You scored 22 out of 25.

Your performance have been rated as 'Very Good'

All the questions in the quiz along with their answers are shown below. Your
answers are bolded. The correct answers have a green background while the
incorrect ones have a red background.

1. A client asks the nurse what a third degree laceration is. She was informed
that she had one. The nurse explains that this is:

* a. that extended their anal sphincter

* b. through the skin and into the muscles

* c. that involves anterior rectal wall

* d. that extends through the perineal muscle.

Third degree laceration involves all in the second degree laceration and the
external sphincter of the rectum. Options B, C and D are under the second
degree laceration.

2. Betina 30 weeks AOG discharged with a diagnosis of placenta previa. The

nurse knows that the client understands her care at home when she says:

* a. I am happy to note that we can have sex occasionally when I have no

bleeding.

* b. I am afraid I might have an operation when my due comes

* c. I will have to remain in bed until my due date comes

* d. I may go back to work since I stay only at the office.

Placenta previa means that the placenta is the presenting part. On the first
and second trimester there is spotting. On the third trimester there is
bleeding that is sudden, profuse and painless.

3. The uterus has already risen out of the pelvis and is experiencing farther
into the abdominal area at about the:

* a. 8th week of pregnancy

* b. 10th week of pregnancy

* c. 12th week of pregnancy

* d. 18th week of pregnancy

On the 8th week of pregnancy, the uterus is still within the pelvic area. On
the 10th week, the uterus is still within the pelvic area. On the 12th week, the
uterus and placenta have grown, expanding into the abdominal cavity. On
the 18th week, the uterus has already risen out of the pelvis and is
expanding into the abdominal area.

4. Which of the following urinary symptoms does the pregnant woman most
frequently experience during the first trimester:

* a. frequency

* b. dysuria

* c. incontinence

* d. burning

Pressure and irritation of the bladder by the growing uterus during the first
trimester is responsible for causing urinary frequency. Dysuria, incontinence
and burning are symptoms associated with urinary tract infection.

5. Mrs. Jimenez went to the health center for pre-natal check-up. the student
nurse took her weight and revealed 142 lbs. She asked the student nurse
how much should she gain weight in her pregnancy.

* a. 20-30 lbs

* b. 25-35 lbs

* c. 30- 40 lbs
 * d. 10-15 lbs

A weight gain of 11. 2 to 15.9 kg (25 to 35 lbs) is currently recommended as

an average weight gain in pregnancy. This weight gain consists of the
following: fetus- 7.5 lb; placenta- 1.5 lb; amniotic fluid- 2 lb; uterus- 2.5 lb;
breasts- 1.5 to 3 lb; blood volume- 4 lb; body fat- 7 lb; body fluid- 7 lb.

6. The nurse is preparing Mrs. Jordan for cesarean delivery. Which of the
following key concept should the nurse consider when implementing nursing
care?

* a. Explain the surgery, expected outcome and kind of anesthetics.

* b. Modify preoperative teaching to meet the needs of either a planned or

emergency cesarean birth.

* c. Arrange for a staff member of the anesthesia department to explain

what to expect post-operatively.

* d. Instruct the mother’s support person to remain in the family lounge

until after the delivery.

A key point to consider when preparing the client for a cesarean delivery is to
modify the preoperative teaching to meet the needs of either planned or
emergency cesarean birth, the depth and breadth of instruction will depend
on circumstances and time available.

7. Bettine Gonzales is hospitalized for the treatment of severe preecplampsia.

Which of the following represents an unusual finding for this condition?

* a. generalized edema

* b. proteinuria 4+

* c. blood pressure of 160/110

* d. convulsions

Options A, B and C are findings of severe preeclampsia. Convulsions is a

finding of eclampsia—an obstetrical emergency.

8. Nurse Geli explains to the client who is 33 weeks pregnant and is

experiencing vaginal bleeding that coitus:

* a. Need to be modified in any way by either partner

* b. Is permitted if penile penetration is not deep.

* c. Should be restricted because it may stimulate uterine activity.

* d. Is safe as long as she is in side-lying position.

Coitus is restricted when there is watery discharge, uterine contraction and

vaginal bleeding. Also those women with a history of spontaneous
miscarriage may be advised to avoid coitus during the time of pregnancy
when a previous miscarriage occurred.

9. Mrs. Precilla Abuel, a 32 year old mulripara is admitted to labor and

delivery. Her last 3 pregnancies in short stage one of labor. The nurses
decide to observe her closely. The physician determines that Mrs. Abuel’s
cervix is dilated to 6 cm. Mrs. Abuel states that she is extremely
uncomfortable. To lessen Mrs. Abuel’s discomfort, the nurse can advise her
to:

* a. lie face down

* b. not drink fluids

* c. practice holding breaths between contractions

* d. assume Sim’s position

When the woman is in Sim’s position, this puts the weight of the fetus on bed,
not on the woman and allows good circulation in the lower extremities.

10. Which is true regarding the fontanels of the newborn?

* a. The anterior is large in shape when compared to the posterior

fontanel.
 * b. The anterior is triangular shaped; the posterior is diamond shaped.

* c. The anterior is bulging; the posterior appears sunken.

* d. The posterior closes at 18 months; the anterior closes at 8 to 12

months.

The anterior fontanel is larger in size than the posterior fontanel. Additionally,
the anterior fontanel, which is diamond shaped closes at 18 month, whereas
the posterior fontanel, which is triangular in shape closes at 8 to 12 weeks.
Neither fontanel should appear bulging, which may indicate increases ICP or
sunken, which may indicate hydration.

11. Mrs. Quijones gave birth by spontaneous delivery to a full term baby boy.
After a minute after birth, he is crying and moving actively. His birth weight is
6.8 lbs. What do you expect baby Quijones to weigh at 6 months?

* a. 13 -14 lbs

* b. 16 -17 lbs

* c. 22 -23 lbs

* d. 27 -28 lbs

The birth weight of an infant is doubled at 6 months and is tripled at 12

months.

12. During the first hours following delivery, the post partum client is given
IVF with oxytocin added to them. The nurse understands the primary reason
for this is:

* a. To facilitate elimination

* b. To promote uterine contraction

* c. To promote analgesia

* d. To prevent infection
Oxytocin is a hormone produced by the pituitary gland that produces
intermittent uterine contractions, helping to promote uterine involution.

13. Nurse Luis is assessing the newborn’s heart rate. Which of the following
would be considered normal if the newborn is sleeping?

* a. 80 beats per minute

* b. 100 beats per minute

* c. 120 beats per minute

* d. 140 beats per minute

The normal heart rate for a newborn that is sleeping is approximately 100
beats per minute. If the newborn was awake, the normal heart rate would
range from 120 to 160 beats per minute.

14. The infant with Down Syndrome should go through which of the Erikson’s
developmental stages first?

* a. Initiative vs. Self doubt

* b. Industry vs. Inferiority

* c. Autonomy vs. Shame and doubt

* d. Trust vs. Mistrust

The child with Down syndrome will go through the same first stage, trust vs.
mistrust, only at a slow rate. Therefore, the nurse should concentrate on
developing on bond between the primary caregiver and the child.

15. The child with phenylketonuria (PKU) must maintain a low phenylalanine
diet to prevent which of the following complications?

* a. Irreversible brain damage

* b. Kidney failure
 * c. Blindness

* d. Neutropenia

The child with PKU must maintain a strict low phenylalanine diet to prevent
central nervous system damage, seizures and eventual death.

16. Which age group is with imaginative minds and creates imaginary
friends?

* a. Toddler

* b. Preschool

* c. School

* d. Adolescence

During preschool, this is the time when children do imitative play,

imaginative play—the occurrence of imaginative playmates, dramatic play
where children like to act, dance and sing.

17. Which of the following situations would alert you to a potentially

developmental problem with a child?

* a. Pointing to body parts at 15 months of age.

* b. Using gesture to communicate at 18 months.

* c. Cooing at 3 months.

* d. Saying “mama” or “dada” for the first time at 18 months of age.

A child should say “mama” or “dada” during 10 to 12 months of age. Options

A, B and C are all normal assessments of language development of a child.

18. Isabelle, a 2 year old girl loves to move around and oftentimes manifests
negativism and temper tantrums. What is the best way to deal with her
behavior?
 * a. Tell her that she would not be loved by others is she behaves that
way..

* b. Withholding giving her toys until she behaves properly.

* c. Ignore her behavior as long as she does not hurt herself and others.

* d. Ask her what she wants and give it to pacify her.

If a child is trying to get attention or trying to get something through

tantrums—ignore his/her behavior.

19. Baby boy Villanueva, 4 months old, was seen at the pediatric clinic for his
scheduled check-up. By this period, baby Villanueva has already increased
his height by how many inches?

* a. 3 inches

* b. 4 inches

* c. 5 inches

* d. 6 inches

From birth to 6 months, the infant grows 1 inch (2.5 cm) per month. From 6
to 12 months, the infant grows ½ inch (1.25 cm) per month.

20. Alice, 10 years old was brought to the ER because of Asthma. She was
immediately put under aerosol administration of Terbutaline. After sometime,
you observe that the child does not show any relief from the treatment given.
Upon assessment, you noticed that both the heart and respiratory rate are
still elevated and the child shows difficulty of exhaling. You suspect:

* a. Bronchiectasis

* b. Atelectasis

* c. Epiglotitis

* d. Status Asthmaticus
Status asthmaticus leads to respiratory distress and bronchospasm despite of
treatment and interventions. Mechanical ventilation maybe needed due to
respiratory failure.

21. Nurse Jonas assesses a 2 year old boy with a tentative diagnosis of
nephroblastoma. Symptoms the nurse observes that suggest this problem
include:

* a. Lymphedema and nerve palsy

* b. Hearing loss and ataxia

* c. Headaches and vomiting

* d. Abdominal mass and weakness

Nephroblastoma or Wilm’s tumor is caused by chromosomal abnormalities,

most common kidney cancer among children characterized by abdominal
mass, hematuria, hypertension and fever.

22. Which of the following danger sings should be reported immediately

during the antepartum period?

* a. blurred vision

* b. nasal stuffiness

* c. breast tenderness

* d. constipation

Danger signs that require prompt reporting are leaking of amniotic fluid,
blurred vision, vaginal bleeding, rapid weight gain and elevated blood
pressure. Nasal stuffiness, breast tenderness, and constipation are common
discomforts associated with pregnancy.

23. Nurse Jacob is assessing a 15 month old child with acute otitis media.
Which of the following symptoms would the nurse anticipate finding?
 * a. periorbital edema, absent light reflex and translucent tympanic
membrane

* b. irritability, purulent drainage in middle ear, nasal congestion and

cough

* c. diarrhea, retracted tympanic membrane and enlarged parotid gland

* d. Vomiting, pulling at ears and pearly white tympanic membrane

Irritability, purulent drainage in middle ear, nasal congestion and cough,

fever, loss of appetite, vomiting and diarrhea are clinical manifestations of
otitis media. Acute otitis media is common in children 6 months to 3 years old
and 8 years old and above. Breast fed infants have higher resistance due to
protection of Eustachian tubes and middle ear from breast milk.

24. Which of the following is the most appropriate intervention to reduce

stress in a preterm infant at 33 weeks gestation?

* a. Sensory stimulation including several senses at a time

* b. tactile stimulation until signs of over stimulation develop

* c. An attitude of extension when prone or side lying

* d. Kangaroo care

Kangaroo care is the use of skin-to-skin contact to maintain body heat. This
method of care not only supplies heat but also encourages parent-child
interaction.

25. The parent of a client with albinism would need to be taught which
preventive healthcare measure by the nurse:

* a. Ulcerative colitis diet

* b. Use of a high-SPF sunblock

* c. Hair loss monitoring

* d. Monitor for growth retardation

Without melanin production, the child with albinism is at risk for severe
sunburns. Maximum sun protection should be taken, including use of hats,
long sleeves, minimal time in the sun and high-SPF sunblock, to prevent any
problems.