CA1

Question 1

The risks for a pregnant woman with cardiac disease and her fetus are greatest between:

A. weeks 8 and 12.
B. weeks 16 and 24.
C. weeks 28 and 32.
D. weeks 36 and 40.

Answer 1

C. weeks 28 and 32.

Question 2

Screening for gestational diabetes in women is usually performed at:

A. 4 to 8 weeks’ gestation.
B. 12 to 16 weeks’ gestation.
C. 24 to 28 weeks’ gestation.
D. 32 to 36 weeks’ gestation.

Answer 2

C. 24 to 28 weeks’ gestation.

Question 3

The ovum of an ectopic pregnancy most commonly lodges in the :

fallopian tube.
abdominal viscera.
ovary.
cervical os.

Answer 3

fallopian tube

Question 4

After a spontaneous abortion, a woman who’s Rh-negative would be given:

magnesium sulfate.
RhoGAM.
terbutaline.
betamethasone.

Answer 4

RhoGAM

Question 5

A major factor contributing to the increased incidence of multiple pregnancy is:

increased use of fertility drugs
women becoming pregnant at a younger age.
previous pregnancy.
underlying iron deficiency anemia.

Answer 5

increased use of fertility drugs

Question 6

Assessment of a woman with placenta previa would most likely reveal:

absence of fetal heart tones.
boardlike abdomen.
painless, bright red vaginal bleeding.
signs of shock.

Answer 6

painless, bright red vaginal bleeding.

Question 7

The drug of choice for treating a pregnant woman with chlamydia is:

doxycycline (Vibramycin)
azithromycin (Zithromax).
acyclovir (Zovirax).
miconazole (Monistat).

Answer 7

azithromycin (Zithromax).

Question 8

Which option isn’t a primary factor in determining the presentation of the fetus duringmbirth?

fetal attitude.
fetal heart rate.
fetal lie.
fetal position.

Answer 8

fetal heart rate.

Question 9

In the LOA and ROA fetal positions, the presenting part is the:

olecranon.
chin.
occiput.
buttocks.

Answer 9

occiput

Question 10

Which of the following drugs is a common ripening agent?

Cervidil.
Pitocin.
Sublimaze.
Stadol.

Answer 10

Cervidil

Question 11

Transition is part of which stage of labor?

first stage.
second stage.
third stage.
fourth stage.

Answer 11

first stage.

Question 12

In which order do the cardinal movements of labor occur?

A. Flexion, extension, internal rotation, external rotation, descent, expulsion
B. Descent, flexion, internal rotation, extension, external rotation, and expulsion
C. Descent, internal rotation, flexion, external rotation, extension, expulsion
D. Descent, extension, internal rotation, flexion, external rotation, expulsion

Answer 12

B. Descent, flexion, internal rotation, extension, external rotation, and expulsion

Question 13

Which of the following signs isn’t a sign of true labor?

Bloody show.
Painful uterine contractions.
Lightening.
Rupture of the membranes.

Answer 13

Lightening

Question 14

Which uncommon fetal attitude results in a brow presentation?

Partial extension
Complete extension.
Moderate flexion.
Complete flexion.

Answer 14

Complete extension

Question 15

Maternal factors indicating the need for cesarean delivery include:

transverse fetal lie.
previous cesarean delivery with bikini incision.
active genital herpes.
hypotension.

Answer 15

active genital herpes.

Question 16

Contraindications for cesarean delivery include:

papilloma.
fetal distress.
transverse fetal lie.
dead fetus.

Answer 16

dead fetus

Question 17

The presence of meconium in the amniotic fluid before birth may indicate:

breech presentation.
transverse lie.
abruptio placentae.
placenta previa.

Answer 17

breech presentation

Question 18

The child born in breech presentation is at risk for:

hypotension.
hypoxia.
intracranial hemorrhage.
infection.

Answer 18

intracranial hemorrhage

Question 19

Administration of oxytocin should be discontinued when:

contractions are less than 2 minutes apart.
contractions are stronger than 50 mm Hg.
contractions are less than 50 seconds long.

Answer 19

contractions are stronger than 50 mm Hg.

Question 20

With the administration of magnesium sulfate, the woman should be observed for:

hyperactivity.
flushing
increased reflexes.
increased respirations.

Answer 20

flushing

Question 21

Which behavior would you expect to assess during the taking-in phase?

A. Strong interest in caring for the neonate.
B. Redefinition of new role.
C. Insecurity about ability to provide neonatal care.
D. Passivity with dependence on others.

Answer 21

Passivity with dependence on others.

Question 22

Where would you expect to assess the uterine fundus in a patient who’s 2 days postpartum?

A. 2 cm above the level of the umbilicus.
B. at the level of the symphysis pubis.
C. approximately 2 cm below the umbilicus.
D. 2 cm above the symphysis pubis.

Answer 22

approximately 2 cm below the umbilicus.

Question 23

At the patient’s 6-week follow-up appointment, you should assess:

lochia rubra.
lochia serosa.
lochia alba.
absence of lochia.

Answer 23

absence of lochia.

Question 24

Which measure would the woman who isn’t breastfeeding use to minimize mengorgement?

cold compresses.
manual expression.
warm showers.
nipple stimulation.

Answer 24

cold compresses.

Question 25

What is considered the major cause of early postpartum hemorrhage?

Uterine atony.
Perineal laceration.
Retained placental fragments.
Dic.

Answer 25

Uterine atony.

Question 26

If a patient’s perineal pad weighs 100 g, you would estimate the blood loss as:

50 ml.
100ml.
150 ml.
200 ml.

Answer 26

100ml

Question 27

Which findings would lead you to suspect that a woman has developed hypovolemic nshock secondary to postpartum hemorrhage?

Respiratory rate of 22 breaths/minute.
Pale-pink, moist skin.
Urine output below 25 ml/hour.
Bounding peripheral pulses.

Answer 27

Urine output below 25 ml/hour.

Question 28

Which factor predisposes a patient to puerperal infection?

External fetal monitoring during labor.
Rupture of membranes 15 hours ago.
labor lasting 20 hours.
Cesarean birth.

Answer 28

Cesarean birth.

Question 29

A patient reports foul-smelling lochia with strong uterine contractions, persisting after birth. Her temperature has been elevated, ranging from 102.2F (39C) to 104 F (40C), for
the past 2 days. Her uterus is firm but tender, and her abdomen is soft with no guarding noted. You would suspect:

localized perineal infection.
peritonitis.
endometritis.
parametritis.

Answer 29

endometritis.

Question 30

Which microorganism most commonly causes mastitis?

staphylococcus aureus.
staphylococcus epidermis.
beta hemolytic streptococcus.
mumps virus.

Answer 30

staphylococcus aureus.

Question 31

If your patient has DVT, which complications should you watch?

Endometritis.
pulmonary embolism.
Hematoma.
Mastitis.

Answer 31

pulmonary embolism.

Question 32

Which option correctly describes the normal anatomy of the umbilical cord?

one artery and one vein.
one artery and one ligament.
two arteries and one vein.
one artery and two veins.

Answer 32

two arteries and one vein.

Question 33

Apgar Scoring evaluates:

A. heart rate, respiratory rate, color, blood pressure, and temperature.
B. heart rate, respiratory effort, muscle tone, reflex irritability, and color.
C. respiratory rate, blood pressure, reflex irritabilty, muscle tone, and temperature.
D. temperature, heart rate, color, muscle tone, and blood pressure

Answer 33

B. heart rate, respiratory effort, muscle tone, reflex irritability, and color.

Question 34

A sign of respiratory distress in a neonate is:

acrocyanosis,
nasal flaring.
abdominal movements.
short periods of apnea (less than 15 seconds)

Answer 34

nasal flaring.

Question 35

Which finding is normal for a neonate’s fontanels?

they’re soft to touch.
they’re depressed.
they’re bulging.
they’re closed.

Answer 35

they’re soft to touch.

Question 36

Which finding is normal for a neonate’s fontanels?

they’re soft to touch.
they’re depressed.
they’re bulging.
they’re closed.

Answer 36

they’re soft to touch.

Question 37

A pregnant patient who is older than age 35 is at greater risk for having:

a low-birth weight infant.
a preterm infant.
PIH.
placenta previa.

Answer 37

placenta previa.

Question 38

A pregnant patient who’s fatigued is likely to be more comfortable in which position?

Modified Sims’
Supine with legs elevated.
Supine with head elevated.
sitting upright with legs elevated.

Answer 38

Modified Sims’

Question 39

When examining a postpartal woman, the nurse should immediately report:

A. a fundus that is palpated 2 cm below the umbilicus on the second postpartal day.
B. a fundus that cannot be located by palpation on the ninth postpartal day.
C. a soft, spongy uterine fundus noted during the first hour postpartum.
D. red, bloody vaginal discharge on the perineal pad on the first day postpartum.

Answer 39

C. a soft, spongy uterine fundus noted during the first hour postpartum.

Question 40

Question

choice 1
choice 2
Choice 3
choice 4

Answer 40

Choice 3

Question 41

A nurse in the postpartum unit is caring for a client who has just delivered a newborn infant following a pregnancy with a Placenta previa. The nurse reviews thee plan of care and prepares to monitor the client for which risk associated with Placenta previa?

infection
hemorrhage
chronic hypertension
Disseminated intravascular coagulation

Answer 41

hemorrhage

Question 42

A nurse in a Labor room is performing a vaginal assessment on a pregnant client in labor. The nurse notes the presence of the umbilical cord protruding from the vagina. Which of the following is an initial nursing action?

A. gently push the cord into the vagina
B. place the client in Trendelenburg’s position
C. find the closest telephone and page the physician stat
D. call the Delivery room to notify the staff that the client will be transported immediately.

Answer 42

B. place the client in Trendelenburg’s position

Question 43

Anurse has developed a plan of care for a client experiencing dystocia and includes several nursing interventions in the plan of care. The nurse prioritizes the plan of care and selects which interventions as the highest priority?

A. providing comfort measures
B. monitoring the fetal heart rate
C. changing the client’s position frequently
D. keeping the significant other informed of the progress of labor

Answer 43

B. monitoring the fetal heart rate

Question 44

A maternity nurse is preparing for the admission of a client in the third trimester of pregnancy who is experiencing vaginal bleeding and has a suspected diagnosis of placenta previa. The nurse reviews the physician’s prescriptions and would question which
prescription?

A. prepare the client for an ultrasound
B. obtain equipment for a manual pelvic examination
C. prepare to draw a hemoglobin and hematocrit blood sample
D. obtain equipment for external electronic fetal heart rate monitoring

Answer 44

B. obtain equipment for a manual pelvic examination

Question 45

A nurse is monitoring the amount of lochia drainage in a client who is 2 hours postpartum and notes that the client has saturated a perineal pad in 1 hour. The nurse reports the amount of lochial flow as:

Scant
light
heavy
excessive

Answer 45

heavy

Question 46

A nurse is caring for four 1-day postpartum clients. Which client has an abnormal finding that would require further intervention?

A. the client with mild afterpains
B. the client with a pulse rate of 60 beats/min.
C. the client with colostrum discharge from both breasts
D. the client with lochia that is red and has a foul-smelling odor

Answer 46

D. the client with lochia that is red and has a foul-smelling odor

Question 47

When performing a postpartum assessment on a client, a nurse notes the presence of ! Point
clots in the lochia. The nurse examines the clots and notes that they are larger than 1 cm. Which nursing action is appropriate?

notify the physician
document the findings
reassess the client in 2 hours
encourage increased oral intake of fluids

Answer 47

notify the physician

Question 48

A nurse is planning care for a postpartum client who had a vaginal delivery 2 hours ago. The client had a midline episiotomy and has several hemorrhoids. What is the priority nursing diagnosis for this client?

Acute pain
Disturbed body image
Impaired urinary elimination
Risk for imbalanced fluid volume

Answer 48

Acute pain

Question 49

A clientin a postpartum unit complains of sudden sharp chest pain and dyspnea. The nurse notes that the client is tachycardic and the respiratory rate is elevated. The nurse suspects a pulmonary embolism. Which of the following would be the initial nursing action?

initiate an intravenous line
assess the client’s blood pressure
prepare to administer morphine sulfate
administer oxygen, 8 to 10 L/min, by face mask.

Answer 49

administer oxygen, 8 to 10 L/min, by face mask.

Question 50

A 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 high 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 diseases
D. a client who has had one sexual partner for the past 10 years

Answer 50

C. a client who has a history of sexually transmitted diseases