Maternity Nursing

St. Louis Review Center

Final Coaching

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.

1. Which of the following

maneuvers should the nurse use

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

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
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

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 straightbacked 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.

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?
a. age and race
b. age and history of diabetes
c. history of diabetes and
familial history of PIH
d. 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

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

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 antihypertensive agent
c. begin chest compression
d. assess fetal heart rate

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

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.

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
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

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.

49. The nurses primary concern

for Mrs. Tierra would be:
a. Tetanic contractions
b. Precipitous labor
c. Uterine rupture
d. abruptio placenta

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

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. 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 breastfeed 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 letdown-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

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 semifowlers 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 breast-feeding
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

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

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

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

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

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

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 anticoagulant 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

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