1. A 26-week gestation woman id diagnosed with severe preeclampsia. The nurse
assesses for which of the following signs/ symptoms associated with
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syndrome?
a. Epigastric pain
b. High serum protein
c. Hyporeflexia
d. Thrombocytopenia
e. Bloody stools
2. Client is being discharged from the hospital after evacuation of a molar
pregnancy. The nurse recognizes that additional discharge teaching is required
when the client states:
a. “I am so sad for my loss”
b. “I may need to have chemotherapy after this”
c. “I will need to see the doctor in one year for a follow-up”
d. “I will use contraception for the next year”
3. A patient who is having a difficult labor is diagnosed with cephalopelvic
disproportion (CPD). The nurse should question which medical order:
a. Maintain NPO status
b. Start IV of Normal Saline
c. Add 10 units of oxytocin to IV fluids – cesarean birth is indicated
when there is a cephalopelvic disproportion, no need toinduce labor may
result in uterine rupture and fetal compromise
d. Record fetal heart tones every 15 minutes
4. A client is admitted to the hospital with an ectopic pregnancy. The symptoms
that caused her to seek health care is most likely to havebeen:
a. Sharp unilateral abdominal pain
b. Uncontrolled vomiting
c. Lack of fetal movement
d. Profuse vaginal bleeding
5. An increased risk for shoulder dystocia is associated with:
a. Preterm labor
b. Maternal diabetes
c. VBAC
d. Previous precipitous birth
6. A primigravida patient who is 29 weeks pregnant comes to the labor anddelivery
unit. She is O+ and rubella immune. She states she is having regular contractions
every 8 minutes. An exam reveals she is 3 cm dilated. Which of the following can
the nurse expect to administer?
a. Folic acid
b. Nifedipine
c. Betamethasone
d. Rhogram
e. IV fluids
f. Morphine
7. A 28 year old, G3G2 has just been diagnosed with gestational diabetes at30
weeks. The client asks what types of complications may occur with this diagnosis.
Which complications should the nurse identify as being associated with gestational
diabetes?
a. Maternal seizures
b. Large for gestational age infant
c. Hyperglycemia in the newborn
d. Hypoglycemia in the newborn
e. Fetal anemia
8. Which of the following is an indication to discontinue administration of
magnesium sulfate in a women with preeclampsia?
a. Blood pressure of 120/70
b. Nausea and vomiting
c. Epigastric pain
d. Respiratory rate of 10
9. When a breech presentation is suspected during the intrapartum period, a priority
nursing interventions is to diligently observe the client for signsof:
a. Hip dysplasia
b. Cord prolapse
c. A precipitous delivery
d. Labor progression
10. A 34 year old with chronic hypertension arrives at the emergency department stating
that she is in labor and complaining of constant pain between contractions. The
nurse palpates a rigid abdomen with no signs of relaxation and concludes that the:
a. fetus birth may be imminent
b. patient may have abruptio placentae
c. patient may have placenta previa
d. fetus may be in the breech presentation
11. A patient is admitted in active labor with her second baby. Her prenatal record
indicates she has a history of genital herpes. When performing the admission
assessment, the nurse notes herpetic lesionson the genitalia confirmed by the
physician, in order to shorten the second stage of labor:
a. Done vaginally, with forceps and an episiotomy, to shorten thesecond
stage of labor
b. Preceded by 2 doses of antibiotics, to decrease transmission to thebaby
c. A cesarean birth, to prevent exposure of the baby to
herpetic lesions
d. A cesarean birth, to decrease maternal stress from the labor andminimize
exacerbation of the herpes.
12. A client who is 3 months pregnant comes to the prenatal clinic because she is
having some dark brown vaginal bleeding and experiencing severe nausea
and vomiting. Her fundal height islarger
than expected, there are no fetal heart tones auscultated. Which of thefollowing
complications should the nurse suspect?
a. Hyperemesis gravidarum
b. Threatened abortion
c. Placenta previa
d. Molar pregnancy
13. A sterile vaginal exam is contraindicated in:
a. A patient with placenta previa
b. A patient who is GBS+ (Group B Strep)
c. A patient with ruptured membranes
d. A patient in transition
14. A primigradida with pregesational type 1 diabeted is at her first prenatal visit.
When discussing changes in insulin needs during pregnancy and birth, the nurse
explains that based on her blood glucoselevels she should expect to decrease her
insulin dosage between the:
a. 8
th and 11th weeks of gestation
b. 18th and 21st weeks of gestation
c. 24th and 28th weeks of gestation- At the end of the second trimester and
the beginning of the third trimester, insulin needs increasebecause of an
increase in maternal resistance to insulin. During the earlier part of
pregnancy, fetal demands for maternal glucose may causea tendency
toward hypoglycemia. During the last weeks of pregnancy, maternal
resistance to insulin decreases and insulin needs decrease accordingly.
d. 36th week of gestation and the time of birth
15. A baby is entering the pelvis in the vertex presentation with theposterior
frontanel palpable near the mothers sacrum. The nurse determines that which
of the following malpositions is consistent withthis situation?
a. LSP (left sacral posterior)
b. ROP (right occiput posterior)
c. LMA (left mentum anterior)
d. RADA (right acromion dorsal anterior)
16. The nurse is planning care for the newborn. Which of the followingnursing
interventions would best protect the newborn from the most common form of heat
loss?
a. Placing the newborn away from air currents
b. Pre-warming the examination table
c. Drying the newborn thoroughly
d. Removing wet linens from the isolate
17. The community nurse is working with poor women, who are formula-feeding their
infants. Which statement indicates that the nurse’seducation session was effective?
a. “I should use only soy-based formula for the first year”
b. “I follow the instructions for mixing the powdered formula
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