Maternal and Child Care Nursing

Situation 1 You are working in a prenatal clinic of a maternity hospital doing assessment of Cherry:
1. A positive sign that Cherry is pregnant is:
A. Fetal heart tones
B. Enlargement of uterus and abdomen

C. Quickening
D. Positive pregnancy test

2. The doctor recommends that Cherry be screened for diabetes because of her family history. You explain to
Cherry that:
A. Carbohydrate metabolism is altered in pregnancy
B. The renal threshold for glucose is decreased in pregnancy
C. Placental hormones produce insulin resistance
D. Increased dietary intake promotes the development of diabetes in pregnancy
3. Cherry smokes and asks you what effect cigarettes might have on her baby. Which would be the BEST
response?
A. Increasing your calories may offset the effects of cigarette smoking
B. Evidence supports a negative effect of smoking on the baby
C. Smoking is safe if you limit cigarette use to one pack a day
D. Smoking may cause the baby to have brain damage from decreased oxygen
4. Assessment and laboratory tests are done on Cherry. You inform her that during pregnancy it is normal to
have:
A. An increased serum creatinine level
B. A rise in blood pressure

C. A fall in haemoglobin and haematocrit

D. A decreased pulse rate

5. When planning instructions to clients like Cherry, you note that the correct order of occurrence of pregnancy
events is as follows:
A. Positive urine pregnancy test, viability, fetal movement felt by the client, fetal heart tones audible by
Doppler
B. Fetal movement felt by the client, fetal heart tones audible by Doppler, positive urine test, viability
C. Viability, positive urine test, fetal heart tones felt by Doppler, fetal movement felt by client
D. Positive urine pregnancy test, fetal heart tones audible by Doppler, fetal movement felt by client,
viability
6.
7.
Situation 2 Shelly, a 27 year old client, informs the nurse that she missed 2 menstrual periods and
tested positive on her home pregnancy test:
8. The nurse listens to Shellys history and based on her assessment, Shelly may be presenting probable signs
of pregnancy such as:
A. Craving for unusual food and fatigue
B. Enlarged uterus, positive pregnancy test
C. Missed menstrual periods, positive pregnancy test
D. Urinary frequency, nausea and vomiting
9. Shellys pregnancy cannot yet be confirmed until positive signs are observed. These positive signs include:
A. Ballottement or upward floating of the fetus when uterus is palpated
B. Increased darkening of the areola of the breasts and labia
C. Report of fetal movement by the mother and an enlarging abdomen
D. Identification of fetal parts and heart sounds
10. Shellys recent blood chemistry result shows anemia with haemoglobin level of 10.5mg/dl. The nurse gives
information about excellent sources of iron in food which include:
A. Citrus fruits, bread products, eggs
B. Clams, leafy greens, enriched cereals and
liver

C. Fish poultry, potatoes, coffee and tea

D. Milk and milk products, vegetable oils

11. Shelly does not want much weight gain during pregnancy. Since maternal nutrition is important to ensure her
health and normal fetal growth, the nurse motivates Shelly to improve her nutrition by informing her that:
A. Total weight gain encouraged throughout pregnancy is 25-35 lbs in a woman with normal weight
B. Food intake should follow the food pyramid guide to make sure that all food groups are part of the daily
diet
C. Mineral supplements and prenatal vitamins must be taken throughout the duration of pregnancy
D. Low weight gain in pregnancy is associated with increased risk of fetal and newborn mortality and
morbidity
12. Shelly eats a lot of ice chips and asks the nurse about going vegetarian. The nurse gives the correct
nutritional information when she says:
1. Ice chips are considered non-nutritive substances and cannot substitute for food
2. Strict vegetarian diets provide fiber but do not have enough calories to meet the needs of a pregnant
woman
3. Absence of animal products may lead to inadequate intake of calcium, zinc, vitamins and proteins
4. Raw vegetables are ideal sources of phytochemicals, boosts the immune system and provides sufficient
nutrients
A. 1, 3 and 4
B. 1, 2 and 4

C. 2, 3 and 4
D. 1, 2 and 3

E.
F.
Situation 3 You admit Esther, 34 years old, 38 weeks AOG. She says she had bloody show an hour ago
and was having very frequent but moderate contractions every 4-5 minutes, felt achy and short of breath.
Contractions slowed down and were less intense when they reached the hospital.
13. To assess the characteristics and pattern of uterine contractions you will:
A. Place your hand on the abdomen below the umbilicus and palpate the uterus with the fingertips
B. Assess every 30 minutes until contractions increase in intensity and duration then every 10 minutes
thereafter
C. Time the duration of contractions from the end of one to the end of the next contraction noting interval
between contractions
D. Press the uterus at the fundus with fingertips to evaluate the intensity and duration of contraction
14. Esther is told that she had Braxton-Hicks contractions and was sent home with instructions to come back
when she is in true labor. Esther is in TRUE labor when:
A. More bloody mucus is passed out and the bag of water ruptures
B. Cervix is fully dilated
C. Lightening or descent of the uterus away from the xiphoid
D. Contractions progress in frequency, duration and pain not relieved by activity
15. Esther returns to the hospital with intense and painful contractions that come every 3-4 minutes. The nurse
does Leopolds maneuver to check fetal presentation and position in the following sequence:
1. Determine whether presenting part moves easily or engaged
2. Facing the mother, assess fetal attitude of relationships of body parts to one another
3. Palpate fetal part at the fundus and identify presenting part
4. Palpate both sides of the abdomen for the smooth side and small part of the fetus to determine fetal lie
and presentation
A. 3,2,1,4
B. 4,3,2,1

C. 3,4,2,1
D. 1,2,3,4

16. Fetal presentation is occiput posterior, causing prolonged labor and severe pain. an epidural block was done
and Pitocin drip was ordered. Immediately post-epidural block nursing care for Esther includes the following
EXCEPT:
A. Monitoring of vital signs focusing on hypotension and fever
B. Instructing client to remain in bed
C. Assisting the client when ambulating
D. Monitoring bladder since client may feel urge to urinate
17. Esther goes into third stage of labor. You monitor client for expulsion of the placenta which is ushered in by
these signs EXCEPT:
A. Upward movement of the fundus
B. Sudden gush of blood from the vagina

C. Boggy uterus
D. Lengthening of the umbilical cord

E.
F.
Situation 4 - Maggie, 22, unmarried, is two months pregnant, drinks socially and occasionally uses
marijuana. She recently confirmed her pregnancy and is very ambivalent about her condition. She is not sure
who the father of the baby is because she has been promiscuous and her current condition exacerbated her
drinking of alcohol.
G.
18. Data from your interview with Maggie indicates that she started drinking alcohol in highschool. You warn her
about the condition called fetal alcohol syndrome and inform her that this syndrome has the following
characteristics EXCEPT:
A. Lowered birth weight
B. Cognitive impairments

C. Facial anomalies
D. Decreased muscle tone

19. You inform Maggie about the effects of alcohol during pregnancy. The CORRECT statement is:
A. Alcohol intake is linked to increased risk of spontaneous abortion
B. Alcohol has no known teratogenic effects on the fetus at low or high intake levels
C. A woman can safely drink a glass of wine if she has heart problems to aid in circulation
D. No safe level of drinking has been set during pregnancy therefore abstinence is advised
20. Maggie tells you I am not ready for this pregnancy. I want an abortion. Which of the following is MOST
appropriate response to Maggie?
A. You are not ready to face the consequences of this pregnancy?
B. All you have to do is stop drinking, is that difficult for you?
C. Why dont you get married so you can have support during your pregnancy?
D. You have to have a lot of faith, pray for guidance so you can make a wise choice.
21. Maggie says that she smokes 1-2 sticks of marijuana when with friends. You advise her to refrain from
smoking marijuana because it:
A. Increases risks of cerebral abnormalities of the fetus
B. Impairs the users coordination and critical thinking that puts her at risk
C. Has strong evidence of teratogenic effects on the fetus
D. Increases risk of sudden infant death syndrome
22. When taking care of pregnant clients who abuse drugs and/or alcohol, your assessment should focus on
potential problems that may have deleterious effects on the fetus such as:
A. Parental role conflict

B. Ineffective individual coping

C. Imbalanced nutrition, less than body

requirements

D. Hygiene self-care deficit

E.
F.
Situation 5 In a normal health center activity, your task includes health assessment of several clients.
23. You are doing breast assessment on a post-menopausal woman. In your assessment, what finding warrants
further attention?
A. Presence of striae and superficial veins noted in both breasts
B. Left brest slightly smaller compared with right breast
C. Inverted nipples
D. Small dimple palpated in the upper outer quadrant of the right breast
24. You are counselling a 52 year old client regarding hormone replacement therapy (HRT). A physician needs to
be notified when she experiences:
A. Vaginal dryness
B. Hot flashes

C. Leg pain
D. Urinary frequency

25.
26. Which of the following observations will make you suspect that the client may have osteoporosis?
A. Change in posture
B. Decrease in height

C. Recent fracture due to trauma

D. Complaints of joint pain

27. You are doing history taking on a post-menopausal woman. One risk factor to watch out for that is associated
with breast cancer is:
A. Nulliparity
B. Age less than 40

C. Late menarche
D. Early menopause

28. Further evaluation of a 64 year old menopausal woman who is NOT on hormone replacement therapy (HRT)
is warranted when she complains of:
A. Thinning of the pubic hair
B. Vaginal bleeding

C. Loss of vaginal lubrication

D. Lower back pain

E.
F.
Situation 6 Erica, 32 weeks pregnant, G1P0, expelled bloody tinged mucus over 24 hours ago. About 15
minutes ago, a sudden gush of warm liquid flowed, accompanied by stronger painful uterine contractions. Erica
was taken to the hospital immediately.
29. Erica informs the nurse that her bag of water (BOW) broke. The MOST appropriate question to ask would be:
A. Describe the appearance of the fluid
B. How much water did you lose

C. Was it accompanied by bloody show?

D. How frequent are your contractions now?

30. Since the membranes ruptured, the nurse protects Erica from increased risk for:
A. Haemorrhage
B. Precipitate labor

C. Intrauterine infection
D. Prolonged labor

31. Upon admission to the labor room, the nurse monitors the fetus and Ericas contractions which are now more
intense, regular and lasting for 60-80 seconds at 2-3 minute intervals. Within an hour from admission, a baby
girl was delivered spontaneously. The nurse records this as:
A. Emergency child birth
B. Precipitous labor

C. Precipitous delivery
D. Hypotonic labor and delivery

32. The condition of Erica and the preterm baby is of paramount importance. The nurses immediate action upon
expulsion of the fetus would be to:
A. Hold the infants feet up to drain any fluids that may clog the airway
B. Dry the infant and wipe off the white cheesy material
C. Receive the infant in a warm blanket to prevent heat loss
D. Clamp then cut the umbilical cord
33. Considering Ericas rapid labor and delivery, the nurses priority intervention would be based on the
following outcomes EXCEPT:
A. Stable maternal vital signs
B. Minimal tissue injuries and lacerations

C. Uterus is contracted and firm after delivery

D. Uterine position and size

E.
F.
Situation 7 Nurse Isabel is a charge nurse in the delivery room. She and her 2 midwives conduct normal
deliveries according to the hospital protocols established by the institution.
34. Right after the baby is expelled from the womb, which of the following is her priority action?
A. Suctioning the nose and the mouth of the
newborn

B. Wiping the nose and the mouth of the

newborn

C. Cutting the cord

D. Putting baby in the nipple of the mother

35. Under the principles of the DOH guidelines, the newborn is to be bathed after how many hours?
A. 4 hours
B. 6 hours

C. 8 hours
D. 10 hours

36. Babies need to be kept warm to prevent all of the following EXCEPT:
A. Brain damage
B. Sepsis

C. Coagulation problems
D. Elimination problems

37. The nurse will keep the baby in the radiant warmer until the babys temperature is stabilized at:
A. 35.5C
B. 36C

C. 37C
D. 37.5C

38. She documents that the weight of the baby is normal when
A. 2.5 to 3 kgs
B. 3 kgs

C. 1.5 to 2 kgs
D. 3 to 4 kgs

E.
F.
Situation 8 Nurse Vera is in charge of a pediatric clinic which attends to different childhood illnesses as
well as attending to well baby monitoring and consultations.
39. Which of te following is an appropriate advice to give to a mother who complains that her 2 yr old child is not
eating adequately?
A. Ask what the child wants before preparing
meals

B. Prepare finger foods that are easily digested

C. Make oatmeal porridge and serve every hour
D. Have baby tested for ascariasis

40. Deworming should be done to children who are atleast:

A. 6 months
B. 1 year and above

C. 18 months and above

D. 2 years or older

41. Baby Alina is 2 and months old. If her immunizations started on time which immunization is due to be
given during this visit?
A. OPV2; DPT2
B. OPV3; DPT3

C. OPV1; DPT1
D. Antimeasles

42.
43. The child who has a mid arm circumference is classified normal if the reading is which of the following?
A. 120mm
B. 130mm

C. 135mm
D. 140mm

44. Noli is a 3 year old boy brought for check up because he has been having cough for 2 days with runny nose.
Which of the following will the nurse teach the mother as a safe home remedy?
A. To give nasal decongestant TID
B. To give steam inhalation for hour TID

C. To give tamarind or calamansi juice

D. To give cough expectorant

E.
F.
Situation 9 Nurse Hilda is attending to patients at the fertility clinic.
45. Which of the following information from the couple is considered a primary cause of their infertility?
A. The wife says that she started to menstruate at age 14
B. The husband works as driver of a bus company
C. The wife has been on anti-depressant medication for 5 years
D. The husband had repair of kryptorchidism
46. When the wife assisted to receive an externally fertilized ovum into her uterus which successfully gets
implanted. This method is which of the following?
A. Surrogate mothering
B. Gamete intra fallopian transfer

C. In vitro fertilization
D. Artificial insemination

47. Mr. B has been suspected to be suffering from erectile dysfunction. Which of the following information will be
included during the assessment of the possible causes of the problem?
A. The family planning methods employed by
the couple
B. The insights of the wife about having
children

C. The feelings of the husband about his sexual

identity
D. The frequency of checkups in the last 2
years

48. Nurse Nida is attending to a woman with secondary amenorrhea. Which of the following may be contributory
to this problem?
A. She has been treated with anti tuberculosis
drugs

B. She is a free lance journalist

C. She is taking anti stress medications
D. She exercises in the gym regularly

49. Lanie complains to the nurse that she has menstruated 5 times in the last 3 months. The nurse will
document this as which of the following?
A. Metrorrhagia
B. Menorrhagia

C. Polymenorrhea
D. Dysmenorrhea

E.
F.
Situation 10 Nurse Dora is a nurse in charge of the obstetric clinic.
50. A woman is confirmed by ultrasound to be 12 weeks pregnant. The nurse is correct when she describes the
development of the fetus as which include all of the following, EXCEPT?
A. The Kidney functions begin
B. The liver functions begin

C. The organs are complete

D. The primitive tails have disappeared

51. The patients internal vaginal examination reveals a softening of the lower uterine segment. This is known as
which of the following?
A. Hegars sign
B. Goodells sign

C. Chadwicks sign
D. Primary sign of pregnancy

52. The mother at 8 months tells she feels breast fullness. Which is the correct information to tell the mother?
A. The increase in FSH is responsible for this
B. Your blood volume is doubled which makes the breast firm
C. The estrogen is responsible for your breast enlargement
D. The luteinizing hormone is responsible for this
53. At 32 weeks age of gestation, the nurse is aware that normal fetus will weigh atleast:
A. 1500 grams
B. 1600 grams

C. 1800 grams
D. 2000 grams

54. Which of the following is appropriate to advice a young pregnant woman about safety?
A. You will need to avoid fatigue by staying at home
B. Wear flat or very low-heeled shoes when going for walks
C. Wear soft non-irritating clothing
D. Avoid colas during pregnancy to prevent vomiting
55.
56.
Situation 11 Nurse Muriel is caring for pregnant patients admitted for various reasons.
57. Which of the following clients she has seen will need further evaluation?
A. A 6 week pregnant for the second time who had a history of tetanus
B. A 5 months pregnant woman who has a diabetic husband
C. A 7 months pregnant who is 70 kilograms
D. A 6 months pregnant who has mild back pains
58. A 7 months pregnant woman is confirmed to have candidiasis. The nurse anticipates which of the following
drugs to be given to the patient?
A. Tetracycline
B. Mycostatin

C. Metronidazole
D. Penicillin

59.
60. A pregnant patient who is an HIV positive is admitted for recurrent fever. The nurse will need to protect her
and her baby by employing which of the following infection control protocols?
A. Respiratory isolation
B. Strict isolation

C. Reverse isolation
D. Universal precautions

61. An 8 months pregnant patient is admitted because of painless vaginal bleeding. The nurse will anticipate
that the bleeding will be characterized as which of the following?
A. Bleeding is bright red in color
B. Mild to moderate in amount

C. Profuse amount of bleeding

D. Bleeding occurs when moving

62. Which of the following is recommended to pregnant women who have history of incompetent cervix?
A. To be on complete bed rest for the full duration of pregnancy
B. To have ultrasound monthly and see if the baby is viable to continue
C. To undergo cerclage (Shirodkar procedure)
D. To take medications (tocolytic) till ultrasound confirms good attachment
63.
64.
Situation 12 Nurse Amelia is attending to Mrs. Tee who is an elderly primipara at 31 weeks with a triplet
pregnancy after an infertility treatment.

65. Which of the following will the nurse be alert for as a common problem for patients with multiple pregnancy?
A. Pre eclampsia
B. Gestational diabetes

C. Bleeding
D. Preterm labor

66. Mrs. Tee is connected to a CTG monitor. What alerts the nurse that she is a candidate for a cesarian section?
A. There are contractions every 5 minutes but she does not feel any pain
B. There are irregular contractions but cervix is closed
C. The bag of water ruptures and cervical dilatation simultaneously occurs
D. There are contractions and the fetal heart rate become high
67. A 34 week pregnant woman is brought by an ambulance to the ER because she has suddenly bleed after the
car she was riding on collided with another vehicle. What will the nurse anticipate to do first?
A. Determine the body part of the mother that was hit first
B. Take the vital signs including fetal heart rate
C. Prepare mother for intubation
D. Prepare to give Dopamine infusion
68. The nurse monitors the fetal heart rate but could hardly hear the beats. Which is likely the problem?
A. The baby has drowned from bleeding
B. There is massive placental hypoperfusion

C. The babies have severe head injury

D. The babies are just sleeping

69. All of the following indicate that the placenta has been detached from the uterus EXCEPT?
A. There are no contractions when connected
to CTG

B. The abdomen is deviated to one side

C. The fundus is rising
D. The vital signs are normal

E.
F.
Situation 13 Nurse Graile is assigned to a Gravida 3 para 2 mother who is 5 hours post cesarian
section. The patient is starting to become fully awake and restless.
70. Which of the following is a care priority?
A. Suctioning the patient
B. Assessing the pain rating

C. Assisting the patient to ambulate

D. Assisting the patient to sit

71. The nurse gets the patients pulse which is 109bpm. Which of the following intervention is next?
A. Checking the wound dressing for soakage
B. Putting the patient in Trendelenburg position

C. Checking the oxygen saturation

D. Palpating the uterus

72. The nurse anticipates that there is evident bleeding with ALL of the following findings EXCEPT?
A. The wound dressing is fully soaked
B. There is vaginal bleeding

C. The uterus is soft and lax

D. The hemovac drain is half full in 2 hours

73. Which of the following drugs will the nurse anticipate to administer to the patient if bleeding is active?
A. Aminocaproic acid
B. Phenergan

C. Epinephrine
D. Hydrocortisone

74. The patient deteriorates further and needs to receive blood transfusion. Which of the following will be
anticipated to be given?
A. Platelets
B. Whole blood

C. Packed RBCs
D. Albumin

E.