CMA Review

Question 1

A client who is 16 weeks of gestation asks the nurse how to prepare her toddler for a younger sibling. Which statement should the nurse make?

a. You should hold your newborn in your arms when you introduce him to your toddler
b. you should move your toddler out of her crib 2 weeks prior to your due date
c. you should give your toddler a gift from the baby when she visit you in the facility
d. You should place your toddler in timeout if she exhibits regressive behavior after the baby is born

Answer 1

c. you should give your toddler a gift from the baby when she visit you in the facility

Question 2

A nurse is observing an adolescent client who is offering her newborn a bottle while he is laying in the bassinet. When the nurse offers to pick the newborn up and place them in the client’s arms, the mother states “No, the baby is too tired to be held”. Which of the following actions should the nurse take?

a. Insist that the mother pick up the newborn to feed him
b. demonstrate how to hold a newborn and allow the client to practice
c. persuade the client to breastfeed the newborn to promote bonding
d. offer to take the newborn to the nursery to finish his feeding

Answer 2

b. demonstrate how to hold a newborn and allow the client to practice

Question 3

A nurse is assessing a client who is in preterm labor and has a new prescription of terbutaline 0.25 mg subcutaneous. For which of the following findings should the nurse withhold the medication and report to the provider?

a. fasting blood glucose 75 mg / DL
b. blood pressure 88/58 mmhg
c. urinary output 40 ml /hr
d. FHR 120/min

Answer 3

b. blood pressure 88/58 mmhg

Question 4

A nurse is providing teaching to the parents of a newborn about the plastibell circumcision technique. Which of the following should the nurse include in the teaching?

a. the plastibell will be removed 4 hours after the procedure
b. notify the provider is the end of your penis appears dark red
c. make sure the newborn’s diaper is snug
d. yellow exudate will form at the surgical site in 24 hours

Answer 4

d. yellow exudate will form at the surgical site in 24 hours

Question 5

A nurse is planning care immediately following birth for a newborn who has Myelomeningocele that is cerebrospinal fluid. Which of the following actions should the nurse include in the plan of care?

a. Administer broad-spectrum antibiotics
b. cleanse the site with Povidone iodine
c. monitor the rectal temperature every 4 hours
d. prepare for surgical closure after 72 hours

Answer 5

a. Administer broad-spectrum antibiotics

Question 6

A nurse is caring for a newborn boy 6 hours old and has a bedside glucose meter reading of 65 mg / DL. The new mother has Type 2 diabetes mellitus. Which of the following actions should the nurse take?

a. Administer 50 mL of dextrose solution IV
b. obtain a blood sample of serum glucose level
c. reassess the blood glucose level prior to the next feeding
d. Feed the newborn immediately

Answer 6

c. reassess the blood glucose level prior to the next feeding

Question 7

A nurse is caring for four interpartum clients. Which of the following clients should the nurse assess first?

a. A client who is at 7 weeks of gestation and reports urinary frequency
b. a client who is at 32 weeks of gestation and reports seeing floating spots
c. a client who is 38 weeks of gestation and reports leg cramps
d. a client who is at 20 weeks of gestation and reports periodic numbness in her fingers

Answer 7

b. a client who is at 32 weeks of gestation and reports seeing floating spots

Question 8

A nurse is planning care for a client who is pregnant and has HIV. Which of the following actions should the nurse include in the plan of care?

a. Use a fetal scalp electrode during labor and delivery
b. Bathe the newborn before initiating skin to skin contact
c. instruct the client to stop taking the antiretroviral medication at 32 weeks of gestation
d. administer pneumococcal immunization to the newborn within 4 hours following birth

Answer 8

d. administer pneumococcal immunization to the newborn within 4 hours following birth

Question 9

A nurse is caring for a client who has placenta previa. Which of the following findings should the nurse expect?

a. Firm rigid abdomen
b. painless, vaginal bleeding
c. uterine hypertonicity
d. persistent headache

Answer 9

b. painless, vaginal bleeding

Question 10

A nurse is planning care for a newborn who is scheduled to start phototherapy using a lamp. Which of the following actions should the nurse include?

a. Apply a thin layer lotion to the newborn skin every 8 hours
b. Dress newborn in a thin layer clothing during the therapy
c. ensure the newborn’s eyes are closed beneath the shield
d. give the newborn 1 oz of glucose water every 4 hours

Answer 10

c. ensure the newborn’s eyes are closed beneath the shield

Question 11

A nurse is providing discharge instructions to a client who is breastfeeding her newborn. Which of the following instructions should the nurse include?

a. Expect 2 to 4 wet diapers every 24 hours
b. allow the baby to feed at least every 3 hours
c. offer the newborn 30 ml (1 oz.) a water between feedings
d. feed the newborn 5 to 10 minutes per breast

Answer 11

b. allow the baby to feed at least every 3 hours

Question 12

A nurse is assessing a client during her first prenatal visit the client reports March 20th us her last menstrual.. Use Niagele’s rule to calculate the estimated date of delivery. Use the mmdd
format with four numerals and no spaces or punctuation.

Answer 12

12/27

Question 13

A nurse is caring for a client who is at 30 weeks of gestation. The nurse should plan to immunize the client to which of the following vaccinations? Select all the apply

a. Varicella
b. human papillomavirus
c. Diphtheria - acellular pertussis
d. inactivated influenza
e. measles, mumps, and rubella

Answer 13

c. Diphtheria - acellular pertussis
d. inactivated influenza

Question 14

A nurse is caring for a client who has preterm labor and receiving magnesium sulfate by continuous IV infusion. Which of the following laboratory values should the nurse review during tocolytic therapy?

a. indirect Coombs test
b. liver enzymes
c. uric acid level
d. Serum medication level

Answer 14

d. Serum medication level

Question 15

A nurse is caring for a client who reports spontaneous rupture. The nurse observed fetal bradycardia in the FHR tracing and notices the umbilical cord is protruding. After calling for assistance and notifying the provider, which of the following should the nurse take next?

a. Initiate an infusion of IV fluids for the client
b. Perform vaginal examination by applying upward pressure on the presenting part
c. Administer oxygen via non rebreather mask at 8L/ min.
d. Cover the umbilical cord with sterile saline saturated towel.

Answer 15

b. Perform vaginal examination by applying upward pressure on the presenting part

Question 16

A nurse is caring for a client who is 36 weeks gestation and has MRSA. Which of the following isolation precautions should the nurse initiate?

a. Droplet
b. Contact
c. Airborne
d. Protective environment

Answer 16

b. Contact

Question 17

A nurse is assessing a client who is 27 weeks of gestation and has pre eclampsia. Which of the following findings should the nurse report to the provider?

a. Hemoglobin 14.8 g/dL
b. Platelet count 60,000/ mm
c. Creatine 0.8 mg/ dL
d. Urine protein concentration 200 mg/24hr

Answer 17

b. Platelet count 60,000/ mm

Question 18

A nurse is providing teaching to a client who is 2 days postpartum and wants to continue using her diaphragm for contraception. Which of the following instructions should the nurse include?

a. You should use an oil based vaginal lubricant when inserting your diaphragm
b. you should store your diaphragm in sterile water after each use
c. you should keep the diaphragm in place for at least 4 hours after intercourse
d. you should have your provider refit you for a new diaphragm

Answer 18

d. you should have your provider refit you for a new diaphragm

Question 19

A nurse is caring for a client who is receiving prenatal care and is at her 24-week appointment. Which of the following laboratory tests should the nurse plan to conduct?

a. 1 hour glucose tolerance test
b. rubella titer
c. Group B strep culture
d. blood type and Rh

Answer 19

a. 1 hour glucose tolerance test

Question 20

A nurse is caring for a client who has gestational diabetes mellitus. Which of the following clinical findings should indicate to the nurse the client has hyperglycemia?

a. double vision
b. increased urination
c. Sweating
d. dizziness

Answer 20

b. increased urination

Question 21

A nurse is reviewing the laboratory results of a newborn. Which of the following findings should the nurse report to the provider?

a. Blood glucose 58 mg / DL
b. hematocrit 48%
c. platelets 100,000/ mm 3
d. hemoglobin 16 G / DL

Answer 21

c. platelets 100,000/ mm 3

Question 22

A nurse is using Niagele’s rule to calculate the expected delivery date of a client who reports the first day of the last menstrual cycle was July 28th. Which of the following dates should the nurse document as a client expected delivery date? 07/28

a. April 21st
b. April 4th
c. May 5th
d. May 21st

Answer 22

c. May 5th

Question 23

The nurse is teaching a client and her partner about the technique of counter pressure during labor. Which of the following statements by the nurse is appropriate?

a. your partner will apply upward pressure on your lower abdomen between contractions
b. your partner will apply continuous from pressure between your thumb and index finger
c. your partner will apply pressure to the top of your uterus during contractions
d. your partner will apply steady pressure with a tennis ball to your lower back

Answer 23

d. your partner will apply steady pressure with a tennis ball to your lower back

Question 24

A nurse is caring for a client who is 6 weeks of gestation and reports nausea and vomiting. Which of the following Recommendations should the nurse make?

a. avoid Eating snacks before bedtime
b. eat high-fat snack before getting out of bed
c. drink additional liquids with each meal
d. consume food served at cool temperatures

Answer 24

d. consume food served at cool temperatures

Question 25

A nurse is providing teaching to a client who is receiving medroxyprogesterone IM for contraception. Which of the following statements by the client indicates an understanding of the teaching?

a. I should discontinue this medication if I experience spotting
b. I will need to return to the clinic in the next eight weeks for my next injection
c. I should increase my calcium intake while taking this medication
d. I will get two shots each time I receive this medication

Answer 25

c. I should increase my calcium intake while taking this medication

Question 26

A nurse is preparing to perform a fundal massage for a postpartum client with hearing seeing uterine atony. In which order should the nurse plan to perform the following actions? (molded steps into the box on the right. Placing them in order of performance use all steps )

Answer 26

1. Ask the client to lie on her back in with her knees flexed
2. Position one hand around the top of the client’s when fundus in one hand just
   above the client’s symphysis pubis
3. Rotate the upper hand to massage that clients uterus while using slight downward pressure to compress the fundus
4. observe the client’s perineum for the passage of clots and the amount of bleeding

Question 27

A nurse is providing discharge teaching to a postpartum client about caring for her 5 day old male newborn at home. Which of the following statements should the nurse make to the client?

a. Retract the foreskin to clean your baby’s penis during each bath
b. use triple antibiotic ointment on your baby’s umbilical cord twice per day
c. Swaddle your baby tightly with legs extended before laying him down to sleep
d. notify your baby’s pediatrician if he urinates less than 6 times per day

Answer 27

d. notify your baby’s pediatrician if he urinates less than 6 times per day

Question 28

A nurse is assessing a newborn whose mother had a primary cytomegalovirus (CMV) infection during pregnancy. The newborn acquired CMV trans placenta Lee. Which of the following findings should the nurse expect the newborn to exhibit?

a. urinary tract infection
b. hearing loss
c. Macrosomia
d. Cataracts

Answer 28

b. hearing loss

Question 29

A nurse is assessing a full-term newborn admission to the nursery. Which of the following clinical findings should the nurse report to the provider?

a. Transient circumoral cyanosis -
b. single Palmar creases
c. subconjunctival hemorrhage
d. rust stain urine

Answer 29

b. single Palmar creases

Question 30

A nurse is caring for a client who is receiving oxytocin to induce labor. The nurse should discontinue the oxytocin if which of the following occurs?

a. Contractions last 60 Seconds
b. non-repetitive early decelerations
c. 6 contractions in 10 minutes
d. moderate variability of the fetal heart rate

Answer 30

c. 6 contractions in 10 minutes

Question 31

A nurse is planning care for a client following a chorionic villus sampling. The nurse should recognize that the client is at risk for developing which of the following complications?

a. Late decelerations
b. Infection
c. Anemia
d. placental insufficiency

Answer 31

b. Infection

Question 32

A nurse is providing dietary teaching to a client who is 32 weeks of gestation and has cholelithiasis. Which of the following foods should the nurse recommend for the client to include in her diet?

a. Baked chicken
b. whole milk
c. french fries
d. bacon cheeseburger

Answer 32

a. Baked chicken

Question 33

A nurse is providing teaching to a client who is primigravid and is scheduled to have an abdominal ultrasound. Which of the following statements by the client indicates an understanding of the teaching?

a. I need to take a stool softener the night before the test
b. I can’t have anything to eat after midnight
c. I won’t apply perfumed lotion to my abdomen before the test
d. I will drink water before the test until my bladder feels full

Answer 33

d. I will drink water before the test until my bladder feels full

Question 34

A nurse is performing an assessment of a newborn’s babinski reflex. Which of the following findings should the nurse expect?

a. Flexion of the forearm
b. extension of the leg
c. Downward curl of the toes
d. dorsiflexion of the greater toes

Answer 34

d. dorsiflexion of the greater toes

Question 35

A nurse is caring for a client who received epidural analgesia during labor and is 4 hours for postpartum. Which of the following client reports should the nurse address first?

a. Itching
b. inability to void
c. abdominal cramps
d. tingling in the legs

Answer 35

a. Itching

Question 36

A nurse is caring for a client who is at 30 weeks of gestation and receiving magnesium sulfate for preeclampsia. The nurse should recognize which of the following manifestations as an adverse reaction to the medication?

a. Respiratory rate a 16 / minutes
b. Hypertension
c. urine output 20 ml / hour
d. Hyperglycemia

Answer 36

c. urine output 20 ml / hour

Question 37

Nurse is performing a Heel stick on a newborn. Which of the following actions should the nurse take?

a. Use an automatic puncture device on the heel
b. Puncture the heels of the inner aspect of the foot
c. cleanse the newborns heel with an alcohol swab after the procedure
d. place an ice pack on the newborn’s heel 5 minutes before the procedure

Answer 37

a. Use an automatic puncture device on the heel

Question 38

A nurse is admitting a client with a birthing unit reports for contractions started 1 hour ago. the nurse determines the client is 80% effaced and 8 cm dilated. The nurse realizes that the client is at risk for which of the following conditions?

a. Ectopic pregnancy
b. postpartum hemorrhage
c. hyperemesis gravidarum
d. incompetent cervix

Answer 38

b. postpartum hemorrhage

Question 39

a nurse is assessing a client who is at 32 weeks of gestation and is receiving magnesium sulfate via continuous IV solution. Which of the following findings should the nurse report to the provider?

a. decrease in frequency of contractions
b. absent deep tendon reflexes
c. urinary output 35 ml/hr
d. BP 150 / 100 mmhg

Answer 39

b. absent deep tendon reflexes

Question 40

A nurse is providing nutritional guidance to a pregnant client who follows a vegan diet. The client asks the nurse which foods she should eat to ensure adequate calcium intake. The nurse should instruct the client which of the following foods has the highest amount of calcium?

a. One cup cooked broccoli
b. one medium potato
c. one large banana

Answer 40

a. One cup cooked broccoli

Question 41

A nurse is providing discharge instructions to a client is 24 hours post partum and has decided not to breastfeed. Which of the following instruction should the nurse include in the teaching?

a. Wear loose-fitting non-binding bra for 72 hours
b. shower daily allow warm water to run directly over your dress
c. Apply ice packs to your breast using a 15 minutes on, 45 minutes off schedule
d. Pump your breast twice-daily to relieve discomfort from engorgement

Answer 41

c. Apply ice packs to your breast using a 15 minutes on, 45 minutes off schedule

Question 42

A nurse in a newborn Nursery is receiving change-of-shift report for four newborns. Which of the following newborn should the nurse assess first?

a. Newborn who is 24 hours old and has not had meconium stool
b. a newborn who is 10 hours old and has a new onset tachypnea
c. newborn who has a short frenulum and is having difficulty breastfeeding
d. a newborn was 30 hours old and has blood-tinged discharge in her diaper

Answer 42

b. a newborn who is 10 hours old and has a new onset tachypnea

Question 43

A nurse is assessing the results of a non-stress test for an antepartum client at 35 weeks of gestation. Which of the following findings should indicate to the nurse the need for further diagnostic testing?

a. 3 fetal movements perceived by the client in a 20-minute testing period
b. No late deceleration in the fetal heart rate loaded with 3 uterine contractions of 60 seconds in duration within a 10-minute testing period
c. Irregular contractions of 10 to 20 seconds in duration that are not felt by the client
d. an increase in fetal heart rate to 150 / minute above Baseline of 140 minute lasting 10 seconds in response to fetal movement with a 40 minute testing period

Answer 43

d. an increase in fetal heart rate to 150 / minute above Baseline of 140 minute lasting 10 seconds in response to fetal movement with a 40 minute testing period

Question 44

A nurse in a prenatal Clinic is reviewing the laboratory results for a client who is at 12 weeks of gestation. Which of the following actions should the nurse take? (Click on the exhibit button for additional information about the client. There are three tabs that contain separate categories of data.)

a. Administer ceftriaxone IM
b. administer rubella vaccine
c. obtain a maternal serum alpha-fetoprotein specimen
d. obtain a blood culture

Answer 44

a. Administer ceftriaxone IM

Question 45

A nurse is reviewing the electronic medical record of a postpartum client. The nurse should identify that which of the following information places the client at risk for infection?

a. Placenta previa
b. midline episiotomy
c. gestational hypertension
d. meconium stained fluid

Answer 45

b. midline episiotomy

Question 46

A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate. Which of the following clinical findings should the nurse instruct the client to report?

a. Increased urinary output
b. increased respiratory rate
c. increased fetal movement
d. increased muscle weakness

Answer 46

d. increased muscle weakness

Question 47

A nurse is providing prenatal teaching to a client who practices of vegan diet and is trying to increase intake on vitamin 12. Which of the following foods should the nurse recommend?

a. fortified soy milk
b. brown rice
c. fresh citrus fruits
d. raw carrots

Answer 47

a. fortified soy milk

Question 48

A nurse is assessing a client who is 6 hours postpartum and has endometritis. Which of the following findings should the nurse expect?

a. Scant lotia
b. urine tenderness
c. temperature 37.4 C ( 99.3 F)
d. WBC 9,000/mm

Answer 48

b. urine tenderness

Question 49

A nurse is conducting a class for a group about birth control. Which of the following information should the nurse include in the teaching?

a. Your fertility will return six months after your provider removes your IUD
b. you should use spermicide 3 hours prior to sexual intercourse
c. you will not need to use birth control for one month after receiving emergency
contraception
d. you should have an annual examination to assess your diaphragm

Answer 49

d. you should have an annual examination to assess your diaphragm

Question 50

A nurse is caring for a newborn who has an exstrophy of the bladder. Which of the following actions should the nurse take prior to the beginning of the surgical correction?

a. keep the newborn in a side-lying position
b. restricted newborns fluid intake
c. Exert gentle pressure on the newborn splattered with sterile gauze
d. cover the newborns bladder with a sterile non-adherent dressing

Answer 50

d. cover the newborns bladder with a sterile non-adherent dressing

Question 51

A nurse is providing teaching to a postpartum client who has a prescription for a rubella immunization. Which of the following client statements indicates an understanding of the teaching?

a. I will receive a series of three immunizations and each one will be a month apart
b. I should avoid becoming pregnant for at least one month following the immunization
c. I should avoid breastfeeding for two weeks following the immunization
d. I will report joint pain that develops after the immunization to my provider immediately

Answer 51

b. I should avoid becoming pregnant for at least one month following the immunization

Question 52

A nurse is reviewing the chart of a client who is 2 days postpartum following a vaginal delivery reports constipation. Which of the following findings should the nurse identify as a contraindication to the use of a suppository?

a. vaginal candidiasis
b. third-degree perineal laceration
c. abdominal distension
d. Afterpains

Answer 52

b. third-degree perineal laceration

Question 53

A nurse is caring for a client following a vaginal delivery of a term fetal demise. Which of the following statements should the nurse make?

a. You should name the baby so she can have an identity
b. you can bathe and dress your baby if you’d like to
c. if you don’t hold the baby it will make Letting Go much harder
d. I’m sure you’ll be able to have another baby when you’re ready

Answer 53

a. You should name the baby so she can have an identity

Question 54

A nurse is assessing a newborn was exposed to cocaine in utero. Which of the following findings should the nurse expect?

a. High-pitched cry
b. Hypotonicity
c. increased head circumference
d. decreased startle response

Answer 54

a. High-pitched cry

Question 55

A nurse is caring for a client who is at 32 weeks of gestation and has gestational diabetes mellitus. Which of the following findings should the nurse report to the provider?

a. The client has a fundal height of 38 cm
b. the client reports 12 fetal movements in 1 hour
c. The client has a fasting blood glucose of 90 mg / DL
d. the client has non pitting pedal edema

Answer 55

a. The client has a fundal height of 38 cm

Question 56

A nurse is in a provider’s office is caring for a 20 year old client at 12 weeks of gestation and request an amniocentesis to determine the sex of the fetus. Which of the following responses should the nurse make?

a. this procedure determines if your baby has genetic or congenital disorders
b. your provider was schedule a chronic villus sampling to determine the sex of your baby
c. you cannot have an amniocentesis until you’re at least 35 years of age
d. we can schedule the procedure for later today if you’d like

Answer 56

a. this procedure determines if your baby has genetic or congenital disorders

Question 57

A nurse is assisting the provider to administer a dinoprostone to induce labor for a client. Which of the following actions should the nurse take?

a. Allow the medication to reach room temperature prior to Administration
b. verify that informed consent is obtained prior to Administration
c. instruct the client to avoid urinary elimination until after Administration

Answer 57

b. verify that informed consent is obtained prior to Administration

Question 58

A nurse is caring for a newborn. Which of the following assessment findings should indicate to the nurse that suctioning of the nasopharynx is needed?

a. The newborn’s pulse oximeter is 91%
b. the newborns respiratory rate is 32 / minutes
c. the newborn is beginning to cough
d. the newborns respiratory rate is the regular

Answer 58

a. The newborn’s pulse oximeter is 91%

Question 59

A nurse is caring for a client who was in active labor and has gonorrhea. Which of the following potential complications of Gonorrhea should the nurse monitor?

a. oligo hydramnios
b. vaginal laceration during birth
c. excessive bleeding after birth
d. chorioamnionitis

Answer 59

d. chorioamnionitis

Question 60

A nurse is performing an initial assessment of a newborn who was delivered with a nuchal cord. Which of the following clinical findings should the nurse expect?

a. facial petechiae
b. Periauricular papillomas
c. Telangiectic nevi
d. Erythema toxicum

Answer 60

a. facial petechiae

Question 61

A nurse is caring for a client who is postpartum and experiencing hypovolemic shock. Which of the following findings should the nurse expect?

a. Bounding pulses
b. cool clammy skin
c. respiratory rate 18 / minutes
d. urinary output 30ml / hour

Answer 61

b. cool clammy skin

Question 62

A nurse is caring for a newborn following delivery. Which of the following actions should the nurse take first?

a. Apply prophylactic eye ointment
b. apply identification bands to the newborn
c. administer IM vitamin K
d. obtain the newborn’s weight

Answer 62

b. apply identification bands to the newborn

Question 63

Nurse is caring for a client who has hyperemesis gravidarum. Which of the following laboratory results should the nurse anticipate?

a. urine ketones
b. rapid plasma reagin
c. Prothrombin time
d. urine culture

Answer 63

a. urine ketones

Question 64

A nurse is providing teaching about the expected effects of magnesium sulfate to a client was at 28 weeks of gestation and has preeclampsia. Which of the following responses by the nurse is appropriate?

a. This medication stabilizes the fetal heart rate
b. this medication improves tissue perfusion
c. this medication prevents seizures
d. this medication increases cardiac output

Answer 64

c. this medication prevents seizures

Question 65

A nurse is caring for a client who is in the latent phase of the first stage of Labor and is in pain. Which of the following nursing interventions is appropriate to reduce pain? Select all that apply

a. have a client sit in a tub of warm water
b. ambulate the client in the hallway
c. apply counter pressure to the sacral area
d. administer 70% nitrous oxide mixed with oxygen
e. perform Leopold’s maneuver

Answer 65

a. have a client sit in a tub of warm water
b. ambulate the client in the hallway
c. apply counter pressure to the sacral area

Question 66

A nurse manager on the labor and delivery unit is teaching a group of newly licensed nurses about maternal cytomegalovirus. Which of the following information should the nurse manager include in the teaching?

a. transmission can occur via the saliva and urine of the newborn
b. this infection requires but airborne precautions be initiated for the newborn
c. lesions are visible on the mother’s genitalia
d. mothers will receive prophylactic treatment with acyclovir year prior to delivery

Answer 66

a. transmission can occur via the saliva and urine of the newborn