough weight for the number of weeks of your
pregnancy.
c. You have gained an appropriate amount for the number of weeks of your
pregnancy.
d. You should not gain any more weight until you reach the third semester.
Normal weight women: 25-35 lb (11.5 - 16 kg)
Underweight women: 28-40 lb (12.6-18 kg)
Overweight women: 15-25 lb (7-11.5 kg)
Twins or Multi-Fetus: 1st trimester: gain 4 to 6 lbs. 2nd/3rd trimester: gain 1.5 lbs/wk. For a
total of 35 to 45 lbs.
25. The client who is 41 week gestation, has just had a biophysical profile with the score of
2. Which of the following nursing interventions would be most appropriate.
a. Recognize this as an equivocal test and notify the health care provider. Score 6
b. Reschedule mother for repeat test during the next month.
c. Tell the mother this indicates fetal well being. Score 8-10
d. Consult the MD as this score is indicative of fetal distress.
26. The nurse who is assessing a G2 P1 client palpates the fundal height at the location noted
on the picture below. The nurse concludes that the fetus is equal to which of the following
gestational ages.
a. 18-20 weeks
b. 36-38 weeks
c. 28- 30weeks
d. 10-12 weeks
27. The nurse who is assessing a G2 P1 client palpates the fundal height at the xiphoid
process. The nurse concludes that the fetus is equal to which of the following
gestational ages?
a. 14-16 weeks Between syphilis and umbilicus
b. 28-30 weeks below Xiphoid process
c. 18-20 weeks Umbilicus
d. 36-38 weeks xiphoid process
G3 P2 Fundal height: at the umbilicus
28. A nurse is caring for a client who is scheduled for an alpha-fetoprotein (AFP) blood test
at 15 weeks’ gestation [OR for a quad blood test at 16 weeks gestation.] The nurse
instruct the client that this test screen for the possibility of:
a. Gestational diabetes in the mother.
b. Spinal defects in the fetus.
c. Inborn errors of metabolism in the fetus.
d. RH incompatibility between the mother and fetus.
29. Amniotic fluid serves which of the following functions: (SATA)
a. Control the fetus’s environmental temperature.
b. Provide protective cushion for the fetus
c. Allow for organ and tissue growth of the client.
d. Prevent teratogens from crossing the placenta.
e. Provide adequate respiration for the fetus.
f. Allows for organ tissue growth of the fetus
g. Is a collection reservoir for fetal urine
Rationale: Function of amniotic fluid :
▪ Acts as a cushion for the fetus when there are sudden maternal movements
▪ Prevents adherence of the developing human to the amniotic membranes
▪ Allows freedom of fetal movement, which aids in symmetrical musculoskeletal
development
▪ Provides a consistent thermal environment -Prevents heat loss; preserves constant fetal
body temperatures.
• Acts as excretion – collection system.
• Facilitates fetal growth & development
30. A pregnant client who is 32 weeks gestation is having a non-stress test for fetal well being.
The nurse interprets that which of the following meets the criteria for a reactive NST:
a. FHR baseline 140 with two accelerations to 155 for 15 seconds with 20 minutes
with moderate variability.
31. A nurse is caring for a client who has a non-stress test performed. The fetal heart rate (FHR)
is 130 to 150 min, but there has been no fetal movement for 15min. Which of the following
actions should the nurse perform?
a. Encourage the client to walk around without the monitoring unit for 10min , then
resume monitoring
b. Immediately report the situation to the client's provider and prepare the client for
induction of labor.
c. Offer the client a snack or orange juice and crackers
d. Turn the client onto the left side.
32. A nurse is caring for a client who is in preterm labor with a current L/S ratio of 1:1. Which
of the following actions should the nurse take?
a. Administer Betamethasone 12mg IM
b. Administer hydralazine 25 mg IV
c. Infuse a bolus of IV fluid
d. Prepare the client for immediate delivery
33. A nurse is caring for a 30-week pregnant client with a Lecithin-sphingomyelin (L/S) ratio
1:1. The nurse interprets this to mean:
a. Low alpha-fetoprotein level which can indicate neural tube defect
 b. Lack of sufficient fetal lung surfactant
c. Low dimer inhibit A (DIA) which can signify fetal chromosomal defects.
d. This is a normal value for a full-term fetus
34. When tubal factors are the cause of infertility, the nurse can educate the client about which
of the following management methods.
a. Zygote intrafollopian transfer
b. Artificial insemination by partner
c. In vitro fertilization
d. Sperm washing
35. When the sperm and oocyte of both partners are joined and placed into the fallopian tube,
the nurse knows that this represents which of the following management methods?
a. Sperm washing [place the sperm sample in a test tube and then centrifuge]
b. Artificial insemination by her partner
c. Gamete intrafallopian transfer
d. In vitro fertilization [egg and sperm combine in vitro in lab]
36. In a routine prenatal visit, the nurse examines a client who is 37 weeks pregnant and notices
that the fetal heart has dropped to 120 beats per minute from a rate of 140 beats per minute
earlier in the pregnancy. The nurse should:
a. Turn the client to the left side
b. Ask if the client has take any sedative
c. Notify the healthcare provider
d. Record the rate has normal
37. The client ask the nurse how a woman can recognize when she is ovulating. Which should be
the nurse’s response ?
a. The mucus produced by the cervix becomes abundant and stretchy.
b. Your appetite may decrease with ovulation.
c. The body temperature drops and stays low for the next 7 days.
d. You can use the over-the-counter urine test which gives a negative luteinizing
hormone result.
38. The client asks the nurse how to recognize when she is ovulating because she and her
husband are trying to get pregnant. Which should be the nurse's response? Select all that
apply
a. Increase in basal body temperature
b. Abundant vaginal mucous that is stretchy
c. Increase in vaginal acidity
d. Increase in libido
e. Increase in urination
Mucous thin, stretchy, slippery. ↑ Libido, ↑ BBT, vaginal spotting, lower abdominal cramps.
Ovulation occurs 14 days before next menses. Pain during ovulation called mittlzeshmirtz
39. The nurse is teaching a student about maternal hormones. Which statement indicates that
FURTHER teaching is needed?
a. The luteinizing hormone rises after ovulation has already occurs
b. Human chorionic gonadotropin is made by the embryo and help maintain the corpus
luteum
c. The follicle stimulating hormone stimulates the development of (follicles) eggs in the
ovaries
d. The corpus luteum produces estrogen and progesterone to prepare the endometrial
 lining for possible implantation.
40. A nurse is at a prenatal clinic, caring for a client who is in her first trimester of pregnancy.
The client tells the nurse that she is upset because although she and her husband planned
this pregnancy, she has been having many doubts and second thoughts about the upcoming
changes in her life. Which of the following is an appropriate response by the nurse.
a. Perhaps you should see a counselor to discuss these feelings further.
b. Ambivalent feelings are quite common for women in early pregnancy.
c. Have you spoken to your mother about these feelings?
d. Don’t worry. You would be fine once the baby is born.
41. The nurse know a normal physiologic alteration of circulatory system associated
thromboembolic event associated in pregnancy is:
a. Decreased hematocrit and increased red blood cell level RBC
b. Increase fibrinogen and decrease fibrinolysis.
c. Increase blood volume and increase cardiac output.
d. Decrease BP and decreased Hgb
42. A father asks the nurse how the baby can exist in fluid for so long without resulting in some
harmful effects on the skin. The nurse best reply would be
a. A soft Lanugo hair protect the skin from exposure to the amniotic fluid
b. There is a thick layer of subcutaneous fat on the baby, so the water does not harm
the skin
c. We will apply cream to the baby’s skin after delivery to make it smooth and soft
d. The baby’s skin is covered with a protective fatty substance called vernix
caseosa
43. The student nurse is preparing a presentation on the nutritional needs of pregnant teens.
Which should be included in her teaching plan.
a. Increase caloric intake by 200 a day.
b. Avoid eating fish containing high levels of mercury.
c. Limit caffeine beverages to 1-2 a day.
d. Do not gain more than 25 pounds in pregnancy due to body image issues.
e. Avoid, alcohol, tobacco and drugs
44. The nurse is preparing a presentation on the nutritional needs of pregnant teens. Which
items should be included in her teaching plan?
a. Avoid alcohol, tobacco and drugs
b. Increase caloric intake by 100 a day
c. Avoid eating fish containing high levels of mercury
d. Do not gain more than 15 pounds in pregnancy due to body image issues
e. Limit caffeine beverages to 1-2 a day
f. Avoid eating cold cuts
45. The student nurse is preparing a presentation on the nutritional needs of pregnant
client: SATA:
a. Limit caffeine bev to 3 a day (200mg daily or 1-2 drinks a day or 500-750 ml)
b. Do not gain more than 20 pounds in pregnancy due to body (gain 25-35 lb)
c. Avoid alcohol, tobacco, and drugs
d. Decrease caloric intake by 300 or more a day (Increase by 300)
e. Decrease eating fish containing high levels of mercury
46. A pregnant woman comes to the obstetrician’s office with complaints of nasal congestion
and epistaxis. What is the correct interpretation of these symptoms by the nurse?
 a. Estrogen increases blood supply to the mucous membranes and results in
congestion and nosebleed
b. Nasal stuffiness and nosebleeds are caused by a decrease in progesterone
c. Estrogen relaxes the smooth muscles in the respiratory tract, so congestion and
epistaxis are common
d. These conditions are abnormal, refer patient to ear, nose and throat specialist
47. A pregnant client has blood type B negative and has received an injection of Rhogam at 28
weeks, informs the client that she may get a second dose of rhogam ..
a. Continues to get rhogam after 72 hours .. if baby is positive after baby is born
48. A pregnant client has a Rh-negative blood type (B negative). Following the delivery of her
infant who has a blood type of B positive. You administer the RhIG D immune globulin
Rhogam. The nurse states that the purpose of this medication is to:
a. Stimulate maternal D immune antigens
b. Promote maternal D antibody formation
c. Prevent maternal D antibody formation
d. Prevent fetal Rh blood formation
49. A 32 year old G3p2 client is returning for her prenatal visit at 28 weeks. Her prenatal labs on
record thus far are as follows: Type & Rh= A negative. Antibody screen normal. RPR=
negative HIV= negative Rubella titer is 1:6 (LOW). Cervical smear is negative for gonorrhea
and chlamydia. Hemoglobin/ hematocrit= 10 mg/dl and 32% (LOW). Gestational diabetes
screen @ 26 weeks- within normal limits. UA negative. Today her plan for care should
include which of the following: (SATA)
a. Obtain a Group Beta Strep culture. (between 35-37 weeks)
b. Administer Rubella Vaccine IM (not while pregnant)
c. Start client on an iron supplement
d. Instruct client on signs and symptoms of preterm labor
e. Administer Rhogam IM
50. A laboring client ask the nurse, why does the healthcare provider wants to use an intrauterine
pressure catheter (IUPC) during labor? The nurse would accurately explain the best rationale
for using IUPC is:
a. The tocodonymater can only be used as the cervix is dilated 2cm
b. The IUPC provides more accurate data than does the tocodonymater
c. The IUPC can be used throughout the birth process
d. A tocodonymatter cannot be used with ruptured membranes
51. A nurse is providing education to a client during her 1st prenatal visit. Which of the following
should the nurse include in the teaching to decrease the risk of preterm labor?
a. Continue the recommended daily allowance vitamin C (85 mg)
b. Increase fluids to 8-10 (8oz) glasses per day.
c. Maintain folic acid intake of 4 mcg per day. [0.4 mg or 400 mcg]
d. Increase caloric intake by 500 calories per day. [^300]
52. A pregnant client tells the nurse she only eats a plant based food diet. How should the nurse
counsel this client?
a. Let's discuss how we can ensure adequate caloric intake and proper nutrient
during your pregnancy
b. Your newborn is at a high risk for developing complications
c. It is important that we refer you to the nutritionist to discuss your eating disorder
d. It is important that you incorporate meat products into your diet for protein during
 pregnancy.
53. During the initial visit with the nurse at the fertility clinic, the patient asks what is the effect
of cigarette smoking or heavy alcohol intake has on the ability to conceive. What is the
nurse's best response?
a. After your first semen analysis, we will see if there will be any difficulty.
b. Only if you smoke more than one pack a day will you have difficulty
c. Smoking and large alcohol intake can affect the quantity of sperm.
d. Smoking and heavy alcohol use have no effect.
54. The nurse is teaching a client about maternal hormones. The woman notes that she has been
able to complete a full term pregnancy. According to her healthcare provider, she and her
husband have been able to achieve fertilization, but implantation never takes place. This is
likely due to the lack of which hormones?
a. Prolactin
b. Follicle stimulating hormone (FSH)
c. Human chorionic gonadotropin (HCG)
d. Progesterones
55. During the third trimester of pregnancy, the nurse knows
that the client may be experiencing which of the following common symptoms?
a. Nausea and vomiting (1rst)
b. Fatigue
c. Dyspnea
d. Stuffy nose and bleeding gums (increased blood production) (1rst)
56. A nurse is caring for a client in the prenatal clinic stating that she think she may be
pregnant because she is able to feel the baby move. Which of the following statement
by the nurse is an appropriate response ?
a. This is a positive sign of pregnancy.
b. This is a presumptive sign of pregnancy.
c. This is a probable sign of pregnancy.
d. This is a possible sign of pregnancy.
57. A nurse is caring for a client in the clinic stating that she thinks she may be pregnant
because she has missed a period and feels fatigued and nauseous. Which of the following
statements by the nurse is) an appropriate response?
a. These are possible signs of pregnancy
b. These are probable signs of pregnancy
c. These are presumptive signs of pregnancy
d. These are positive signs of pregnancy
58. A nurse is caring for a client in the clinic stating that she thinks she may be
pregnant because she has started to feel fluttering sensations. The nurse knows that
fetal movement felt by the patient is considered a positive sign of pregnancy if
a. It is accompanied by morning sickness
b. The fluttering sensations are strong
c. It is felt by the examiner
d. It is accompanied by positive human chorionic gonadotropin (HCG)
PRESUMPTIVE- amenorrhea- missed period; + PT in 1-2 wks. N & V [1st trimester]
Urinary frequency due to growing fetus Tender breasts [1st sign of preg.] Fatigue [1st tr.]
Quickening [ 16-20 wks.] movement felt by mom. [gas?] Thinning & softening of fingernails
[hormones]
PROBABLE - Suggests pregnancy. Not 100% Uterine enlargement : growth of fetus.
Goodell’s sign: cervix softens [8 wks] Chadwick’s: bluish color cervix, vagina, vulva [6-8 wks]
Hegar’s sign: softening lower uterine segment [6 wks] Chloasma; “mask of pregnancy” - ↑ skin
pigmentation linea nigra - dark vertical line center of abdomen.; nipples, areola Striae
gravidarum - stretch marks Braxton Hick’s contractions: periodic uterine tightening
Ballottement: fetus bounces off abdominal. wall with Vag exam. + HCG urine/blood test;
[possible ectopic - not viable]
POSITIVE- [not attributed to other conditions] Fetal heartbeat [heard by examiner] with
Doppler by 10-12 weeks Ultrasound [by 8 wks. complete fetus seen] Fetal movement [felt by
examiner & mom @ ~ 20 wks.]
59. A nurse in prenatal clinics completing a skin assessment of a client who is in the 2nd
trimester. Which of the following findings should the nurse expect? SATA
a. Chloasma
b. Linea nigra
c. Eczema
d. Psoriasis
e. Striae gravidarum
f. Darkening of areola
60. A pregnant patient enjoys exercising at a local health spa once a week. Which patient
comment indicates to the nurse that additional health teaching is needed?
a. I am earning to play table tennis
b. I limit exercising to low impact aerobics
c. Nothing feels nicer than a hot tub soak after exercise.
d. The gym gets hot and stuffy by mid morning.
61. A pregnant patient enjoys exercising at a local health spa once a week. Which patient
comment indicates to the nurse that additional health teaching is needed?
a. I don’t swim in the pool because I am afraid that the water will hurt
the baby
b. I walk around the indoor track
c. The gym gets hot and stuffy by mid-morning
d. I limit exercising to low-impact aerobics
62. A pregnant client at 16 weeks of gestation, has a hematocrit 35%. Her prepregnant
hematocrit was 40%. Which of the following statements by the nurse best explains this
change.
a. You are not eating iron rich foods like meat
b. Your change may indicate a serious problem that might harm the baby
c. Because your blood volume has increased, your hematocrit count is low.
d. Because of your pregnancy, you are not making enough red blood cells.
63. A nurse is caring for an antepartum client whose laboratory findings indicate a rubella titer
of 1:15. Which of the following is the correct interpretation of the data?
a. The client is immune to the rubella virus.
b. The client requires a rubella immunization during delivery.
c. The client requires rubella vaccination at this time.
d. The client is not experiencing a rubella infection at this time.
>1:8 immune , <1:8 non-immune
64. A client is 7 (or 10)-weeks pregnant and is experiencing nausea and vomiting each day.
Which of the following strategies would the nurse recommend to the client? (SATA)
 a. Eat crackers or plain toast before getting out of bed.
b. Eat a large evening meal.
c. Avoid foods with strong aroma
d. Drink a glass of orange juice before going to bed.
e. Eat high carbohydrate snacks before bed.
65. A nurse is reviewing a prenatal record of a client at 37 weeks gestation. The woman’s history
reveals: the birth of a twin girls at 39 weeks and a spontaneous abortion at 10 weeks.
According to the Gravida TPAL system which of the following describes the client’s present
situation
a. 3-2-0-1-2 → A) 3-1-1-0-1-2
b. 4-2-0-2-2
c. 5-1-0-2-1
d. 3-0-2-1-2
66. 27) A nurse is reviewing the prenatal record of a client at 35 weeks’ gestation. The woman’s
history reveals the birth of twin girls at 40 weeks, and a spontaneous abortion at 8 weeks
and 10 weeks. According to the Gravida Para TPAL system which of the following
describes the client’s present situation?
a. 4-2-2-0-2-2
b. 4-1-1-2-1-2
c. 4-1-1-0-2-2
d. 4-1-0-2-1-2
G- got pregnant - how many times?
P - number of deliveries via pregnancy
T- terms (birth - ex: 37 weeks)
P - premature birth
A - abortion
L - alive
67. A newborn is diagnosed with cystic fibrosis. His parents cannot understand how this could
happen because no one in their family has the disease. The nurse teaching should be based
on the fact that with autosomal recessive inheritance:
a. There is 1 in 4 chance that each offspring of a carrier couple would have the
disorder
b. Most affected genes occur because of random mutation
c. There is no male to female transmission
d. Each chick had 50% of developing the disease
Disease potential to an offspring has a potential of 25 %
68. A nurse is caring for an adolescent client who is 20 weeks pregnant. She states that her
parents don’t know about the pregnancy. The appropriate response by the nurse is:
a. You seem afraid to tell your parents.
b. Give your parents a chance. They will understand.
c. If you want me to, I can tell your parents.
d. Your parents would have to know eventually.
69. The nurse instructs a pregnant client that the purpose of an amniocentesis at (36) 37 weeks
gestation is for:
a. Identify the sex of the fetus
b. Identification of abnormal fetal cells
c. Determine fetal lung maturity
 d. Detection of metabolic abnormalities
70. A newborn is diagnosed with fetal alcohol syndrome. The father comments to the nurse, “I
am so worried about my baby’s health” what other comment by the father indicates the need
for more teaching?
a. I know it can cause intellectual impairment
b. I know it can cause developmental delays.
c. I know it can cause irreversible brain damage
d. I know the symptoms will improve with prompt medical care
71. A client after attempting to get pregnant for over 1 year is determined to be anovulatory.
Which medication should a nurse anticipate being ordered?
a. Rhogam
b. Calcium gluconate
c. Oxytocin
d. Clomiphene citrate
72. A nurse is caring for a client who did not get prenatal care and is 38 weeks’ gestation. The
clients report moderate red vaginal bleeding that started in the morning and is not
accompanied by contractions. The client is not in distress and states she can “feel the
baby moving”. An ultrasound is scheduled. The nurse should explain to the client that the
ultrasound is being done today to assess for which of the following? What is the nurse’s
best response?
a. Fetal distress
b. Placenta previa
c. Fetal lung maturity [Amniocentesis by 2nd or 3rd trimester]
d. Nuchal translucency
73. Client reports moderate red vaginal bleeding that started in the morning and not
accompanied by contractions. MD suspects placenta previa. The nurse should explain
to the client which test will be done right away to assess the problem??
a. Answer: ultrasound
74. A nurse is teaching a client that is 16 weeks pregnant and HIV positive about HIV
treatment. Which of the following made by the client indicates that she needs more
teaching?
a. Without HIV treatment, transmission to my baby is 100% (25%)
b. My baby will get Zidovudine (ZVD) by mouth right after birth He needs ZVD, 12
hours after
c. During labor, I will continue to get ZVD through my IV
d. During pregnancy, I will take my ZVD tablet at the same time every day
75. A nurse is teaching a client that is 16 weeks pregnant and HIV positive about HIV
treatment. Which statement is correct?
a. Answer: During labor, I will continue to get Zidovudine through my IV
76. Changes she is noticing in her breasts ..
Tender breasts
Linea nigra
77. Prevention of …is good hand washing

Math:
1. 3200 gram baby. Med ordered is 0.2 mg/kg . Find mg
2. The healthcare provider has ordered 0.35 mg of atropine sulfate subcatenoiusly.
Based on the label below, how much should the nurse administer.
Order= 0.35 mg
Supplied dose= 0.4 mg/1 ml
Ans= 0.35 mg/x mL * 0.4 mg/1 ml Answer= 0.88 ml

3. A newborn who weighs 4 kg is to receive 15 mg/kg of cefuroxime q 12

hours. The supply on hand is 50mg/1 mL. To safely administer this
medication. How many milliliters dies the nurse draws up.
4 kg * 15 mg/1 kg= 60 mg
60 mg/x ml * 50 mg/ 1 ml= 1.2 ml