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Health Promotion & Labor & Delivery

Total questions: 70

Worksheet time: 37mins

Name
Class
Date
1.

Where does implantation of the fertilized ovum usually occur?

a)

Lower uterine wall

b)

Side of the uterus

c)

Fundus of the uterus

d)

Body of the uterus

2.

A patient has been diagnosed with a tubal pregnancy. What is the typical outcome of a tubal pregnancy?

a)

The patient will carry the pregnancy to term and have a cesarean delivery.

b)

The patient will have to remain in bed for the remainder of the pregnancy.

c)

The patient will spontaneously abort this ectopic pregnancy.

d)

The patient will require surgery to remove the zygote.

3.

How long does the embryonic stage of pregnancy typically last?

a)

3 weeks

b)

4 weeks

c)

6 weeks

d)

8 weeks

4.

Why is the nurse concerned about a patient in her first trimester of pregnancy being exposed to German measles?

a)

The disease is capable of causing a spontaneous abortion.

b)

The disease is capable of causing birth defects.

c)

The disease is capable of causing high fever and convulsions.

d)

The disease is capable of interfering with placental implantation.

5.

Which hormone is secreted by the placenta?

a)

Follicle-stimulating hormone (FSH)

b)

Alpha-fetoprotein (AFP)

c)

Human chorionic gonadotropin (HCG)

d)

Luteinizing hormone (LH)

6.

What protects the fetus from most bacterial infections?

a)

The yolk sac

b)

The placental barrier

c)

The cotyledons

d)

The chorionic villa

7.

What period of the maternity cycle does the intrapartal period cover?

a)

Beginning of pregnancy to midterm

b)

Conception to third trimester

c)

Onset of labor to delivery of the baby

d)

Onset of labor to delivery of the placenta

8.

A woman who has just discovered she is pregnant states that the first day of her last menstrual period was July 10. What will be her expected date of birth (EDB)?

a)

April 10

b)

April 17

c)

May 10

d)

October 17

9.

Which is a positive sign of pregnancy?

a)

Positive pregnancy test

b)

Positive Chadwick sign

c)

Ultrasonic tracing of the fetus

d)

Positive Goodell sign

10.

What is the cause of frequent urination in early pregnancy?

a)

Increased fluid intake

b)

The fetus’s kidneys functioning

c)

Retention of fluid

d)

Increased circulating volume

11.

A woman asks the nurse about the safety of sexual intercourse during her pregnancy. Which response by the nurse is the most correct?

a)

"Sexual activity should be avoided after the first trimester."

b)

"Sexual activity should be ceased in the case of vaginal bleeding."

c)

"Sexual activity should be avoided in the second trimester."

d)

"Sexual activity should be limited to activity that does not include intercourse."

12.

A woman tells the nurse that this is her third pregnancy. She has had twin girls at full term and one miscarriage. How does the nurse record the information?

a)

G2, T2, L3

b)

G4, T3, A1, L1

c)

G3, T3, A2, L1

d)

G3, T1, A1, L2

13.

During which gestational week can a primigravida expect to first feel fetal movement?

a)

8

b)

10

c)

16

d)

20

14.

At what week of fetal development can the nurse expect to first hear fetal heart tones with an amplified stethoscope?

a)

10

b)

12

c)

14

d)

16

15.

The nurse assures an anxious primigravida that during fetal development from week 34 and beyond, maternal antibodies are transferred to the baby. How long will these antibodies provide the baby with immunity?

a)

1 month

b)

3 months

c)

4 months

d)

6 months

16.

Early in the first trimester, a woman complains of morning sickness. What does the nurse suggest to aid with the discomfort?

a)

Eating something with a high-fat content

b)

Eating dry crackers before getting up

c)

Eating three well-balanced meals

d)

Getting rest and taking antiemetics

17.

What does the increase in circulating blood volume during pregnancy cause in the mother?

a)

Shortness of breath

b)

Frontal headaches

c)

Decreased white blood cell count

d)

Decreased hemoglobin

18.

A woman entering the 22nd week of pregnancy complains that she has become unsightly because of chloasma. What should the nurse recommend to reduce the appearance of the chloasma?

a)

Use heavy makeup

b)

Take extra doses of vitamin A

c)

Avoid exposure to the sun

d)

Reduce caffeine intake

19.

During the final weeks of pregnancy, urinary frequency may return due to the enlarged uterus, compressing the bladder against the pelvic bones. What does the nurse suggest to aid in relieving the urinary frequency?

a)

Decrease fluid intake

b)

Use the knee-chest position

c)

Sleep on her side

d)

Avoid fluid intake in evening

20.

A pregnant teenager presents with the following complaints. Which complaint could be an indicator of a serious complication?

a)

Painful hemorrhoids

b)

Linea nigra

c)

Visual disturbances

d)

Low back pain

21.

During the last trimester of pregnancy, the nurse recommends that the woman wear low-heeled shoes. What is the nurse trying to prevent with this recommendation?

a)

Lower back pain

b)

Leg cramps

c)

Leg swelling

d)

Joint pain

22.

The newly diagnosed primigravida who is 6 weeks pregnant states, “I don’t feel like I have a real baby inside me.” To reassure the mother, the nurse provides reassurance that which of the following is functioning in the 6-week-old embryo?

a)

Brain

b)

Lungs

c)

Hands

d)

Heart

23.

Smoking by the mother can have what effect in the fetus?

a)

Hearing deficits

b)

Neuromuscular deformities

c)

Cerebral palsy

d)

Low birth weight

24.

When can the sex of the fetus be confirmed?

a)

Conception

b)

2 weeks

c)

6 weeks

d)

9 weeks

25.

The health care provider decides to send the mother for a test to determine the fetal lung maturity. What is the name of this fetal well-being test?

a)

Biophysical profile

b)

Alpha-fetoprotein

c)

Amniocentesis

d)

Ultrasound

26.

When the young primigravida asks about how to adjust her diet for her pregnancy, what should the nurse suggest the mother add to her diet?

a)

Leafy green vegetables and fruit

b)

Beef and poultry

c)

Foods high in sodium and potassium

d)

Bread and grains

27.

Which of the following discomforts of a pregnant woman should be reported to the health care provider at the first occurrence?

a)

Leg cramps

b)

Pelvic discomfort

c)

Vaginal bleeding

d)

Urinary frequency

28.

What do the arteries in the umbilical cord carry?

a)

Nutrients to the fetus from the placenta

b)

Oxygenated blood to perfuse the placenta

c)

Antibodies from the fetus to the mother

d)

Deoxygenated blood back to the placenta

29.

What should a nurse instruct the patient to do before assessing fundal height?

a)

Press her lower back against the examination table

b)

Empty her bladder

c)

Take a deep breath and hold it

d)

Bear down

30.

The nurse concludes that the prenatal patient has no need for further instruction when she correctly states that amniocentesis can determine which of the baby’s characteristics? (Select all that apply.)

a)

Sex

b)

Maturity

c)

Approximate weight

d)

Health

e)

Genetic defects

31.

Which of the following demonstrate culturally competent care of the pregnant patient? (Select all that apply.)

a)

Discuss beliefs with the patient and incorporate them in the plan of care.

b)

Prohibit visits from anyone other than immediate family members.

c)

Require the patient’s participation in every aspect of the health care system.

d)

Maintain the patient’s modesty at all times.

e)

Strive to maintain a harmonious environment for the patient.

32.

The nurse instructor reminds the nursing student that the “Shiny Schultz” is a name given to the (a)   side of the placenta.

33.

The chorion and the amnion are the two components of the (a)   membrane.

34.

During the 30th week of gestation, the nurse would anticipate that the fundal height would be (a)   cm above the symphysis.

35.

The nurse assesses a reactive result to a nonstress test when the fetal heart rate increases (a)   beats/min.

36.

A woman who is 38 weeks’ pregnant tells the nurse that the baby has dropped and she is having urinary frequency again. What do these symptoms describe?

a)

Lightening

b)

Braxton-Hicks contractions

c)

Initiation of labor

d)

Engagement

37.

How do Braxton-Hicks contractions differ from labor contractions?

a)

Last several minutes

b)

Are always regular

c)

Do not dilate the cervix

d)

Are only mild

38.

The nurse is trying to differentiate true labor from false labor. Which of the following is correct regarding true labor?

a)

Discomfort of the contraction is in the fundus.

b)

Contractions do not follow a pattern.

c)

Contractions get stronger with ambulation.

d)

Contractions may stop with ambulation.

39.

Why is the size and shape of the true pelvis more important than that of the false pelvis?

a)

The fetal head must be able to pass through the true pelvis.

b)

The true pelvis are the mother’s measurements.

c)

The size of the false pelvis can change.

d)

The size of the true pelvis needs to be larger.

40.

What method is used to visualize soft tissue and to determine adequacy of the pelvis with no detrimental effects to the fetus?

a)

Pelvimetry

b)

Palpation

c)

Ultrasonography

d)

X-ray

41.

What area of the uterus provides the force during a contraction?

a)

Lower portion

b)

Middle portion

c)

Upper portion

d)

Cervical portion

42.

What is the largest diameter of the fetal skull?

a)

Temporal

b)

Biparietal

c)

Lateral

d)

Frontal-occipital

43.

A nurse is teaching a group of primigravidas that during delivery, pressure on the fetal skull may produce changes in the shape of the skull. What is the reshaping of the skull called?

a)

Pressure response

b)

Overlapping

c)

Molding

d)

Spacing

44.

What is the ideal attitude for the fetal body during labor?

a)

Extension

b)

Lateral

c)

Flexion

d)

Transverse

45.

Using Leopold maneuvers to assess fetal position, the nurse finds a soft rounded prominence at the level of the fundus, a hard round prominence just above the symphysis pubis, and nodulations on the left side of the uterus. How should the nurse document the fetal position?

a)

Right occiput anterior (ROA), vertex

b)

Left occiput anterior (LOA), vertex

c)

Right occiput transverse (ROT), breech

d)

Left occiput anterior (LOA), breech

46.

During the second stage of labor, how often should the nurse monitor the fetal heart rate?

a)

Every 5 minutes

b)

Every 15 minutes

c)

Every 30 minutes

d)

Every hour

47.

Which type of monitor will assess the intensity of contractions?

a)

External monitor

b)

Fetal monitor

c)

Maternal monitor

d)

Internal monitor

48.

When observing the fetal heart monitor, the nurse recognizes the fetal heart rate (FHR) decreases to 120 beats/min at the beginning of a contraction and returns to a baseline of 155 beats/min at the end of the contraction. What should this indicate to the nurse?

a)

Early deceleration due to head compression

b)

That the fetus is in acute distress

c)

Variable decelerations due to cord compression

d)

That these are late decelerations

49.

The first-time mother has been told by the nurse that the first stage of labor is the longest. What would be an appropriate nursing intervention for comfort during this time?

a)

Cool fluids to drink

b)

A backrub in the sacral area

c)

Assisting to lie in a supine position

d)

Decreasing illumination in the room

50.

A woman is admitted in active labor, and the nurse assesses the fetal heart rate (FHR) at 124 beats/min. What action should the nurse take based on the assessment?

a)

Position patient on her left side.

b)

Start oxygen per nasal cannula.

c)

Reassure the mother the rate is normal.

d)

Notify the health care provider at once.

51.

The patient’s membranes have just ruptured. What is the first priority of the nurse?

a)

Turn the patient on the left side.

b)

Perform a Nitrazine test.

c)

Check the fetal heart rate (FHR).

d)

Perform a vaginal examination.

52.

A patient arrives at the hospital having contractions. How should the nurse determine that the patient is in true labor?

a)

There is no dilation.

b)

The contractions are in the fundus.

c)

The cervix has softened and effaced.

d)

The contractions are irregular.

53.

The nurse is alarmed as she assesses a protruding umbilical cord from the vagina. What immediate action should the nurse take?

a)

Monitor intensity of contractions.

b)

Place the patient in the knee-chest position.

c)

Notify the charge nurse.

d)

Ask the patient to perform a Valsalva’s maneuver.

54.

A nurse is assessing the printout from the fetal monitor. What is the legal responsibility of the nurse?

a)

Correctly identifying abnormal FHR patterns and prescribing medication

b)

Correctly identifying abnormal FHR patterns and notifying the health care provider

c)

The nurse is not legally responsible for fetal monitoring

d)

Providing technical assessment to the monitor technicians

55.

A mother is in early labor and asks the nurse how long the labor will last. The nurse explains that the first stage of labor lasts from the beginning of regular contractions until when?

a)

The cervix is completely effaced.

b)

The baby is in position.

c)

The cervix is fully dilated.

d)

The woman begins pushing.

56.

The nurse is admitting a patient to the labor and delivery unit. While performing the initial assessment, which assessment is the priority?

a)

The number of previous pregnancies

b)

When the baby is due

c)

When the patient last ate

d)

The timing of contractions

57.

During labor, the patient screams at her husband to get out of her sight. What would be the most appropriate action for the nurse?

a)

Ask the husband to leave the room.

b)

Assure the husband that such behavior is normal.

c)

Remind the patient that the husband wants to help.

d)

Change the patient’s position.

58.

A primigravida patient is admitted to the labor and delivery unit. During initial assessment, the baby is found to be engaged. Which statement is true?

a)

The narrowest diameter of the presenting part has reached the pelvic outlet.

b)

The descending part is being initiated through the midpelvis.

c)

The widest diameter of the presenting part crosses the pelvic inlet.

d)

The narrowest diameter of the presenting part is at the ischial spines.

59.

The health care provider has decided to induce labor with prostaglandin gel and an amniotomy. When should the nurse expect that labor will start?

a)

1 hour

b)

4 hours

c)

8 hours

d)

12 hours

60.

A mother has entered the second stage of labor. When does the second stage of labor end?

a)

When the mother begins to push

b)

When the baby’s head crowns

c)

With delivery of the baby

d)

With delivery of the placenta

61.

Why is oxytocin administered in the third stage of labor?

a)

To stimulate lactation

b)

To relieve postpartum pain

c)

To stimulate uterine contractions

d)

To sedate the mother so she can rest

62.

After the delivery of a newborn, what is the priority action of the nurse?

a)

Place the newborn on the right side.

b)

Cover the cord stump.

c)

Dry the infant immediately.

d)

Suction nose and mouth.

63.

An infant presents 5 minutes after delivery with a heart rate of 105, is crying, has some flexion in the arms, sneezes, and has a pink body and blue limbs. What Apgar score should be assigned to this infant?

a)

5

b)

7

c)

8

d)

10

64.

For the first hour following delivery, how often should the nurse assess the mother?

a)

Every 5 minutes

b)

Every 10 minutes

c)

Every 15 minutes

d)

Every 30 minutes

65.

When the nurse performs the Nitrazine test on vaginal secretions of a patient who thinks her membranes have ruptured, the paper turns yellow. What does this finding indicate?

a)

Acidic discharge, membranes intact

b)

Acidic discharge, membranes have ruptured

c)

Neutral, not enough discharge to measure

d)

Alkaline, membranes have ruptured

66.

Which assessment findings suggest probable fetal distress?

a)

Fetal heart rate (FHR) of 120

b)

Meconium-stained amniotic fluid

c)

Decreased FHR during contractions

d)

Strong contractions 10 seconds apart

e)

Slow return of FHR to baseline

67.

A pregnant woman is discussing her desire to have her baby in a birthing center. Which factors could exclude the patient from delivering in a birthing center?

a)

The patient is a primigravida.

b)

The patient will be having a planned cesarean delivery.

c)

The mother has preeclampsia.

d)

The baby is a boy.

e)

The mother has no support system.

68.

The nurse explains to the patient whose membranes ruptured an hour ago that deliveryis usually accomplished (a)   in to 24 hours postrupture.

69.

A primigravida has a pelvis of the android type, which usually means the delivery will bea (a)   .

70.

A nurse shows the patient an x-ray of the fetal spine in parallel alignment with the mother’s to demonstrate a (a)   lie.