1.
A primigravid client in the second stage of indicate to the nurse that the placenta is about
labor feels the urge to push. The client has had
no analgesia or anesthesia. Anatomically, which
of the following would be the best position for
the client to assume?
a. Dorsal recumbent
b. Lithotomy
c. Hands and knees
d. Squatting
2. A primigravid patient is admitted as an
outpatient for an external cephalic version. For
which of the following would the nurse assess
the client as a possible contraindication for the
procedure?
a. Multiple gestation
b. breech presentation
c. maternal Rh-negative blood type
d. History of gestational diabetes
3. When developing the plan of care for a
multigravid client with class III heart disease,
which of the following areas would the nurse
expect to assess frequently?
a. dehydration
b. nausea and vomiting
c. iron-deficiency anemia
d. tachycardia
4. While caring for a moderately obese
primigravid client in active labor at term, the
nurse would expect to monitor the client for
signs of which of the following?
a. hypotonic reflexes
b. increased uterine resting tone
c. soft tissue dystocia
d. increased fear and anxiety
5. A primiparous client, who has just delivered a
healthy term neonate after 12 hours of labor,
holds and looks at her neonate and begins to
cry. The nurse correctly interprets this
behaviour as a sign of which of the following?
a. disappointment of the baby’s gender
b. grief over the ending of the pregnancy
c. a normal response to birth
d. indication of postpartum “blues”
6. A 24-year old primigravid client who delivers
a viable term neonate is ordered to receive
oxytocin intravenously after the delivery of the
placenta. Which of the following signs would
to be delivered?
a. the cord lengthens outside the vagina
b. there is decreased vaginal bleeding
c. the uterus cannot be palpated
d. uterus changes to discoid shape
7. A primigravid client in early labor asks the
nurse what effleurage means. The nurse
explains that it is:
a. deep kneading of superficial muscles
b. secure grasping of muscular tissues
c. light stroking of the skin surface
d. prolonged pressure of specific sites
8. The physician orders an amniocentesis for a
primigravid client at 37 weeks gestation in early
labor to determine fetal lung maturity. The
nurse expects the fluid sample to be tested for
which of the following?
a. amount of bilirubin present
b. presence of red blood cells
c. barr body determination
d. Lecithin-sphingomyelin (L/S) ratio
9. The nurse explains to a newly admitted
primigravida in active labor that, according to
the gate control theory of pain, a closed gate
means that the client should experience:
a. No pain
b. Sharp pain
c. Light pain
d. Moderate pain
10. The cervix of a primigravida in active labor
who received epidural anesthesia 4 hours ago is
now completely dilated, and the client is ready
to begin pushing. Before the client begins to
push, which of the following would the nurse
assess?
a. fetal heart rate variability
b. cervical dilation again
c. vital signs
d. bladder status
11. The nurse is caring for a primigravid client in
active labour who has had two fetal blood
samplings to check for fetal hypoxia. The nurse
determines that the fetus is showing signs of
acidosis when the scalp blood pH is below
which of the following?
a. 7.5
b. 7.4
c. 7.3
d. 7.2
12. One hour after vaginal delivery of a term
neonate, the nurse palpates the fundus of a
primigravid client, noting several large clots and
a small trickle of bright red vaginal bleeding.
The client’s blood pressure is 136/92 mm Hg.
Which of the following would the nurse do
next?
a. Continue to monitor the client’s fundus every
15 minutes.
b. Ask the physician for an order for
methylergonovine (Methergine).
c. Immediately notify the physician of the
client’s symptoms.
d. Change the clients perineal pads every 15
minutes.
13. Approximately 15 minutes after delivery of a
viable term neonate, a multiparous client
complains of a chill. Which of the following
would the nurse do next?
a. Assess the client’s pulse rate.
b. Decrease the rate of intravenous fluids.
c. Provide the client with a warm blanket.
d. Assess the amount of blood loss.
14. The physician plans to perform an
amniotomy on a multiparous client admitted to
the labour area at 41 weeks gestation for labor
induction. After the amniotomy, which of the
following would the nurse expect to do first?
a. Monitor the client’s contraction pattern.
b. Assess the fetal heart rate for 1 full minute.
c. Assess the client’s temperature and pulse.
d. Document the colour of the amniotic fluid.
15. Which of the following would the nurse
expect as a common finding for a multiparous
client delivering a viable neonate at 41 weeks’
gestation with the aid of a vacuum extractor?
a. Neonatal scalp edema
b. uterine separation
c. maternal lacerations
d. Neonatal intracranial hemorrhage
16. While the nurse is caring for a multiparous
client in active labour at 36 weeks’ gestation,
the client tells the nurse, “I think my water just
broke.” Which of the following would the nurse
do first?
a. Turn the client to the right side.
b. Assess the color, amount and odor of the
fluid.
c. Assess the fetal heart rate pattern.
d. Check the client’s cervical dilation.
17. After suctioning to clear the airway of a
term neonate who appears in good condition
after spontaneous vaginal delivery, which of the
following would the nurse do next?
a. Place the infant in a radiant warmer.
b. Instill erythromycin in the eyes.
c. Obtain the neonate’s weight.
d. Put identification bracelets on each wrist.
18. A multigravid client is in active labor with
twins at 38 weeks gestation. The nurse would
monitor the client closely for symptoms of
which of the following?
a. PIH
b. UTI
c. Chorioamnionitis
d. Precipitous delivery
19. A multigravid client in active labor at 39
weeks gestation has a history of smoking one to
two packs of cigarettes daily. For which of the
following would the nurse be alert when
assessing the client’s neonate?
a. Hyperirritability
b. Hyperbilirubinemia
c. Low birth weight
d. Hypocalcemia
20. During the first hour after a precipitous
delivery, the nurse would monitor a
multiparous client for signs and symptoms of
which of the following?
a. Postpartum blues
b. Uterine atony
c. Intrauterine infection
d. Urinary tract infection