Perinatal Nursing Exam Materials
Course Introduction
Perinatal Nursing is a specialized field that focuses on providing care to women and their families during the antepartum, intrapartum, postpartum, and neonatal periods. This course covers assessment and management of the physiological and psychological changes associated with pregnancy, labor, birth, and the transition to parenthood. Students will explore topics such as prenatal care, fetal development, complications of pregnancy and childbirth, pain management, newborn assessment, breastfeeding, family adaptation, and the role of the perinatal nurse as part of an interdisciplinary healthcare team. Emphasis is placed on evidence-based practices, cultural competence, patient education, and promoting optimal outcomes for mothers, infants, and families.
Recommended Textbook
Foundations of Maternal Newborn and Womens Health Nursing 6th Edition by Murray
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37 Chapters
1131 Verified Questions
1131 Flashcards
Source URL: https://quizplus.com/study-set/167 Page 2
Chapter 1: Maternity and Women's Health Care Today
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26 Verified Questions
26 Flashcards
Source URL: https://quizplus.com/quiz/2112
Sample Questions
Q1) The nurse is teaching a parenting class to new parents. Which statement should the nurse include in the teaching session about the characteristics of a healthy family?
A) Adults agree on the majority of basic parenting principles.
B) The parents and children have rigid assignments for all the family tasks.
C) Young families assume total responsibility for the parenting tasks, refusing any assistance.
D) The family is overwhelmed by the significant changes that occur as a result of childbirth.
Answer: A
Q2) Evidence-based care
A)A practice model that uses a systematic approach to identify specific patients and manage their care in a coordinated way
B)Identifies desired patient outcomes, specifies timelines for achievement of those outcomes, directs appropriate interventions and sequencing of interventions, includes interventions from a variety of disciplines, promotes collaboration, and involves a comprehensive approach to care
C)Develops clinical practice guidelines to provide safe and effective care
Answer: C
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3
Chapter 2: The Nurse's Role in Maternity and Women's Health Care
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/2113
Sample Questions
Q1) Which of the following indicates a nurse's role as a researcher?
A) Reading peer-reviewed journal articles
B) Working as a member of the interdisciplinary team to provide client care
C) Helping client to obtain home care post-discharge from the hospital
D) Delegating tasks to unlicensed personnel to allow for more teaching time with clients
Answer: A
Q2) Paraphrasing
A)Calling attention to differences or inconsistencies in statements
B)Using nonverbal responses or succinct comments to encourage the person to continue
C)Restating in words other than those used by the woman what she seems to express; a form of clarification
Answer: C
Q3) Which goal is most appropriate for the collaborative problem of wound infection?
A) The client will not exhibit further signs of infection.
B) Maintain the client's fluid intake at 1000 mL/8 hr.
C) The client will have a temperature of 98.6° F within 2 days.
D) Monitor the client to detect therapeutic response to antibiotic therapy.
Answer: D
Page 4
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Chapter 3: Ethical, Social, and Legal Issues
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27 Verified Questions
27 Flashcards
Source URL: https://quizplus.com/quiz/2114
Sample Questions
Q1) A nurse is working in the area of labor and birth. Her assignment is to take care of a gravida 1 para 0 who presents in early labor at term. Vaginal exam reflects the following: 2 cm, cervix posterior, -1 station, and vertex with membranes intact. The client asks the nurse "if she can break her water so that her labor can go faster?" The nurse's response, based on the ethical principle of nonmaleficence, is which of the following?
A) Tell the client that she will have to wait until she has progressed further on the vaginal exam and then she will perform an amniotomy.
B) Have the client write down her request and then call the physician for an order to implement the amniotomy.
C) Instruct the client that only a physician or certified midwife can perform this procedure.
D) Give the client an enema to stimulate labor.
Answer: C
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Chapter 4: Reproductive Anatomy and Physiology
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/2115
Sample Questions
Q1) Delayed onset of menstruation or primary amenorrhea is considered if the girl's periods have not begun by which age in years? Record your answer in a whole number.
Q2) The clinic nurse is reviewing breastfeeding with a pregnant client. Which hormone will the nurse include in the patient's teaching plan as the one primarily responsible for lactation after birth?
A) Prolactin
B) Estrogen
C) Luteinizing
D) Progesterone
Q3) Which 16-year-old girl may experience secondary amenorrhea?
A) Jackie, 5 ft 2 in, 130 lb
B) Karen, 5 ft 9 in, 150 lb
C) Carol, 5 ft 7 in, 96 lb
D) Linda, 5 ft 4 in, 120 lb
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Chapter 5: Hereditary and Environmental Influences on Childbearing
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25 Verified Questions
25 Flashcards
Source URL: https://quizplus.com/quiz/2116
Sample Questions
Q1) People who have two copies of the same abnormal autosomal dominant gene will usually be:
A) mildly affected with the disorder.
B) infertile and unable to transmit the gene.
C) carriers of the trait but not affected with the disorder.
D) more severely affected by the disorder than people with one copy of the gene.
Q2) Two healthy parents who carry the same abnormal autosomal recessive gene have what percentage chance of having a child affected with the disorder caused by this gene? Record your answer as a whole number.
_____%
Q3) Which characteristic is related to Down syndrome?
A) Up-slanting eyes
B) Abnormal genitalia
C) Bleeding tendency
D) Edema of extremities
Q4) X-linked recessive
A)Two genes are required to produce the trait.
B)A single copy of the gene is enough to produce the trait.
C)Only one copy of the gene is needed to cause the disorder in the male.
Page 7
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Chapter 6: Conception and Prenatal Development
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/2117
Sample Questions
Q1) An infant is diagnosed with fetal anemia. What information would support that clinical diagnosis?
A) Presence of excess maternal hormones
B) Maternal blood type O-negative, Rh-negative, and infant blood type O-negative, Rhnegative
C) Passive immunity
D) Rh-negative mother and Rh-positive baby
Q2) Which physical characteristics decrease as the fetus nears term? (Select all that apply.)
A) Vernix caseosa
B) Lanugo
C) Port wine stain
D) Brown fat
Q3) Which best describes what occurs during the fetal period of development?
A) Maturation of organ systems
B) Development of basic organ systems
C) Resistance of organs to damage from external agents
D) Development of placental oxygen-carbon dioxide exchange
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Chapter 7: Physiologic Adaptations to Pregnancy
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56 Verified Questions
56 Flashcards
Source URL: https://quizplus.com/quiz/2118
Sample Questions
Q1) Use Nägele's rule to determine the EDD (estimated day of birth) for a client whose last menstrual period started on April 12.
A) February 19
B) January 19
C) January 21
D) February 7
Q2) A pregnant client's mother is worried that her daughter is not "big enough" at 20 weeks of gestation. The nurse palpates and measures the fundal height at 20 cm, which is even with the woman's umbilicus. Which should the nurse report to the client and her mother?
A) "You're right. We'll inform the practitioner immediately."
B) "Lightening has occurred, so the fundal height is lower than expected."
C) "The body of the uterus is at the belly button level, just where it should be at this time."
D) "When you come for next month's appointment, we'll check you again to make sure that the baby is growing."
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Chapter 8: Psychosocial Adaptations to Pregnancy
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24 Verified Questions
24 Flashcards
Source URL: https://quizplus.com/quiz/2119
Sample Questions
Q1) In some Middle Eastern and African cultures, female genital mutilation is a prerequisite for marriage. Women who now live in North America need care from nurses who are knowledgeable about the procedure and comfortable with the abnormal appearance of their genitalia. When caring for this client, the nurse can formulate a diagnosis with the understanding that the client may be at risk for which of the following? (Select all that apply.)
A) Infection
B) Laceration
C) Hemorrhage
D) Obstructed labor
E) Increased signs of pain response
Q2) While teaching an Asian client about prenatal care, the nurse notes that the client refuses to make eye contact. Which is the most likely cause?
A) A submissive attitude
B) Lack of understanding
C) Embarrassment about the subject
D) Cultural beliefs about eye contact
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Chapter 9: Nutrition for Childbearing
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53 Verified Questions
53 Flashcards
Source URL: https://quizplus.com/quiz/2120
Sample Questions
Q1) The nurse is teaching a breastfeeding client about substances to avoid while she is breastfeeding. Which substances should the nurse include in the teaching session? (Select all that apply.)
A) Caffeine
B) Alcohol
C) Omega-6 fatty acids
D) Appetite suppressants
E) Polyunsaturated omega-3 fatty acids
Q2) The pregnant client with significant iron deficiency anemia is prescribed iron supplements. The client confides to the nurse that she can't take iron because it makes her nauseous. What is the best response by the nurse?
A) "Iron will be absorbed more readily if taken with orange juice."
B) "It is important to take this drug regardless of this side effect."
C) "Taking the drug with milk may decrease your symptoms."
D) "Try taking the iron at bedtime on an empty stomach."
Q3) Zinc
A)Important in cell growth and neuromuscular function
B)Important in thyroid function
C)Important in DNA and RNA synthesis
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Page 11
Chapter 10: Antepartum Fetal Assessment
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38 Verified Questions
38 Flashcards
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Sample Questions
Q1) Which should be considered a contraindication for transcervical chorionic villus sampling?
A) Rh-negative mother
B) Gestation less than 15 weeks
C) Maternal age younger than 35 years
D) Positive for group B Streptococcus
Q2) Doppler ultrasound
A)A test for estimating fetal lung maturity
B)A test to assess blood flow to identify abnormalities
C)A test to diagnose fetal chromosomal, metabolic, or DNA abnormalities
Q3) The health care provider has prescribed an initial rate of 1 milliunits (mU)/min of diluted Pitocin to be started on a client having a contraction stress test (CST). What mL/hr will the nurse set the infusion pump if the dilution of the Pitocin is 10 units of Pitocin in 1000 mL of 0.25 normal saline? Record your answer as a whole number. ___________ mL/hr
Q4) Chorionic villus sampling (CVS)
A)A test for estimating fetal lung maturity
B)A test to assess blood flow to identify abnormalities
C)A test to diagnose fetal chromosomal, metabolic, or DNA abnormalities
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Chapter 11: Perinatal Education
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27 Verified Questions
27 Flashcards
Source URL: https://quizplus.com/quiz/2122
Sample Questions
Q1) Martha is a gravida 3, para 2, whose last child was born 5 years ago. She attended childbirth preparation classes with her first pregnancy. Which class would be most appropriate for her?
A) Refresher course
B) Infant care classes
C) Postpartum classes
D) Early pregnancy classes
Q2) A relaxation technique that can be used during the childbirth experience to decrease maternal pain perception is:
A) using increased environmental stimulation as a method of distraction.
B) restricting family and friends from visiting during the labor period to keep the client focused on breathing techniques.
C) medicating the client frequently to reduce pain perception.
D) assisting the client in breathing methods aimed at taking control of pain perception based on the contraction pattern.
Q3) Dick-Read childbirth education
A)Includes the father as a support person and a coach
B)Psychoprophylaxis class that uses the mind to prevent pain
C)Classes focus on breathing to prevent the fear-tension-pain cycle
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Page 13
Chapter 12: Processes of Birth
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40 Verified Questions
40 Flashcards
Source URL: https://quizplus.com/quiz/2123
Sample Questions
Q1) The nurse who elects to practice in the area of obstetrics often hears discussion regarding the four Ps. What are the four Ps that interact during childbirth? (Select all that apply.)
A) Powers
B) Passage
C) Position
D) Passenger
E) Psyche
Q2) To determine if the client is in true labor, the nurse would assess for changes in:
A) cervical dilation.
B) amount of bloody show.
C) fetal position and station.
D) pattern of uterine contractions.
Q3) Pregnant clients can usually tolerate the normal blood loss associated with childbirth because they have:
A) a higher hematocrit.
B) increased leukocytes.
C) increased blood volume.
D) a lower fibrinogen level.
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Page 14
Chapter 13: Nursing Care During Labor and Birth
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43 Verified Questions
43 Flashcards
Source URL: https://quizplus.com/quiz/2124
Sample Questions
Q1) A gravida 1, para 0, 38 weeks' gestation is in the transition phase of labor with SROM and is very anxious. Vaginal exam, 8 cm, 100% effaced, -1 station vertex presentation. She wants the nurse to keep checking her by performing repeated vaginal exams because she is sure that she is progressing rapidly. What is the best response that the nurse can provide to this client at this time?
A) Performing more frequent vaginal exams will not make the labor go any quicker.
B) Even though she is in transition, frequent vaginal exams must be limited because of the potential for infection.
C) Tell the client that she will check every 30 minutes.
D) Medicate the client as needed for anxiety so that the labor can progress.
Q2) A nursing priority during admission of a laboring client who has not had prenatal care is:
A) obtaining admission labs.
B) identifying labor risk factors.
C) discussing her birth plan choices.
D) explaining importance of prenatal care.
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15
Chapter 14: Intrapartum Fetal Surveillance
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45 Verified Questions
45 Flashcards
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Sample Questions
Q1) Variable decelerations
A)Caused by umbilical cord compression
B)Caused by fetal head compression
C)Caused by uteroplacental insufficiency
Q2) Which of the following therapeutic applications provides the most accurate information related to uterine contraction strength?
A) External fetal monitoring (EFM)
B) Internal fetal monitoring
C) Intrauterine pressure catheter (IUPC)
D) Maternal comments based on perception
Q3) The nurse admits a laboring patient at term. On review of the prenatal record, the patient's pregnancy has been unremarkable and she is considered low risk. In planning the patient's care, at what interval will the nurse intermittently auscultate (IA) the fetal heart rate during the first stage of labor?
A) Every 10 minutes
B) Every 15 minutes
C) Every 30 minutes
D) Every 60 minutes
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Chapter 15: Pain Management During Childbirth
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47 Verified Questions
47 Flashcards
Source URL: https://quizplus.com/quiz/2126
Sample Questions
Q1) The nurse is providing care to a patient in the active phase of the first stage of labor. The patient is crying out loudly with each contraction. What is the nurse's priority action for this patient?
A) Ask the patient's labor coach if this is a usual expression of pain for her.
B) Refer to the patient's chart to determine any orders for pain medication.
C) Tell the patient that she is disturbing the other laboring patients on the unit.
D) Encourage the patient to try to suppress her noisiness during contractions.
Q2) A labor client has brought in with her a picture of her two children and asks the nurse to place it on the wall so that she can look at it during labor contractions. This is an example of:
A) focal point.
B) distraction.
C) effleurage.
D) relaxation.
Q3) Which client will most likely have increased anxiety and tension during labor?
A) Gravida 2 who refused any medication
B) Gravida 2 who delivered a stillborn baby last year
C) Gravida 1 who did not attend prepared childbirth classes
D) Gravida 3 who has two children younger than 3 years
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Page 17
Chapter 16: Nursing Care During Obstetric Procedures
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52 Verified Questions
52 Flashcards
Source URL: https://quizplus.com/quiz/2127
Sample Questions
Q1) The greatest risk to the newborn after an elective cesarean birth is:
A) tachypnea because of maternal anesthesia.
B) tachycardia because of maternal narcotics.
C) trauma because of manipulation during birth.
D) prematurity because of miscalculation of gestation.
Q2) The labor nurse is providing care for a patient admitted for induction of labor at 38 weeks' gestation. The patient's Bishop score is 5, and an infusion of oxytocin (Pitocin) is initiated with orders that read as follows: mix 30 units of Pitocin in 500 mL of NS, increase the rate of infusion by 2 mL/hr every 15 to 60 minutes until a pattern of three contractions in 10 minutes is established. What is the priority nursing action for this patient?
A) Increase the infusion of Pitocin every 30 to 60 minutes.
B) Assess for changes in the patient's cervix every 2 hours.
C) Obtain a reactive non-stress test prior to starting the infusion.
D) Determine the fetal heart rate baseline for 30 minutes prior to starting the infusion.
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18
Chapter 17: Postpartum Physiologic Adaptations
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36 Verified Questions
36 Flashcards
Source URL: https://quizplus.com/quiz/2128
Sample Questions
Q1) The nurse is caring for a postpartum client who delivered by the vaginal route 12 hours ago. Which assessment finding should the nurse report to the health care provider?
A) Pulse rate of 50
B) Temperature of 38° C (100.4° F)
C) Firm fundus, but excessive lochia
D) Lightheaded when moving from a lying to standing position
Q2) Postpartal overdistention of the bladder and urinary retention can lead to which complication?
A) Fever and increased blood pressure
B) Postpartum hemorrhage and eclampsia
C) Urinary tract infection and uterine rupture
D) Postpartum hemorrhage and urinary tract infection
Q3) Vaginal exam findings reveal a slitlike opening of the cervix. What is the correct interpretation of this finding with regard to obstetric history?
A) Client has not been pregnant.
B) Client has had a C section as a method of birth.
C) Client has been treated for an STD with resultant scarring of the cervix.
D) Client has a history of pregnancy.
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Page 19
Chapter 18: Postpartum Psychosocial Adaptations
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29 Verified Questions
29 Flashcards
Source URL: https://quizplus.com/quiz/2129
Sample Questions
Q1) A husband calls the nurse's station stating that his wife, who delivered last week, is happy one minute and crying the next. He says, "She was never like this before the baby was born." Which should be the nurse's initial response?
A) Reassure him that this behavior is normal.
B) Advise him to get immediate psychological help for her.
C) Tell him to ignore the mood swings because they will go away.
D) Instruct him in the signs, symptoms, and duration of postpartum blues.
Q2) The postpartum client who continually repeats the story of her labor, birth, and recovery experiences is doing which?
A) Making the birth experience "real"
B) Accepting her response to labor and birth
C) Providing others with her knowledge of events
D) Taking hold of the events leading to her labor and birth
Q3) Taking-hold
A)Passive, dependent
B)Begins to see self as a mother
C)Autonomous, seeking information
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Page 20
Chapter 19: Normal Newborn: Processes of Adaptation
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29 Verified Questions
29 Flashcards
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Sample Questions
Q1) An infant at 36 weeks' gestation was just delivered; included in the protocol for a preterm infant is an initial blood glucose assessment. The nurse obtains the blood and the reading is 58 mg/dL. What is the priority nursing action based on this reading?
A) Document the finding in the newborn's chart.
B) Double-wrap the newborn under a warming unit.
C) Feed the newborn a 10% dextrose solution.
D) Notify the neonatal intensive care unit (NICU) of the pending admission.
Q2) In the newborn nursery, you are reviewing the maternal medication list to ascertain if there is any significant risk to the newborn. Which medications would pose a potential risk to the newborn in terms of clotting ability? (Select all that apply.)
A) Carbamazepine
B) Phenytoin (Dilantin)
C) Phenobarbital
D) INH (Isoniazid)
Q3) Immunoglobulin G (IgG)
A)Only immunoglobulin to cross the placenta
B)First immunoglobulin produced by the newborn when stressed
C)Important in protection of the gastrointestinal and respiratory system
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21
Chapter 20: Assessment of the Normal Newborn
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26 Verified Questions
26 Flashcards
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Sample Questions
Q1) The nurse is performing a gestational age assessment on a newborn. Which characteristics indicate a preterm newborn? (Select all that apply.)
A) Translucent skin
B) Extended limp arms and legs
C) The ear springs back when folded
D) Square window angle of 45 degrees or less
E) Large clitoris and labia minora in the female newborn
Q2) The nurse is assessing a newborn delivered 24 hours ago for jaundice. What is the best way to evaluate for this finding?
A) Depress the tip of the nose.
B) Stroke the outer aspect of the foot.
C) Place a finger in the palm of the hand.
D) Rotate the hips in an upward and outward direction.
Q3) Cephalohematoma
A)Bleeding between the periosteum and the skull
B)An area of localized edema that appears over the vertex of the newborn's head
C)Changes in the shape of the head that allow it to pass through the birth canal
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22
Chapter 21: Care of the Normal Newborn
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Sample Questions
Q1) The nurse has just completed discharge teaching to parents on newborn bathing. Which statement made by the parents indicates a further need for teaching? (Select all that apply.)
A) "We will clean the diaper area last."
B) "We will use cotton-tipped swabs to clean the ears."
C) "We will use an antibacterial soap during the sponge bath."
D) "We can submerge the baby in a tub of water after the cord falls off."
E) "We will shampoo the baby's head using a football hold before unwrapping."
Q2) A 38 weeks' gestation fetus is delivered via cesarean section and transported to the newborn nursery in an isolette. Apgar scores were 8, 9, and 10. At this time, the infant is receiving an initial assessment in the newborn nursery. Which is the priority nursing diagnosis?
A) Risk for injury related to potential equipment malfunction of radiant warmer
B) Altered tissue perfusion related to use of medications during delivery process
C) Ineffective airway clearance due to mode of delivery and use of anesthetics
D) Risk for ineffective thermoregulation related to gestational age
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23
Chapter 22: Infant Feeding
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Sample Questions
Q1) A newborn infant weighs 7 pounds, 2 ounces, on the fifth day of life. How much water should be given to the newborn based on required fluid needs?
A) Fluid replacement should be based on weight and calculated in the range of 60 to 100 mL/kg.
B) Offer additional water to tolerance in between infant feedings to maintain hydration.
C) Give 12 ounces of fluid per feeding.
D) No water is needed because formula and breast milk are adequate to maintain hydration.
Q2) For which infant should the nurse anticipate the use of soy formula? (Select all that apply.)
A) Preterm infant
B) Infant with galactosemia
C) Infant with phenylketonuria
D) Infant with lactase deficiency
E) Infant with a malabsorption disorder
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Chapter 23: Home Care of the Infant
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Sample Questions
Q1) Parents ask the nurse, "How many wet diapers a day should we expect and how will we know the baby's stools are normal?" Which response should the nurse make if the infant is being formula fed? (Select all that apply.)
A) The stools should be watery.
B) The stools should be dry and hard.
C) The infant should have at least one stool a day.
D) The infant should have at least six wet diapers a day.
Q2) Which infant should be seen immediately by a health care provider?
A) A 1-week-old infant with a diaper rash
B) A 1-month-old infant with an axillary temperature of 99.8° F (37.7° C)
C) A 3-week-old breast-fed infant who has had two loose stools
D) A 2-week-old infant with nasal congestion and respirations of 64 breaths/min
Q3) Infant immunizations should begin at which age?
A) Birth
B) 2 months
C) 3 months
D) 4 months
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Chapter 24: The Childbearing Family with Special Needs
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Sample Questions
Q1) During which phase of the cycle of violence does the batterer become contrite and remorseful?
A) Battering
B) Honeymoon
C) Tension-building
D) Increased drug taking
Q2) Many teens wait until the second or even third trimester to seek prenatal care. The nurse should understand that the reasons behind this delay include which of the following? (Select all that apply.)
A) Continuing to deny the pregnancy
B) Uncertainty about where to go for care
C) Lack of realization that they are pregnant
D) A desire to gain control over their situation
E) Wanting to hide the pregnancy as long as possible
Q3) Which environment can assist a pregnant teen to achieve the task of establishing a stable identity?
A) Home schooling
B) Alternative education program
C) School-based mothers' program
D) Continuing mainstream high school classes
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Chapter 25: Complications of Pregnancy
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Sample Questions
Q1) The physician suspects that the client may have gestational trophoblastic disease. Which clinical manifestations support this diagnosis? (Select all that apply.)
A) Increased levels of beta-hCG in the serum
B) Fundal height correlating with reported gestational age
C) Vaginal bleeding
D) Vomiting
E) Maternal hypotension
Q2) The labor and birth nurse is reviewing the risk factors for placenta previa with a group of nursing students. The nurse determines that the students understood the discussion when they identify which patient being at the highest risk for developing a placenta previa?
A) Female fetus, Mexican-American, primigravida
B) Male fetus, Asian-American, previous preterm birth
C) Male fetus, African-American, previous cesarean section
D) Female fetus, European-American, previous spontaneous abortion
Q3) What is the value of the main line fluid rate for your client, whose total fluid intake is ordered at 150 mL/hr and who is also being given magnesium sulfate at 1 g/hr (1 g = 25 mL/hr) IV piggyback and pitocin at 15 mU/min (l mU/min = 1 mL/hr) IV piggyback.
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Chapter 26: Concurrent Disorders During Pregnancy
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Sample Questions
Q1) Examination of a newborn in the birth room reveals bilateral cataracts. Which disease process in the maternal history would likely cause this abnormality?
A) Rubella
B) Cytomegalovirus (CMV)
C) Syphilis
D) HIV
Q2) Antiinfective prophylaxis is indicated for a pregnant client with a history of mitral valve stenosis related to rheumatic heart disease because the client is at risk of developing:
A) hypertension.
B) postpartum infection.
C) bacterial endocarditis.
D) upper respiratory infections.
Q3) Which factor is most important in diminishing maternal, fetal, and neonatal complications in a pregnant client with diabetes?
A) Evaluation of retinopathy by an ophthalmologist
B) The client's stable emotional and psychological status
C) Degree of glycemic control before and during the pregnancy
D) Total protein excretion and creatinine clearance within normal limits
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Page 28
Chapter 27: Intrapartum Complications
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Q1) A pregnant client with premature rupture of membranes is at higher risk for postpartum infection. Which assessment data indicate a potential infection?
A) Fetal heart rate, 150 beats/min
B) Maternal temperature, 99° F
C) Cloudy amniotic fluid, with strong odor
D) Lowered maternal pulse and decreased respiratory rates
Q2) Which client situation presents the greatest risk for the occurrence of hypotonic dysfunction during labor?
A) A primigravida who is 17 years old
B) A 22-year-old multiparous client with ruptured membranes
C) A primigravida who has requested no analgesia during her labor
D) A multiparous client at 39 weeks of gestation who is expecting twins
Q3) Which intervention would be most effective if the fetal heart rate drops following a spontaneous rupture of the membranes?
A) Apply oxygen at 8 to 10 L/min.
B) Stop the Pitocin infusion.
C) Position the client in the knee-chest position.
D) Increase the main line infusion to 150 mL/hr.
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Chapter 28: Postpartum Maternal Complications
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Q1) Which temperature indicates the presence of postpartum infection?
A) 99.6° F in the first 48 hours
B) 100° F for 2 days postpartum
C) 100.4° F in the first 24 hours
D) 100.8° F on the second and third postpartum days
Q2) A postpartum client has developed deep vein thrombosis (DVT) and treatment with warfarin (Coumadin) has been initiated. Which dietary selection should be modified in view of this treatment regimen?
A) Fresh fruits
B) Milk
C) Lentils
D) Soda
Q3) If the nurse suspects a pulmonary embolism in the client who suddenly complains of chest pain, she or he should immediately:
A) assess for abnormal breath sounds.
B) apply O2 via tight face mask at 8 to 10 L/min.
C) position the client in a supine position with the head of the bed flat.
D) monitor pulse oximetry for decreased oxygen saturation.
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Chapter 29: High-Risk Newborn: Complications Associated with Gestational Age and Development
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Q1) Which data should alert the nurse caring for an SGA infant that additional calories may be needed?
A) The latest hematocrit was 53%.
B) The infant's weight gain is 40 g/day.
C) The infant is taking 120 mL/kg every 24 hours.
D) Three successive temperature measurements were 97°, 96°, and 97° F.
Q2) A nurse is observing a 38-week gestation newborn in the nursery. Data reveals periods of apnea lasting approximately 10 seconds followed by a period of rapid respirations. The infant's color and heart rate remain unchanged. The nurse suspects that the infant:
A) Is exhibiting signs of RDS.
B) Requires tactile stimulation around the clock to ensure that apneic periods do not progress further.
C) Is experiencing periodic breathing episodes and will require continuous monitoring while in the nursery unit.
D) Requires the use of CPAP to promote airway expansion.
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Chapter 30: High-Risk Newborn: Acquired and Congenital Conditions
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Q1) While caring for a post-term infant, the nurse recognizes that the elevated hematocrit level most likely results from:
A) hypoxia in utero.
B) underproduction of red blood cells.
C) increased breakdown of red blood cells.
D) the normal expected shift from fetal hemoglobin to normal hemoglobin.
Q2) A mother with diabetes has done some reading about the effects of her condition on a newborn. Which statement shows a misunderstanding that should be clarified by the nurse?
A) "The red appearance of my baby's skin is due to an excessive number of red blood cells."
B) "My baby will be watched closely for signs of low blood sugar, especially during the early days after birth."
C) "My baby's pancreas may not produce enough insulin because the cells became smaller than normal during my pregnancy."
D) "Although my baby is large, some women with diabetes have very small babies because the blood flow through the placenta may not be as good as it should be."
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Page 32
Chapter 31: Family Planning
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Q1) The method of contraception that is considered the safest for women is a(n):
A) IUD.
B) diaphragm.
C) male condom.
D) oral contraceptive.
Q2) Which contraceptive method provides protection against sexually transmitted diseases?
A) Oral contraceptives
B) Tubal ligation
C) Male or female condoms
D) Intrauterine device (IUD)
Q3) A male client asks, "Why do I have to use another contraceptive? I had a vasectomy last week." The best response is:
A) "A vasectomy is only 85% effective."
B) "A vasectomy is not effective in all men."
C) "Semen may contain sperm for 6 months following a vasectomy."
D) "Complete sterilization doesn't occur until all sperm have left the system."
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Chapter 32: Infertility
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Q1) The procedure in which ova are removed by laparoscopy, mixed with sperm, and the embryo(s) returned to the woman's uterus is:
A) in vitro fertilization.
B) tubal embryo transfer.
C) therapeutic insemination.
D) gamete intrafallopian transfer.
Q2) Which adverse reactions are associated with the administration of clomiphene citrate (Clomid)? (Select all that apply.)
A) Abdominal bloating
B) Diarrhea
C) Oliguria
D) Nausea and vomiting
E) Abnormal uterine bleeding
Q3) Large amounts of leukocytes in the seminal fluid suggest:
A) inadequate fructose.
B) inflammation of the testes.
C) an infection of the genital tract.
D) an obstruction in the vas deferens.
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34
Chapter 33: Preventive Care for Women
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Q1) While interviewing a 48-year-old client during her annual physical examination, the nurse learns that she has never had a mammogram. The American Cancer Society recommends annual mammography screening starting at age 40. Before the nurse encourages this client to begin annual screening, it is important for her to understand the reasons why women avoid testing. These reasons include which of the following? (Select all that apply.)
A) Fear of x-ray exposure
B) Expense of the procedure
C) Reluctance to hear bad news
D) Having heard that the test is painful
E) Belief that lack of family history makes this test unnecessary
Q2) Findings of a Pap smear exam denote atypical cells of undetermined significance (ASCUS). The Pap test is repeated at 6 months and the same finding of ASCUS are reported. Which therapeutic treatment option would the nurse expect the practitioner to order?
A) Mammography
B) Bone scan
C) Transvaginal ultrasound
D) Biopsy
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Chapter 34: Women's Health Problems
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Q1) You are taking care of a client who has had a colporrhaphy. Which option would indicate a priority assessment during the postoperative period?
A) Documentation of a pessary in the operative procedure notes by the physician
B) Removal of vaginal packing as ordered by the physician
C) Use of a cell saver for transfusion therapy in the postoperative period
D) Order for removal of staples 2 to 3 days post-procedure
Q2) Which statement is true about primary dysmenorrhea?
A) Primary dysmenorrhea is experienced by all women.
B) It is unaffected by oral contraceptives.
C) It occurs in young multiparous women.
D) It may be caused by excessive endometrial prostaglandin.
Q3) Which client is most at risk for fibroadenoma of the breast?
A) Janice, 38 years old
B) Helen, 50 years old
C) Mary, 16 years old
D) Anna, 27 years old
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