1. A 26-year-old client who delivered a baby 24 hours prior, reports cramping pain
while breast-feeding. The nurse caring for the client understands this
... [Show More] is a result of?
a. Oxytocin
b. Progesterone
c. Estrogen
d. Prolactin
2. The nurse anticipates that the health care provider will order carboprost to treat
which condition related to labor and delivery?
a. Ripening of the cervix
b. Labor induction
c. Uterine atony
d. Postpartum infection
3. The nurse is performing an assessment on a client who is at 38 weeks' gestation
and notes that the fetal heart rate is 174 beats/minute. On the basis of this finding,
what is the priority nursing action?
a. Document the finding.
b. Check the mother's heart rate.
c. Notify the health care provider (HCP).
d. Tell the client that the fetal heart rate is normal.
4. The health care provider (HCP) is assessing the client for the presence of
ballottement. To make this determination, the HCP should take which action?
a. Auscultate for fetal heart sounds.
b. Assess the cervix for compressibility.
c. Palpate the abdomen for fetal movement.
d. Initiate a gentle upward tap on the cervix.
5. The nurse is collecting data during an admission assessment of a client who is
pregnant with twins. The client has a healthy 5-year-old child who was delivered at
38 weeks and tells the nurse that she does not have a history of any type of
abortion or fetal demise. Using GTPAL, what should the nurse document in the
client's chart?
a. G = 3, T = 2, P = 0, A = 0, L = 1
b. G = 2, T = 1, P = 0, A = 0, L = 1
c. G = 1, T = 1, P = 1, A = 0, L = 1
d. G = 2, T = 0, P = 0, A = 0, L = 1
6. The nurse is providing instructions to a pregnant client who is scheduled for an
amniocentesis. What instruction should the nurse provide?
a. Strict bed rest is required after the procedure.
b. Hospitalization is necessary for 24 hours after the procedure.
c. An informed consent needs to be signed before the procedure.
d. A fever is expected after the procedure because of the trauma to the abdomen.
7. The nurse has performed a nonstress test on a pregnant client and is reviewing
the fetal monitor strip. The nurse interprets the test as reactive. How should the
nurse document this finding?
a. Normal
b. Abnormal
c. The need for further evaluation
d. That findings were difficult to interpret
8. A pregnant client asks the nurse about the types of exercises that are allowable
during pregnancy. The nurse should tell that client that which exercise is safest?
a. Swimming
b. Scuba diving
c. Low-impact gymnastics
d. Bicycling with the legs in the air
9. A pregnant client calls a clinic and tells the nurse that she is experiencing leg
cramps that awaken her at night. What should the nurse tell the client to provide
relief from the leg cramps?
a. "Bend your foot toward your body while flexing the knee when the cramps occur."
b. "Bend your foot toward your body while extending the knee when the cramps
occur."
c. "Point your foot away from your body while flexing the knee when the cramps
occur."
d. "Point your foot away from your body while extending the knee when the cramps
occur."
10. The nurse in a health care clinic is instructing a pregnant client how to perform
"kick counts." Which statement by the client indicates a need for further
instructions?
a. "I will record the number of movements or kicks."
b. "I need to lie flat on my back to perform the procedure."
c. "If I count fewer than 10 kicks in a 2-hour period I should count the kicks again
over the next 2 hours."
d. "I should place my hands on the largest part of my abdomen and concentrate on
the fetal movements to count the kicks."
11. The home care nurse visits a pregnant client who has a diagnosis of mild
preeclampsia. Which assessment finding indicates a worsening of the preeclampsia
and the need to notify the health care provider?
a. Urinary output has increased.
b. Dependent edema has resolved.
c. Blood pressure reading is at the prenatal baseline.
d. The client complains of a headache and blurred vision.
12. The nurse implements a teaching plan for a pregnant client who is newly
diagnosed with gestational diabetes mellitus. Which statement made by the client
indicates a need for further teaching?
a. "I should stay on the diabetic diet."
b. "I should perform glucose monitoring at home."
c. "I should avoid exercise because of the negative effects on insulin production."
d. "I should be aware of any infections and report signs of infection immediately to
my health care provider."
13. The home care nurse is monitoring a pregnant client with gestational
hypertension who is at risk for preeclampsia. At each home care visit, the nurse
assesses the client for which classic signs of preeclampsia? Select all that apply.
a. Proteinuria
b. Hypertension
c. Low-grade fever
d. Generalized edema
e. Increased pulse rate
14. The nurse is assessing a pregnant client with type 1 diabetes mellitus about her
understanding regarding changing insulin needs during pregnancy. The nurse
determines that further teaching is needed if the client makes which statement?
a. "I will need to increase my insulin dosage during the first 3 months of pregnancy."
b. "My insulin dose will likely need to be increased during the second and third
trimesters."
c. "Episodes of hypoglycemia are more likely to occur during the first 3 months of
pregnancy."
d. "My insulin needs should return to normal within 7 to 10 days after birth if I am
bottle-feeding."
15. The nurse is providing instructions to a maternity client with a history of cardiac
disease regarding appropriate dietary measures. Which statement, if made by the
client, indicates an understanding of the information provided by the nurse?
a. "I should increase my sodium intake during pregnancy."
b. "I should lower my blood volume by limiting my fluids."
c. "I should maintain a low-calorie diet to prevent any weight gain."
d. "I should drink adequate fluids and increase my intake of high-fiber foods."
16. The clinic nurse is performing a psychosocial assessment of a client who has
been told that she is pregnant. Which assessment finding indicates to the nurse that
the client is at risk for contracting human immunodeficiency virus (HIV)?
a. A client who has a history of intravenous drug use
b. A client who has a significant other who is heterosexual
c. A client who has a history of sexually transmitted infections
d. A client who has had one sexual partner for the past 10 years
17. A client in the first trimester of pregnancy arrives at a health care clinic and
reports that she has been experiencing vaginal bleeding. A threatened abortion is
suspected, and the nurse instructs the client regarding management of care. Which
statement made by the client indicates a need for further instruction?
a. "I will watch for the evidence of the passage of tissue."
b. "I will maintain strict bed rest throughout the remainder of the pregnancy."
c. "I will count the number of perineal pads used on a daily basis and note the
amount and color of blood on the pad."
d. "I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks
following the last evidence of bleeding."
18. The clinic nurse has provided home care instructions to a client with a history of
cardiac disease who has just been told that she is pregnant. Which statement, if
made by the client, indicates a need for further instructions?
a. "It is best that I rest lying on my side to promote blood return to the heart."
b. "I need to avoid excessive weight gain to prevent increased demands on my
heart."
c. "I need to try to avoid stressful situations because stress increases the workload
on the heart."
d. "During the pregnancy, I need to avoid contact with other individuals as much as
possible to prevent infection."
19. The nurse in the prenatal clinic is conducting a session about nutrition to a
group of adolescents who are pregnant. Which measure is most appropriate to
teach these adolescents?
a. Eat only when hungry.
b. Eliminate snacks during the day.
c. Avoid meals in fast-food restaurants.
d. Monitor for appropriate weight gain patterns.
20. A home care nurse is visiting a pregnant client with a diagnosis of mild
preeclampsia. What is the priority nursing intervention during the home visit?
a. Monitor for fetal movement.
b. Monitor the maternal blood glucose.
c. Instruct the client to maintain complete bed rest.
d. Instruct the client to restrict dietary sodium and any food items that contain
sodium.
21. A clinic nurse is instructing a pregnant client regarding dietary measures to
promote a healthy pregnancy. The nurse tells the client about the importance of an
adequate daily fluid intake. Which client statement best indicates an understanding
of the daily fluid requirement?
a. "I should drink 12 glasses of fruit juices and milk every day."
b. "I should drink 8 to 10 glasses of fluid a day, and I can drink as many diet soft
drinks as I want."
c. "I should drink 12 glasses of fluid a day, and I can include the coffee or tea that I
drink in the count."
d. "I should drink at least 8 to 10 glasses of fluid each day, of which at least 6
glasses should be water."
22. The clinic nurse is reviewing the medical record of a woman scheduled for her
weekly prenatal appointment. The nurse notes that the woman has been diagnosed
with mild preeclampsia. Of the following interventions, which should the nurse list
as having the lowest priority in planning nursing care for this client?
a. Assess blood pressure.
b. Discuss the need for hospitalization.
c. Assess deep tendon reflexes and edema.
d. Teach the importance of keeping track of a daily weight.
23. A pregnant woman in her second trimester calls the prenatal clinic nurse to
report a recent exposure to a child with rubella. Which response by the nurse would
be most appropriate and supportive to the woman?
a. "You should avoid all school-age children during pregnancy."
b. "There is no need to be concerned if you don't have a fever or rash within the
next 2 days."
c. "Be sure to tell the health care provider on your next prenatal visit, but there is
little risk in the second trimester."
d. "You were wise to call. I will check your rubella titer screening results, and we can
immediately identify whether future interventions are needed."
24. A contraction stress test is scheduled for a pregnant woman, and she asks the
nurse to describe the test. What should the nurse tell the woman?
a. Uterine contractions are stimulated by Leopold's maneuvers.
b. An external fetal monitor is attached, and the woman ambulates on a treadmill
until contractions begin.
c. The uterus is stimulated to contract by the administration of small amounts of
oxytocin (Pitocin) or by nipple stimulation.
d. Small amounts of oxytocin (Pitocin) are administered during internal fetal
monitoring to stimulate uterine contractions.
25. A nurse implements a teaching plan for a pregnant client who is newly
diagnosed with gestational diabetes mellitus. Which statement by the client
indicates a need for further teaching?
a. "I need to stay on the diabetic diet."
b. "I will perform glucose monitoring at home."
c. "I cannot exercise because of the negative effects on insulin production."
d. "I will report signs of infection immediately to my health care provider."
26. A pregnant woman tests positive for the hepatitis B virus (HBV). The woman
asks the nurse if she will be able to breast-feed the baby as planned after delivery.
Which response by the nurse is most appropriate?
a. "You will not be able to breast-feed the baby until 6 months after delivery."
b. "Breast-feeding is allowed after the baby has been vaccinated with immune
globulin."
c. "Breast-feeding is not advised, and you should seriously consider bottle-feeding
the baby."
d. "Breast-feeding is not a problem, and you will be able to breast-feed immediately
after delivery."
27. The nurse is caring for a client in labor. Which assessment finding indicates to
the nurse that the client is beginning the second stage of labor?
a. The contractions are regular.
b. The membranes have ruptured.
c. The cervix is dilated completely.
d. The client begins to expel clear vaginal fluid.
28. The nurse in the labor room is caring for a client in the active stage of the first
phase of labor. The nurse is assessing the fetal patterns and notes a late
deceleration on the monitor strip. What is the most appropriate nursing action?
a. Administer oxygen via face mask.
b. Place the mother in a supine position.
c. Increase the rate of the oxytocin (Pitocin) intravenous infusion.
d. Document the findings and continue to monitor the fetal patterns.
29. The nurse is performing an assessment of a client who is scheduled for a
cesarean delivery. Which assessment finding would indicate the need to contact the
health care provider?
a. Hemoglobin of 11 g/dL
b. Fetal heart rate of 180 beats/minute
c. Maternal pulse rate of 85 beats/minute
d. White blood cell count of 12,000 cells/mm3
30. 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. Accelerations
c. Early decelerations
d. Variable decelerations
31. A client in labor is transported to the delivery room and prepared for a cesarean
delivery. After the client is transferred to the delivery room table, the nurse should
place the client in which position?
a. Supine position with a wedge under the right hip
b. Trendelenburg's position with the legs in stirrups
c. Prone position with the legs separated and elevated
d. Semi-Fowler's position with a pillow under the knees
32. The nurse is monitoring a client in active labor and notes that the client is
having contractions every 3 minutes that last 45 seconds. The nurse notes that the
fetal heart rate between contractions is 100 beats/minute. Which nursing action is
most appropriate?
a. Notify the health care provider (HCP).
b. Continue monitoring the fetal heart rate.
c. Encourage the client to continue pushing with each contraction.
d. Instruct the client's coach to continue to encourage breathing techniques.
33. The nurse is admitting a pregnant client to the labor room and attaches an
external electronic fetal monitor to the client's abdomen. After attachment of the
electronic fetal monitor, what is the next nursing action?
a. Identify the types of accelerations.
b. Assess the baseline fetal heart rate.
c. Determine the intensity of the contractions.
d. Determine the frequency of the contractions.
34. The nurse is reviewing true and false labor signs with a multiparous client. The
nurse determines that the client understands the signs of true labor if she makes
which statement?
a. "I won't be in labor until my baby drops."
b. "My contractions will be felt in my abdominal area."
c. "My contractions will not be as painful if I walk around."
"My contractions will increase in duration and intensity."
35. The nurse is reviewing the health care provider's (HCP's) prescriptions for a
client admitted for premature rupture of the membranes. Gestational age of the
fetus is determined to be 37 weeks. Which prescription should the nurse question?
a. Monitor fetal heart rate continuously.
b. Monitor maternal vital signs frequently.
c. Perform a vaginal examination every shift.
d. Administer ampicillin 1 g as an intravenous piggyback every 6 hours. [Show Less]