Which of the following foods, if selected by the mother with a

child with celiac. would indicate her understanding of the dietary

instructions?

A. Whole-wheat toast

B. Angel hair pasta

C. Reuben on rye

D.Rice cereal

(a)  

A 25-year-old client with a goiter is admitted to the unit. What

would the nurse expect the admitting assessment to reveal?

A. Slow pulse

B. Anorexia

C. Bulging eyes

D. Weight gain

(a)  

As the client reaches 6cm dilation, the nurse notes late decelerations on the fetal monitor. What is the most likely explanation of

this pattern?

A. The baby is sleeping.

B. The umbilical cord is compressed.

C. There is head compression.

D. There is uteroplacental insufficiency.

(a)  

The rationale for inserting a French catheter every hour for the

client with epidural anesthesia is:

A. The bladder fills more rapidly because of the medication used for the epidural.

B. Her level of consciousness is such that she is in a

trancelike state.

C. The sensation of the bladder filling is diminished or lost.

D. She is embarrassed to ask for the bedpan that frequently.

(a)  

A client with diabetes asks the nurse for advice regarding methods

of birth control. Which method of birth control is most suitable for the client with diabetes?

A. Intrauterine device

B. Oral contraceptives

C. Diaphragm

D. Contraceptive sponge

(a)  

The doctor suspects that the client has an ectopic pregnancy.

Which symptom is consistent with a diagnosis of a ruptured

ectopic pregnancy?

A. Painless vaginal bleeding

B. Abdominal cramping

C. Throbbing pain in the upper quadrant

D. Sudden, stabbing pain in the lower quadrant

(a)  

A client tells the doctor that she is about 20 weeks pregnant. The

most definitive sign of pregnancy is:

A. Elevated human chorionic gonadatropin

B. The presence of fetal heart tones

C. Uterine enlargement

D. Breast enlargement and tenderness

(a)  

Which of the following instructions should be included in the

nurse's teaching regarding oral contraceptives?

A. Weight gain should be reported to the physician.

B. An alternate method of birth control is needed when taking antibiotics.

C. If the client misses one or more pills, two pills should

be taken per day for one week.

D. Changes in the menstrual flow should be reported to the physician.

(a)  

A client telephones the emergency room stating that she thinks

that she is in labor. The nurse should tell the client that labor has

probably begun when:

A. Her contractions are two minutes apart.

B. She has back pain and a bloody discharge.

C. She experiences abdominal pain and frequent urination.

D. Her contractions are five minutes apart.

(a)  

The nurse is teaching a group of prenatal clients about the effects of

cigarette smoke on fetal development. Which characteristic is asso-

cited with babies born to mothers who smoked during pregnancy?

A. Low birth weight

B. Large for gestational age

C. Preterm birth, but appropriate size for gestation

D. Growth retardation in weight and length

(a)  

The physician has ordered an injection of RhoGam for the post-

partum client whose blood type is A negative but whose baby is 0

positive. To provide postpartum prophylaxis, RhoGam should be

administered:

A. Within 72 hours of delivery

B. Within one week of delivery

C. Within two weeks of delivery

D. Within one month of delivery

(a)  

A newborn with narcotic abstinence syndrome is admitted to the

nursery. Nursing care of the newborn should include:

A. Teaching the mother to provide tactile stimulation

B. Wrapping the newborn snugly in a blanket

C. Placing the newborn in the infant seat

D. Initiating an early infant-stimulation program

(a)  

A client, who is 2 weeks postpartum, calls her obstetrician's nurse and states that

she has had a whitish discharge for 1 week but today she is,

"Bleeding and saturating

a pad about every 2 hour." Which of the following is an appropriate response

by the nurse?

1. "That is normal. You are starting to menstruate again.

2. "You should stay on complete bed rest until the bleeding subsides.”

3. "Pushing during a bowel movement may have loosened your stitches."

4. "The physician should see you. Please come in whenever you are ready.”

(a)  

A gestational diabetic client, who delivered yesterday, is currently on the postpartum

unit. Which of the following statements is appropriate for the nurse to make at

this time?

1. "Monitor your blood glucose five times a day until your 6-week check-up."

2. "I will teach you how to inject insulin before you are discharged."

3. "Daily exercise will help to prevent you from becoming diabetic in the future.

4. "Your baby should be assessed every 6 months for signs of juvenile diabetes.

(a)  

A client has been receiving magnesium sulfate for severe preeclampsia for 12 hours.

Her reflexes are O and her respiratory rate is 10. Which of the following situations

could be a precipitating factor in these findings?

1. Apical heart rate 104.

2. Urinary output 240 cc/12 hr.

3. Blood pressure 160/120.

4. Temperature 100°F.

(a)  

17. A client received general anesthesia during her cesarean section 4 hours ago. Which

of the following postpartum nursing interventions is important for the nurse to

make?

1. Place the client flat in bed.

2. Assess for dependent edema.

3. Auscultate lung fields.

4. Check patellar reflexes.

(a)  

The nurse is developing a standard care plan for the post-cesarean client. Which of

the following should the nurse plan to implement?

1. Maintain client in left lateral recumbent position.

2. Teach sitz bath use on second postoperative day.

3. Perform active range of motion exercises until ambulating.

4. Assess central venous pressure during first postoperative day.

(a)  

The nurse has administered Benadryl (diphenhydramine) to a post-cesarean client

is experiencing side effects from the parenteral morphine sulfate that was administered

inutes earlier. Which of the following actions should the nurse perform

owing the administration of the drug?

A. monitor the urinary output hourly.

B. supervise while the woman holds her newborn.

C. Position the woman slightly elevated on her left side.

D. Ask any visitors to leave the room.

(a)  

The nurse should expect to observe which behavior in a 3-week multigravid postpartum

client with postpartum depression?

1. Feelings of infanticide.

2. Difficulty with breastfeeding latch.

3. Feelings of failure as a mother.

4. Concerns about sibling jealousy.

(a)  

A breast feeding woman calls the pediatric nurse with the following complaint:

“ I woke up this morning with a terrible cold. I don't want my baby to get sick. Which

kind of formula should I give the baby until I get better?" Which of the following

replies by the nurse is appropriate at this time?

1. "Any formula brand is satisfactory, but it is essential that it be mixed with water

that has been boiled for at least 5 minutes."

2. "Don't forget to pump your breasts every

hours while you are feeding the

baby the prescribed formula."

3. "The best way to keep your baby from getting sick is for you to keep breastfeeding

him rather than switching him to formula."

4. "In addition to feeding the baby formula, you should wear a surgical face mask

when you are around him."

(a)  

The nurse is developing a standard care plan for the post-cesarean client. Which

the following should the nurse plan to implement?

1. Maintain client in left lateral recumbent position.

2. Teach sitz bath use on second postoperative day.

3. Perform active range of motion exercises until ambulating.

4. Assess central venous pressure during first postoperative day.

(a)  

A woman, who wishes to breastfeed, advises the nurse that she had a breast reduction

one year earlier. Which of the following responses by the nurse is appropriate?

1. Advise the woman that unfortunately she will be unable to breastfeed.

2. Examine the woman's breasts to see where the incision was placed.

3. Monitor the baby's daily weights for excessive weight loss.

4. Inform the woman that reduction surgery rarely affects milk transfer.

(a)  

The nurse is caring for a postoperative cesarean client. The woman is obese and is

an insulin-dependent diabetic. For which of the following complications should the

nurse carefully monitor this client?

1. Ineffective lactogenesis.

2. Dysfunctional parenting.

3. Wound dehiscence.

4. Projectile vomiting.

(a)  

The nurse is discharging four Rh-negative clients from the maternity unit. The

nurse knows that further teaching is needed when the client who had which of the

following deliveries asks why she has not received her RhoGAM?

1. Abortion at 10 weeks' gestation.

2. Fetal demise at 24 weeks' gestation.

3. Birth of Rh-negative twins at 35 weeks'

gestation.

4. Delivery of a 40-week-gestation Rh-positive baby.

(a)  

Which of the following situations should a nurse report a possible deep vein

thrombosis (DVT) even when the woman has a negative Homan's sign?

1. The woman complains of numbness in the toes and heel of one foot.

2. The woman has cramping pain in a calf that is relieved when the foot is

dorsiflexed.

3. One of the woman's calves is swollen, red, and warm to the touch.

4. The veins in the ankle of one of the woman's legs are spider-like and purple

(a)  

A woman, 26 weeks' gestation, has just delivered a fetal demise. Which of the following

nursing actions is appropriate at this time?

1. Remind the mother that she will be able to have another baby in the future.

2. Dress the baby in a tee shirt and swaddle the baby in a receiving blanket.

3. Ask the woman if she would like the doctor to prescribe a sedative for her.

4. Remove the baby from the delivery room as soon as possible.

(a)  

A client is postpartum 24 hours from a spontaneous vaginal delivery with rupture of

membranes for 42 hours. Which of the following signs/symptoms should the nurse

report to the client's health care practitioner?

1. Foul-smelling lochia.

2. Engorged breasts.

3. Cracked nipples.

4. Cluster of hemorrhoids.

(a)  

A client is 36 hours post-cesarean section. Which of the following assessments

would indicate that the client may have a paralytic ileus?

1. Abdominal striae.

2. Oliguria.

3. Omphalocele.

4. Absent bowel sounds.

(a)  

A nurse is working on a postpartum unit. Which of the following client should the nurse assess first?

A. PP1 from vaginal delivery complains of burning on urination.

B. PP1 From forceps delivery with the loss of 500 ml at time of delivery.

C. PP3 from vacuum delivery with hemoglobin of 7.2 g/dL.

D. PO3 from cesarean delivery complains of firm and painful breast.

(a)  

A nurse has administered Methergine (methylergonovine) 0.2 mg po to a grand

multipara who delivered vaginally 30 minutes earlier. Which of the following outcomes

indicates that the medication is effective?

1. Blood pressure 120/80.

2. Pulse rate 80 bpm and regular.

3. Fundus firm at umbilicus.

4. Increase in prothrombin time.

(a)  

A postpartum woman has been diagnosed with postpartum psychosis. Which of the

following signs/symptoms would the client exhibit?

1. Hallucinations.

2. Polyphagia.

3. Induced vomiting.

4. Weepy sadness.

(a)  

A 25-year-old gravida 2, para 2-0-0-2 gave birth 4 hours ago to a 9-Ib, 7-ounce boy after augmentation of labor with Pitocin. She puts on her call light and asks for her nurse right away, stating,

"I'm bleeding a lot." The most likely cause of after birth

hemorrhage in this woman is:

a. retained placental fragments.

b. unrepaired vaginal lacerations.

c. uterine atony.

d. puerperal infection

(a)  

On examining a woman who gave birth 5 hours ago, the nurse finds that the woman has completely

saturated a perineal pad within

15 minutes. The nurse's first action is to:

a. begin an intravenous (IV) infusion of Ringer's lactate solution.

b. assess the woman's vital signs.

c. call the woman's primary health care provider.

d. massage the woman's fundus.

(a)  

A woman gave birth vaginally to a 9-Ib, 12-ounce girl yesterday. Her primary health care provider

has written orders for perineal ice packs, use of a sit bath tid, and a stool softener.

What information is most closely correlated with these orders?

a. The woman is a gravida 2, para 2.

b. The woman had a vacuum-assisted birth.

c. The woman received epidural anesthesia.

d. The woman has an episiotomy.

(a)  

A woman gave birth 48 hours ago to a healthy infant girl. She has decided to bottle-feed. During your

assessment you notice that both of her breasts are swollen, warm, and tender on palpation.

The woman should be advised that this condition can best be treated by:

a. running warm water on her breasts during a shower.

b. applying ice to the breasts for comfort.

c. expressing small amounts of milk from the breasts to relieve pressure.

d. wearing a loose-fitting bra to prevent nipple irritation.

(a)  

A after birth woman overhears the nurse tell the obstetrics clinician that she has a positive

Homans' sign and asks what it means. The nurse's best response is:

a. "You have pitting edema in your ankles."

b. "You have deep tendon reflexes rated 2+."

c. "You have calf pain when the nurse flexes your foot."

d. "You have a "fleshy' odor to your vaginal drainage."

(a)  

Excessive blood loss after childbirth can have several causes; the most common is:

a. vaginal or vulvar hematomas.

b. unrepaired lacerations of the vagina or cervix.

c. failure of the uterine muscle to contract firmly.

d. retained placental fragments

(a)  

Because a full bladder prevents the uterus from contracting normally, nurses intervene to help

the woman empty her bladder spontaneously as soon as possible. If all else fails, the last thing

the nurse could try is:

a. pouring water from a squeeze bottle over the woman's perineum.

b. placing oil of peppermint in a bedpan under the woman.

c. asking the physician to prescribe analgesics.

d. inserting a sterile catheter.

(a)  

If a woman is at risk for thrombus and is not ready to ambulate, nurses may intervene by performing

a number of interventions. Which intervention should the nurse avoid?

a. Putting the patient in antiembolic stockings (TED hose) and/or sequential

compression device (SCD) boots.

b. Having the patient flex, extend, and rotate her feet, ankles, and legs.

c. Having the patient sit in a chair.

d. Notifying the physician immediately if a positive Homans' sign occurs.

(a)  

Discharge instruction, or teaching the woman what she needs to know to care for herself and

her newborn, officially begins:

a. at the time of admission to the nurse's unit.

b. when the infant is presented to the mother at birth.

c. during the first visit with the physician In the unit.

d. when the take-home information packet is given to the couple.

(a)  

Postpartal overdistention of the bladder and urinary retention can lead to which complications?

a. After birth hemorrhage and eclampsia

b. Fever and increased blood pressure

c. After birth hemorrhage and urinary tract infection

d. Urinary tract infection and uterine rupture

(a)  

Rho immune globulin will be ordered after birth if which situation occurs?

a. Mother Rh-, baby Rh+

b. Mother Rh-, baby Rh-

c. Mother Rh+, baby Rh+

d. Mother Rh+, baby Rh-

(a)  

Which nursing action is most appropriate to correct a boggy uterus that is displaced above and to

the right of the umbilicus?

a. Notify the physician of an impending hemorrhage.

b. Assess the blood pressure and pulse.

c. Evaluate the lochia.

d. Assist the patient in emptying her bladder.

(a)  

When caring for a newly delivered woman, the nurse is aware that the best measure to prevent

abdominal distention after a cesarean birth is:

a. rectal suppositories.

b. early and frequent ambulation.

c. tightening and relaxing abdominal muscles.

d. carbonated beverages.

(a)  

The nurse caring for the after birth woman understands that breast engorgement is caused by:

a. overproduction of colostrum.

b. accumulation of milk in the lactiferous ducts and glands.

c. hyperplasia of mammary tissue.

d. congestion of veins and lymphatics.

(a)  

Which are signs of hyperventilation?

A. Dizzy; numbness of  hands and feet

B. Sweating; increased pulse

C. Headache; confusion

D. Low respiratory rate; anxiety

(a)  

What is the shape of the anterior fontanelle?

A. Triangular

B. Oval/ovoid

C. Diamond

D. Square-ish (but soft)

(a)  

Which should the nurse anticipate if baby is in a face presentation?

1. Painful delivery

2. Administer an analgesic

3. An episiotomy

4. Prepare for c/section

(a)  

In normal labor, contractions usually become stronger and also usually become…

1. Less frequent

2. Less painful

3. Longer in duration

4. Shorter in duration

(a)