Situation:

Mrs. Buenavista, G1P0 comes to the antepartum clinic for a routine

prenatal examination. She is 36 weeks pregnant and thus far
has had an uncomplicated pregnancy.

Situation:
Mrs. Tierra, G4P3 arrives at the hospital in active labor she has had
three children by cesarean section and was scheduled for a
repeat cesarean section.

1. Which of the following maneuvers should the nurse use to

determine the fetal position?
a. Credes
b. Ritgens
c. Valsalvas
d. Leopolds

49. The nurses primary concern for Mrs. Tierra would be:
a. Tetanic contractions
b. Precipitous labor
c. Uterine rupture
d. abruptio placenta

2. The physician notes state that the fetal position is ROA. The
nurse will listen for fetal heart tones in which quadrant of the
mothers abdomen?
a. upper right
b. lower right
c. upper left
d. lower left
3. Mrs. Buenavista inquires about signs of true labor. The nurse
tells her to call the doctor if the following occurs:
a. loss of the mucus plug
b. increased vaginal discharge
c. frequent regular contractions that
do not cease with walking
d. increased urinary frequency
4. Mrs. Buenavista complains of frequent indigestion. In order to
decrease this occurrence the nurse suggest that she:
a. use an antacid as needed
b. decrease intake of spicy foods
c. increase amount of fruit eaten
d. discontinue the use of sugar substitutes
5. Constipation is a common third trimester problem. Which of the
following is not part of the nursing instructions for Mrs.
Buenavista?
a. increase fluid intake
b. add banana to her diet
c. use enema as needed
d. exercise regularly each day
6. Mrs. Buenavista reports a weight gain of 1 pound a week during
her 8th month of pregnancy. Which of the following actions
should be taken?
a. None, since this is a normal weight increase
b. make an appointment with the nutritionist
c. suggest a weight loss program
d. check for proteinuria and hypertension
Situation:
Mrs. Lujan, age 28, arrives at the antepartal clinic for her initial
visit. She has missed two menstrual periods, her last period
was October 30. Her obstetric history reveals one elective
abortion 6 years ago and the birth of a son 4 years ago at the
39th week of gestation. Her present pregnancy has been
confirmed.
7. Based on the above history, the nurse should classify Mrs. Lujan
as:
a. Gravida 2 Para 1101
b. Gravida 2 Para 1011
c. Gravida 3 Para 0111
d. Gravida 3 Para 1011
8. Which assessment findings noted during the initial examination
would support the diagnosis of pregnancy?
a. ballottement
b. abdominal enlargement
c. bluish discoloration of the vaginal
mucosa
d. softening of the lower uterine

50. Based on her knowledge of the management of clients who

have previously delivered by cesarean section, the nurse
knows that:
a. Once a cesarean, always a cesarean.
b. Labor may be safe if the uterine incision was transverse
c. Labor is more risky if there were vaginal deliveries prior to
the cesarean.
d. The type of abdominal incision is indicative of the type of
uterine incision.
51. Mrs. Tierra suddenly cries out and complains of a searing pain
in the abdomen. The Nurses priority nursing intervention is
to:
a. call the physician
b. turn Mrs. Tierra on her right side
c. check the contraction pattern
d. increase the rate of IV
52. In the recovery room following her emergency cesarean
delivery and hysterectomy, Mrs. Tierra complains of
abdominal pain. The nurse should:
a. check time of the last dose of pain medication
b. assess the amount of lochia and record
c. vigorously massage the uterus until it is firm
d. apply heat to the abdomen
Situation:
Mrs. Nevada, G2P1, is expecting twins.
53. A significant goal of her care will be to:
a. limit weight gain
b. promote physical endurance
c. equalize size of twins
d. prevent premature delivery
54. The nurse explains to Mrs. Nevada that the correct way to time
the frequency of uterine contractions is from the:
a. beginning of one contraction until end of contraction
b. beginning of one to the beginning of next contraction
c. end of one to the beginning of next contraction
d. end of one until the end of the next contraction
55. The nurse monitors Mrs. Nevada closely following delivery
because she is at higher risk for which of the following?
a. uterine atony
b. urinary tract infection
c. retained placental fragments
d. breast engorgement
Situation:
Mrs. Barcelona, a primigravida is admitted to labor and delivery.
She is a 4 cm. dilated and having firm contractions every 4
minutes. Mrs. Barcelona asks which anesthesia will best relieve
both pain of contractions during labor and the pain of delivery.
56. The nurse tells Mrs. Barcelona that the type of anesthesia she
desires would be:
a. lumbar epidural block
b. pudendal nerve block
c. paracervical block
d. local anesthesia

segment
9. Using Nageles rule, the nurse would calculate Mrs. Lujans
expected date of delivery as:
a. May 2
b. July 6
c. July 31
d. August 6
10. Mrs. Lujan, tells the nurse that her morning sickness is
lessening but she still feels nauseated in the afternoons.
Which nursing action would be most appropriate?
a. suggesting that she eat dry crackers before getting out of
bed
b. suggesting that she eat small frequent meals
c. instructing her to drink skim milk with her meals
d. determining her food preferences
11. Which physiologic change of pregnancy probably is causing
Mrs. Lujans nausea and vomiting?
a. high levels of human chorionic gonadotropin
b. increased gastric motility
c. reflux of acidic secretions into lower esophagus
d. altered stomach position
12. Mrs. Lujan drinks one quart of milk daily, which supplies her
with large amount of:
a. Vitamin B12 and Niacin
b. Folic acid and Thiamine
c. Riboflavin and Vitamin A
d. Vitamin C
13.

The nurse notices that Mr. Lujan exhibiting some of the

symptoms associated with Couvade Syndrome during a
conversation about Mrs. Lujans condition. The nurse should
understand that:
a. Such symptoms usually are physiologically based
b. Such behavior is a fathers attempt at bonding with his
unborn child
c. Such behavior is not unusual; it is a way in which an
expectant father can explore his feelings
d. Such behavior must to be redirected to promote a healthy
father image

14. Mrs. Lujan tells the nurse that she has experienced intermittent
nosebleeds. Which normal physiologic change of pregnancy
is probably responsible?
a. elevated HCG level
b. hyperemia of the nasal mucous
membranes
c. vascular congestion of nasal
turbinates from tissue edema
d. elevated blood pressure
15. Mrs. Lujan experiences urinary frequency. This condition
which is common during the first trimester of pregnancy is
physiologically related to:
a. pressure on the bladder from the enlarging uterus
b. increased renal blood flow and glomerular filtration rate
c. excessive intake of coffee
d.
smooth muscle relaxation caused by an increase
production of progesterone
Situation:
Mrs. Lujan is now in her second trimester of pregnancy, continues
coming to the clinic for her monthly check-ups.
16. During the second trimester, the nurse would expect Mrs. Lujan
to:
a. feel ambivalent about her pregnancy
b. identify the fetus as a separate human being
c. anticipate labor and delivery
d. realistically prepare for childbirth

57. Demerol 25 mg is ordered for IV administration when Mrs.

Barcelona is 6 cm dilated. For safest administration, the
nurse should:
a. give it slowly during contractions
b. inject it during relaxation of uterine contractions
c. withhold if the fetal heart rate range is 130-140
d. discontinue if the maternal pulse is 70-80
58.

Mrs. Barcelona has been taking tetracycline during her

pregnancy. Fetal damage resulting from tetracycline is:
a. deafness
b. webbed fingers
c. discolored teeth
d. mental retardation

Situation:
Mrs. Carissa, G1P1 had a spontaneous vaginal delivery of an 8
pound infant.
59. Mrs. Carissa complains of episiotomy pain in the recovery
room following delivery. Edema is noted. The nurse should:
a. apply pressure pad
b. expose perineum to heat lamp
c. elevate the hips on the pillows
d. place an ice pack to the episiotomy
60. During a postpartum check, the nurse finds that Mrs. Carissas
uterus is displaced to her right side. This is most likely
indicative of:
a. uterine rupture
b. uterine atony
c. a distended bladder
d. hematoma formation
Situation:
Mrs. Futura, gravida 3 para 3003, is admitted to the postpartal unit
after an uncomplicated labor and vaginal delivery. She plans to
bottle-feed her neonate.
61. Mrs. Futura tells the nurse that she has urinated four (4) times
within the last hour but only voided a small amount each time.
The nurses initial action should be to:
a. catheterize Mrs. Futura to remove any retained urine
b. explain that this is normal during the first 24 hours after
delivery
c. begin measuring and recording Mrs. Futuras I and O
d. Palpate Mrs. Futuras fundus to assess uterine consistency
and location
62. Which assessment finding is most indicative of postpartal
infection?
a. elevated body temperature
b. increased pulse rate
c. white blood cell count of 25,000/meg.
d. foul-smelling lochia
63. Mrs. Futura asks the nurse when her menstrual period will
return. The nurse correctly states that non-breast feeding
patients typically resume menstruating in about:
a. 4-6 weeks
b. 8-12 weeks
c. 3-6 weeks
d. 4-8 weeks
64. The physician prescribes a rubella vaccination because Mrs.
Futuras rubella titer is negative. Which information should
the nurse emphasize to Mrs. Futura before administering the
vaccine?
a. she must avoid pregnancy for at least 3 months
b. the rubella vaccine has no adverse effects
c. she should avoid contact with her neonate for at least 24
hours after vaccination

d.
17. The physician diagnoses slight megaloblastic anemia from
folic acid deficiency. To help correct this anemia, Mrs. Lujan
should increase her intake of:
a. fish, cheese and eggs
b. green leafy vegetables
c. milk and milk products
d. citrus fruits
18. During the second trimester, Mrs. Lujan develops recurrent
ankle edema in the afternoon. Assessment reveals that her
blood pressure and urinalysis results are within normal limits.
The edema is probably related to:
a. pressure from the enlarging uterus
b. pregnancy induced hypertension
c. increased serum albumin levels
d. increased progesterone levels
19. Which nursing instruction would not be appropriate when
teaching Mrs. Lujan how to relieve her ankle edema?
a. Elevate her legs and feet for a short period several times
daily
b. Avoid tight clothing, tight socks and knee high stockings
c. Lie down on her left side when resting or sleeping
d. Restrict her fluid intake during the later afternoon
Situation:
Mrs. Lujan enters her third trimester of pregnancy.
20. Mrs. Lujan complains to the nurse that she is having frequent
leg cramps. The nurses initial action should be:
a. to assess Mrs. Lujans intake of dairy products
b. to assess for positive Homans sign
c. to determine how frequently Mrs. Lujan performs pelvic
rocking exercises
d. to assess Mrs. Lujans intake of foods from the bread and
cereal group
21. To prevent leg cramps from disturbing her sleep, Mrs. Lujan
should:
a. extend her legs and dorsiflex her foot before bedtime
b. elevate and support her legs on pillows while sleeping
c. massage her calves with lotion before bedtime
d. drink a warm glass of milk before bedtime
22. Mrs. Lujan also reports occasional lower back pain. Which
nursing measure would be most appropriate?
a. teaching her how to apply sacral pressure
b. encouraging her to take frequent long walks
c. teaching her pelvic rocking exercises
d. suggesting that she sit in straight-backed chairs
23. Mr. Lujan tells the nurse that his wife is insisting that he attend
Lamaze classes with her. One purpose of the breathing
techniques taught in Lamaze classes is to decrease the
discomfort of uterine contractions during labor by:
a. elevating the diaphragm during contractions
b. enhancing fetal descent through the pelvis
c. reducing the strength of the contractions
d. lowering the diaphragm during contractions
Situation:
Angelica, 26 year old mother of 5 year old twin sons, is making her
initial visit to the antepartal clinic. Her obstetric history reveals
the birth of a stillborn infant in the 38th week of gestation and
the birth of her twins in the 35th week of gestation. The
physician has confirmed her current pregnancy and estimated
her fetus to be at 16 weeks of gestation.

the rubella vaccine provides passive immunity to the

patient and protects her neonate from acquiring the
disease

65. Which oral medication might the physician prescribe to inhibit

Mrs. Futuras lactation?
a. Menotropins (Pergonal)
b. Bromocriptine mesylate (Parlodel)
c. Ergonovine maleate (Ergotrate)
d. Estradiol (Delestrogen)
Situation:
Mrs. Palmera, gravida 2 para 2002 has been admitted to the
postpartal unit after an uncomplicated labor and vaginal
delivery. She plans to breast-feed her neonate
66. Mrs. Palmera complains of severe cramping. The nurse knows
that much cramping commonly is associated with:
a. infection
b. retained placental fragments
c. uterine involution
d. bladder distention
67. The nurse prepares to help Mrs. Palmera ambulate for the first
time after delivery. Which statement about early ambulation is
true?
a. It may cause hypotensive episodes
b. It facilitates uterine involution
c. It requires no special nursing interventions
d. It should not be attempted for at least 6 hours after delivery
68. When preparing Mrs. Palmera for breast-feeding, the nurse
should assess for a functional let-down-reflex. Which sign
indicates that Mrs. Palmeras let-down-reflex is functioning
properly?
a. The neonates vigorous sucking at the breast
b. Nipple soreness
c. Leakage of milk from one breast while the neonate nurses
at the other breast
d. feeling of breast fullness
69. About two weeks after delivery, Mrs. Palmera develops a small,
reddened area on one breast that is hot and tender to touch.
She complains that she feels as if she is coming down with flu
and her temperature is 100.6 F (38.1 C). These signs and
symptoms indicate:
a. blocked milk duct
b. cracked nipple
c. breast engorgement
d. mastitis
70. Which organism is the moist common cause of mastitis?
a. Staphylococcus aureus
b. Escherichia coli
c. Beta Hemolytic streptococci
d. Methicillin-resistant Staphylococcus aureus
71. Which change in the cardiac system is not expected during
pregnancy?
a. increase in cardiac volume
b. increase in blood pressure
c. displacement of the heart
d. increase of 10 beats/minute in the resting heart rate
72. A decrease in the baseline FHR may be caused by all of the
following factors, EXCEPT:
a. fetal sleep
b. fetal hypoxia
c. maternal drug administration
d. maternal fever

24. Based on Mrs. Angelicas obstetric history, the nurse should

classify her as:
a. Gravida 2 Para 1102

b. Gravida 3 Para 1201

c. Gravida 3 Para 1102
d. Gravida 4 Para 1202
25. Mrs. Angelicas blood is Rh-negative. The physician would
schedule administration of human Rho (D) immune globulin
(RhoGAM) at the 28th week of gestation if Mrs. Angelica had
a:
a. negative Direct Coombs test result
b. negative Indirect Coombs test result
c. positive Direct Coombs test result
d. positive Indirect Coombs test result
26.

As her pregnancy advances, Mrs. Angelica, develops a

waddling gait. Which hormone probably caused this change?
a. Estrogen
b. Progesterone
c. Relaxin
d. Human placental lactogen

27. The physician schedules Mrs. Angelica for a 1-hour (50 g)

Glucose Tolerance Test (GTT) during her 28th week of
pregnancy. She asks the nurse the reason for the test, which
was not performed during her previous pregnancies. The
nurse should respond that it will:
a. determine if she has diabetes mellitus
b. screen for gestational diabetes mellitus
c. screen for pregnancy-induced hypertension
d. measure the percentage of glucose attached to hemoglobin
28. Mrs. Angelicas GTT reveals a blood glucose level of 145 mg/Dl.
How should the nurse interpret this?
a. result within the normal range
b. result is abnormal; test should be repeated in a week
c. result necessitates further monitoring of her blood pressure
and urine protein levels
d. result calls for a 3-hour oral GTT
Situation:
Mrs. Veranice, 21 year old primigravid patient is making her initial
visit to the antepartal clinic. The physician has confirmed her
pregnancy; she is in the 14th week of gestation.
29. While assessing the fetal heart rate, the nurse counts 130
beats/minute and detects a synchronous whistling sound.
These findings indicate:
a. uterine souffle
b. funic souffl
c. fetal bradycardia
d. fetal tachycardia
30. Mrs. Veranice asks the nurse, What does the bag of waters
do? The nurses best response would be:
a. It helps the fetus obtain nourishment from the placenta
b. It protects the fetus skin
c. It maintains the fetus temperature
d. It contains nutrients for the fetus
31. Mrs. Veranice has been practicing Kegel exercises during the
prenatal period and plans to continue them postpartally.
Which muscles do these exercises strengthen?
a. puborectalis
b. transverse muscle of the perineum
c. pubococcygeus
d. bulbocavernosus
Situation:
Mrs. Dela Fuente, a 24 year old gravida 1 with class D diabetes, is
admitted to the high risk antepartal unit at 32 weeks gestation
with a diagnosis of PIH and orders for a complete bed rest.
32. Which factors in Mrs. Dela Fuentes health history predispose
her to developing PIH?

73.

A pregnant Rh-negative patient who has not previously

received Rho (D) immune globulin (RhoGAM) should receive
the drug after all of the following, EXCEPT:
a. amniocentesis
b. maternal serum-alpha fetoprotein testing
c. blunt trauma to the abdomen
d. chorionic villi sampling

74. Which statement about human placental lactogen is not true?

a. HPL is antagonistic to insulins action
b. HPL stimulates insulin secretion
c. Maternal HPL levels increase during pregnancy
d. HPL promotes lipolysis
75. The daily sodium intake for a woman with pregnancy induced
hypertension should be approximately:
a. 1000 mg.
b. 2500 mg.
c. 4500 mg.
d. 5000 mg.
76.

To prevent constipation in a pregnant patient taking oral

supplemental iron, the nurse should tell her to:
a. increase her dietary fiber and water intake
b. use over-the-counter laxatives as needed
c. use sodium biphosphate (Fleet) enemas every 2-3 days
d. take at least 1 tablespoon of mineral oil daily

77. Which assessment finding is not a contraindication for using a

tocolytic agent to manage preterm labor?
a. active vaginal bleeding
b. fetal distress
c. cervical dilation of 2-3 cm.
d. cervical dilation of 10 cm.
78. When a patient in labor receives an epidural anesthetic the
nurse should immediately:
a. assess the FHR
b. assess patients BP, pulse and respirations
c. administer oxygen via face mask
d. place the patient in semi-fowlers position
79. Which prophylactic measure taken immediately after delivery is
most effective in preventing conjunctivitis in the neonate?
a. instilling silver nitrate drops in each eye
b. flushing each eye with normal saline solution followed by
distilled water
c. instilling erythromycin ointment into each conjunctival sac
d. instilling prednisone ophthalmic ointment into each
conjunctival sac
80. Which of the following is not a benefit of initiating breastfeeding soon after delivery?
a. decreased risk of fetal hyperbilirubinemia
b. enhanced maternal-infant bonding
c. enhanced uterine involution
d. elimination of the need for a vitamin K injection
81. When teaching a prepared childbirth class about the effects of
cigarette smoking on the fetus, the nurse should explain that:
a. smoking is associated with low birth weight
b. smoking is associated with neurologic impairment
c. smoking increases the risk of cardiac anomalies
d. smoking is associated with respiratory distress syndrome
82. Which complications of pregnancy are common in diabetic
patients?
a. polyhydramnios, fetal macrosomia and pre-eclampsia
b. hypotension, fatigue and UTI
c. mitral valve prolapse and still birth
d. placenta previa and hypoglycemia

a.
b.
c.
d.

age and race

age and history of diabetes
history of diabetes and familial history of PIH
race and gestational age

33. Mrs. Dela Fuentes condition worsens and she is brought to the
labor and delivery area for magnesium sulfate therapy.
MgSo4 is administered primarily to:
a. increase the CNSs response to stimuli
b. decrease neuromuscular irritability
c. increase calcium resorption by the muscles
d. reduce peripheral vascular resistance and lower BP
34.

The nurse should assess Mrs. Dela Fuente for clinical

manifestation of magnesium sulfate toxicity, which include:
a. headache, blurred vision and 3 proteinuria
b. respiratory depression and loss of deep tendon reflex
c. flushing and sweating
d. ringing in the ears and metallic taste in the mouth

83. Which factor would be most helpful in assessing the adequacy

of placental perfusion?
a. duration and intensity of contractions
b. ability of the client to cope with the discomfort of labor
c. duration of the rest phases between contractions
d. effectiveness of the client breathing techniques during
contraction
84. After receiving the pudendal block, which reaction a patient is
likely to experience?
a. delayed voiding after delivery because of numbness of the
nerves supplying the bladder
b. complete relief from the discomfort of uterine contractions
during labor
c. numbness of the legs after delivery
d. numbness of the birth canal and perineum to allow pushing
during delivery

35. Which assessment finding in Mrs. Dela Fuente might be a

prodromal manifestation of seizures associated with
eclampsia?
a. loss of deep tendon reflexes
b. dramatic decrease in BP
c. epigastric pain
d. respiratory depression

85. Two days after delivery, the nurse discovers that the neonate
weighs 3 oz (85 g) less than his birth weight. This weight
loss:
a. is normal during the first few days after delivery
b. is probably sign of dehydration
c. indicates the need to increase the neonates nutritional
intake
d. is probably a sign of neonatal infection

36. Mrs. Dela Fuente suddenly experiences a seizure. The nurses

first action should be to:
a. establish and maintain a patent airway
b. administer an anti-hypertensive agent
c. begin chest compression
d. assess fetal heart rate

86. Oxytocin (Pitocin) is

administered via I.V. to:
a. help contract the uterine muscles
b. prevent DIC
c. relax the uterine muscles
d. augment the clotting action of platelets

37. Once the seizure has passed, the nurses first action should be
to:
a. evaluate the fetal heart rate for signs of fetal hypoxia
b. catheterize the patient if a chateter is already in place
c. administer an anti-hypertensive agent to prevent CVA
d. turn the patient on her side to prevent aspiration in case
vomiting occur

87. Which hormone is responsible for the production of clear,

elastic cervical mucus associated with spinnbarkeit and
ferning?
a. progesterone
b. prostaglandin
c. estrogen
d. follicle-stimulating hormone

Situation:
Mrs. Kassandra, a 32 year old gravida 6 para 2305 with a history of
chronic hypertension arrives at the labor and delivery area with
dark red vaginal bleeding, and severe abdominal pain. The
physician, Dr. Luis Ignacio diagnoses abruptio placenta.

88. Combined oral contraceptives prevent pregnancy by inhibiting

the production of
a. FSH and prolactin
b. Luteinizing hormone and estrogen
c. FSH and LH
d. estrogen and progesterone

38. Abruptio placenta is defined as:

a. abnormal implantation of the placenta
b. impaired blood supply to the placenta resulting in Necrosis
c. premature separation of normally implanted placenta
d. abnormal adherence of the placenta to the uterine wall
39.

Which assessment findings are characteristic of abruptio

placenta?
a. tender, increasingly rigid uterus and increased maternal PR
b. soft uterus and maternal hypotension
c. tender uterus, soft abdomen and decreased maternal PR
d. rigid uterus, increased urine output and decreased maternal
PR

40. Abruptio placenta threatens fetal well-being primarily because

it:
a. increases intrauterine pressure
b. lowers the number of placental oxygen exchange sites
c. decreases uterine tone
d. increases the risk of umbilical cord prolapse
41. Which of Mrs. Kassandras body systems should the nurse
assess first?
a. endocrine

89. Which characteristic normally is not present in a fetus at 20

weeks gestation?
a. surfactant production
b. active movement
c. meconium in the intestinal tract
d. vernix caseosa covering the skin
90. Heparin is the preferred anti-coagulant for a pregnant cardiac
patient because it:
a. does not cross the placental barrier
b.
does not affect the patients activated partial
thromboplastin time
c. has a serum half life of 3-4 days
d. can be administered orally
91. A patient receiving an infusion of oxytocin to augment labor,
suddenly complains of chest pains. Assessment reveals
diaphoresis and pink frothy sputum on expectoration. These
findings are early manifestations of:
a. placenta previa
b. amniotic fluid embolism
c. disseminated intravascular coagulation
d. pneumonia

b. cardiovascular
c. neuromuscular
d. renal

42. Disseminated intravascular coagulation (DIC) is a possible

complication of abruption placenta. Which assessment
finding would indicate that Mrs. Kassandra has developed
DIC?
a. bleeding of the nose and gums
b. rapid clotting at the venipuncture sites
c. joint pain
d. increased CVP
Situation:
Mrs. Dela Vega, gravida 1, is admitted to the labor and delivery area
in labor. She complains of abdominal pain that seems to come
and go and states that her water may have broken on the way
to the hospital.
43. Which procedure would best determine if Mrs. Dela Vega has
spontaneously ruptured amniotic membranes?
a. complete blood count
b. fern test
c. urinalysis
d. vaginal examination
44. Mrs. Dela Vega is experiencing true labor when her contraction
pattern shows:
a. occasional irregular contractions
b. irregular contractions that increase in intensity
c. regular contractions that remain the same
d. regular contractions that increase in frequency and
duration
45. The nurse performs Leopolds maneuvers on Mrs. Dela Vega to
assess:
a. fetal position
b. cervical dilation
c. fetal well being
d. stage of labor
46. During the active phase of labor, Mrs. Dela Vega reports severe
back pain that becomes increasingly intense during
contractions. The nurse should place Mrs. Dela Vega in which
position?
a. supine
b. semi-Fowlers
c. squatting
d. side-lying on the side of the fetus back
47. The nurse should encourage Mrs. Dela Vega to void frequently
during labor, primarily to:
a. enhance fetal descent
b. prevent urinary tract infection
c. strengthen vaginal and perineal muscles
d. assess urine specimens for albumin
48.

The physician determines that Mrs. Dela Vegas amniotic

membranes ruptured several hours ago. Which action would
be the nurses priority in caring for Mrs. Dela Vega?
a. increasing her fluid intake
b. monitoring her fluid intake and output
c. providing frequent perineal care
d. measuring her temperature every two hours

92. Which labor position is preferred for a cardiac patient with

problems from increased preload?
a. left lateral
b. high semi-fowlers
c. prone
d. lithotomy
93. Cardiac patients are given prophylactic antibiotics during labor
and after delivery primarily to prevent:
a. mitral valve prolapse
b. subacute bacterial endocarditis
c. pulmonary edema
d. lower urinary tract infections
94. After delivery, a cardiac patient should not breastfeed if she is:
a. receiving heparin therapy
b. receiving warfarin sodium (coumadin) therapy
c. receiving antibiotic therapy
d. receiving anti-inflammatory agent
95. Compared with mature breast milk, colostrums contains:
a. less fat and carbohydrates
b. less protein and minerals
c. less immunoglobulins
d. same amount of nutrients
96.

Which sign should the nurse attempt to solicit to help

determine if a patient has femoral thrombophlebitis?
a. Kernigs sign
b. Babinskis sign
c. Homans sign
d. Goodells sign

97.

The physician confirms the diagnosis of femoral

thrombophlebitis and orders 5,000 units of heparin
subcutaneously every 12 hours. Heparin was prescribed for
the patient to:
a. increase the amount of active plasmin in the blood
b. cause total lysis of the clot
c. prevent additional thrombus formation
d. decrease patients risk of developing DIC

98. After 5 days, the physician discontinues patients heparin

therapy and prescribes warfarin sodium (Coumadin) which
she will continue taking after discharge. To help the
physician determine the correct dosage during the warfarin
therapy, the nurse should assess the patients:
a. bleeding time
b. clotting time
c. prothrombin time
d. hematocrit
99. Which precautionary measure is necessary to prevent the
patient (positive for HIV) from transmitting HIV to the nurse
during the postpartal period?
a. respiratory isolation
b. blood and fluid precautions
c. enteric precautions
d. strict isolation
100. The patient positive for HIV is continuing to receive zidovudine
(Retrovir) a drug prescribed for her during her third trimester.
Which effect is not associated with zidovudine therapy?
a. prevention of viral replication
b. delayed development of acquired
immunodeficiency syndrome
c. stimulation of bone marrow activity
d. production of increased numbers of CD4 T cells