NCM 102-High Risk Pregnancy and Infant B.

Pregnancy-induced hypertension
Final Exam
Instruction: Choose the Best Answer.
1. When assessing the adequacy of sperm for
conception to occur, which of the following is
the most useful criterion?
A. Sperm count
B. Sperm motility
C. Sperm maturity
D. Semen volume
2. A couple who wants to conceive but has been
unsuccessful during the last 2 years has
undergone many diagnostic procedures. When
discussing the situation with the nurse, one
partner states, “We know several friends in our
age group and all of them have their own child
already, Why can’t we have one?”. Which of
the following would be the most pertinent
nursing diagnosis for this couple?
A. Fear related to the unknown
B. Pain related to numerous procedures.
C. Ineffective family coping related to
infertility.
D. Self-esteem disturbance related to infertility.
3. Which of the following urinary symptoms does
the pregnant woman most frequently
experience during the first trimester?
A. Dysuria
B. Frequency
C. Incontinence
D. Burning
C. Pressure on blood vessels from the enlarging
uterus
D. The force of gravity pulling down on the
uterus
8. Which of the following would the nurse
identify as a classic sign of PIH?
A. Edema of the feet and ankles
B. Edema of the hands and face
C. Weight gain of 1 lb/week
D. Early morning headache
9. In which of the following types of spontaneous
abortions would the nurse assess dark brown
vaginal discharge and a negative pregnancy
test?
A. Threatened
B. Imminent
C. Missed
D. Incomplete
10. Which of the following factors would the nurse
suspect as predisposing a client to placenta
previa?
A. Multiple gestation
B. Uterine anomalies
C. Abdominal trauma
D. Renal or vascular disease
11. Which of the following would the nurse assess
in a client experiencing abruptio placenta?
A. Bright red, painless vaginal bleeding
B. Concealed or external dark red bleeding
C. Palpable fetal outline
D. Soft and nontender abdomen

4. Heartburn and flatulence, common in the 12. Which of the following is described as
second trimester, are most likely the result of premature separation of a normally implanted
which of the following? placenta during the second half of pregnancy,
A. Increased plasma HCG levels usually with severe hemorrhage?
B. Decreased intestinal motility A. Placenta previa
C. Decreased gastric acidity B. Ectopic pregnancy
D. Elevated estrogen levels C. Incompetent cervix
D. Abruptio placentae
5. On which of the following areas would the
nurse expect to observe chloasma? 13. Which of the following factors is the underlying
A. Breast, areola, and nipples cause of dystocia?
B. Chest, neck, arms, and legs A. Nurtional
C. Abdomen, breast, and thighs B. Mechanical
D. Cheeks, forehead, and nose C. Environmental
D. Medical
6. A pregnant client states that she “waddles”
when she walks. The nurse’s explanation is 14. Which of the following amounts of blood loss
based on which of the following as the cause? following birth marks the criterion for
A. The large size of the newborn describing postpartum hemorrhage?
B. Pressure on the pelvic muscles A. More than 200 ml
C. Relaxation of the pelvic joints B. More than 300 ml
D. Excessive weight gain C. More than 400 ml
D. More than 500 ml
7. When talking with a pregnant client who is
experiencing aching swollen, leg veins, the 15. Smoking is contraindicated in pregnancy
nurse would explain that this is most probably because?
the result of which of the following? A.Nicotine causes vasodilation of the mother’s
A. Thrombophlebitis blood vessels
 B.Carbon monoxide binds with the hemoglobin
of the mother reducing available hemoglobin
for the fetus
C.The smoke will make the fetus and the
mother feel dizzy
D.Nicotine will cause vasoconstriction of the
fetal blood vessels
16. Which of the following is the most likely effect
on the fetus if the woman is severely anemic
during pregnancy?
A.Large for gestational age (LGA) fetus
B.Hemorrhage
C.Small for gestational age (SGA) baby
D.Erythroblastosis fetalis
17. Which of the following signs and symptoms
will most likely make the nurse suspect that the
patient is having hydatidiform mole?
A.Slight bleeding
B.Passage of clear vesicular mass per vagina
C.Absence of fetal heart beat
D.Enlargement of the uterus
18. Upon assessment the nurse found the
following: fundus at 2 fingerbreadths above the
umbilicus, last menstrual period (LMP) 5
months ago, fetal heart beat (FHB) not
appreciated. Which of the following is the most
possible diagnosis of this condition?
A.Hydatidiform mole
B.Missed abortion
C.Pelvic inflammatory disease
D.Ectopic pregnancy
19. A gravido-cardiac mother is advised to observe
bedrest primarily to
A.Allow the fetus to achieve normal
intrauterine growth
B.Minimize oxygen consumption which can
aggravate the condition of the compromised
heart of the mother
C.Prevent perinatal infection
D.Reduce incidence of premature labor
20. A pregnant mother is admitted to the hospital
with the chief complaint of profuse vaginal
bleeding, AOG 36 wks, not in labor. The nurse
must always consider which of the following
precautions:
A.The internal exam is done only at the
delivery under strict asepsis with a double set-
up
B.The preferred manner of delivering the baby
is vaginal
C.An emergency delivery set for vaginal
delivery must be made ready before examining
the patient
D.Internal exam must be done following
routine procedure
21. Which of the following signs will distinguish
threatened abortion from imminent abortion?
A.Severity of bleeding
B.Dilation of the cervix
C.Nature and location of pain
D.Presence of uterine contraction
22. In placenta praevia marginalis, the placenta is
found at the:
A.Internal cervical os partly covering the
opening
B.External cervical os slightly covering the
opening
C.Lower segment of the uterus with the edges
near the internal cervical os
D.Lower portion of the uterus completely
covering the cervix
23. Which of the following is TRUE in Rh
incompatibility?
A.The condition can occur if the mother is
Rh(+) and the fetus is Rh(-)
B.Every pregnancy of an Rh(-) mother will
result to erythroblastosis fetalis
C.On the first pregnancy of the Rh(-) mother,
the fetus will not be affected
D.RhoGam is given only during the first
pregnancy to prevent incompatibility
24. Which of the following conditions will lead to a
small-for-gestational age fetus due to less blood
supply to the fetus?
A.Diabetes in the mother
B.Maternal cardiac condition
C.Premature labor
D.Abruptio placenta
25. When the bag of waters ruptures, the nurse
should check the characteristic of the amniotic
fluid. The normal color of amniotic fluid is
A.Clear as water
B.Bluish
C.Greenish
D.Yellowish
26. After an Rh(-) mother has delivered her Rh (+)
baby, the mother is given RhoGam. This is
done in order to:
A.Prevent the recurrence of Rh(+) baby in
future pregnancies
B.Prevent the mother from producing
antibodies against the Rh(+) antigen that she
may have gotten when she delivered to her
Rh(+) baby
C.Ensure that future pregnancies will not lead
to maternal illness
D.To prevent the newborn from having
problems of incompatibility when it breastfeeds
27. To enhance milk production, a lactating mother
must do the following interventions EXCEPT:
A.Increase fluid intake including milk
B.Eat foods that increases lactation which are
called galactagues
C.Exercise adequately like aerobics
D.Have adequate nutrition and rest
28. The nursing intervention to relieve pain in
breast engorgement while the mother continues
 to breastfeed is
A.Apply cold compress on the engorged breast
B.Apply warm compress on the engorged
breast
C.Massage the breast
D.Apply analgesic ointment
29. The neonate of a mother with diabetes mellitus
is prone to developing hypoglycemia because:
A.The pancreas is immature and unable to
secrete the needed insulin
B.There is rapid diminution of glucose level in
the baby’s circulating blood and his pancreas is
normally secreting insulin
C.The baby is reacting to the insulin given to
the mother
D.His kidneys are immature leading to a high
tolerance for glucose
30. The nurse is assessing a multigravida, 36 weeks
gestation for symptoms of pregnancy-induced
hypertension and preeclampsia. The nurse
should give priority to assessing the client for:
A. Facial swelling
B. Pulse deficits
C. Ankle edema
D. Diminished reflexes
31. The nurse has completed discharge instructions
for a primigravida woman who is 29 weeks
gestation and hospitalized for treatment of
deep vein thrombosis. Which of the following
statements, if made by the patient to the nurse,
indicates that teaching has been successful?
A. “I should check my leg once a week.”
B. “I will message my leg nightly.”
C. “I can take Pepto-Bismol for diarrhea.”
D. “I will give myself heparin every day.”
32. The nurse is caring for a woman who is 37-
weeks gestation. The nurse would be MOST
concerned by which of the following findings?
A. B/P 150/95
B. 4+ proteinuria.
C. The patient complained of right quadrant
pain.
D. 3+ pitting edema of the ankles.
33. The nurse knows that which of the following
patients has the lowest risk of developing a
deep vein thrombosis (DVT)?
A. A 67-year-old carpenter undergoing a left
total knee replacement.
B. A 22-year-old woman who weighs 230 lbs
and is 2 months pregnant with her second
child.
C. A 44-year-old woman with ovarian cancer
experiencing vomiting from chemotherapy.
D. A 50-year-old executive following removal
of cataracts.
34. The nurse is assessing the deep tendon reflexes
of a client with preeclampsia. Which method is
used to elicit the biceps reflex?
A. The nurse places her thumb on the muscle
inset in the antecubital space and taps the
thumb briskly with the reflex hammer.
B. The nurse loosely suspends the client's arm
in an open hand while tapping the back of
the client's elbow.
C. The nurse instructs the client to dangle her
legs as the nurse strikes the area below the
patella with the blunt side of the reflex
hammer.
D. The nurse instructs the client to place her
arms loosely at her side as the nurse strikes
the muscle insert just above the wrist.
35. Which of the following is a characteristic of a
reassuring fetal heart rate pattern?
A. A fetal heart rate of 170–180bpm
B. A baseline variability of 25–35bpm
C. Ominous periodic changes
D. Acceleration of FHT with fetal movements
36. A Client With Diabetes Visits The Prenatal Clinic
At 28 Weeks Gestation. Which Statement Is
True Regarding Insulin Needs During
Pregnancy?
A. Insulin Requirements Moderate As The
Pregnancy Progresses.
B. A Decreased Need For Insulin Occurs
During The Second Trimester.
C. Elevations In Human Chorionic
Gonadotrophin Decrease The Need For
Insulin.
D. Fetal Development Depends On Adequate
Insulin Regulation
37. A client in the prenatal clinic is assessed to have
a blood pressure of 180/96. The nurse should
give priority to:
A. Providing a calm environment
B. Obtaining a diet history
C. Administering an analgesic
D. Assessing fetal heart tones
38. A pregnant client with diabetes has an order for
ultrasonography. Preparation for an ultrasound
includes:
A. Increasing fluid intake
B. Limiting ambulation
C. Administering an enema
D. Withholding food for 8 hours
39. Which of the following matches the definition:
abnormal placenta development covering the
cervix?
A. Placenta Previa
B. Abruptio Placentae
C. Multigravida
D. Proliferative phase
40. What is the best antidote for magnesium sulfate
toxicity?
A: calcium glutonate
B: magnesium glutonate
C: radium sulfate
D: barium extract