Nursing Care of Women and Newborns Final Exam Questions
Course Introduction
This course explores the principles and practices of nursing care for women and newborns, emphasizing the physiological, psychological, and social aspects of maternal and neonatal health. Students will learn about prenatal, intrapartum, postpartum, and newborn care, with a focus on normal processes and common complications. The curriculum includes assessment skills, patient education, and evidence-based interventions to support the mother-newborn dyad, while considering cultural competence, ethical issues, and family-centered care throughout the childbearing cycle.
Recommended Textbook
Maternity and Womens Health Care 11th Edition by Lowdermilk
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Page 2
Chapter 1: 21st Century Maternity and Womens Health
Nursing
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Sample Questions
Q1) Which statement best describes maternity nursing care that is based on knowledge gained through research and clinical trials?
A) Maternity nursing care is derived from the Nursing Intervention Classification.
B) Maternity nursing care is known as evidence-based practice.
C) Maternity nursing care is at odds with the Cochrane School of traditional nursing.
D) Maternity nursing care is an outgrowth of telemedicine.
Answer: B
Q2) Which methods help alleviate the problems associated with access to health care for the maternity client?
A) Provide transportation to prenatal visits.
B) Provide child care to enable a pregnant woman to keep prenatal visits.
C) Increase the number of providers that will care for Medicaid clients.
D) Provide low-cost or no-cost health care insurance.
E) Provide job training.
Answer: A,B,C,D
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Chapter 2: Community Care: The Family and Culture
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Sample Questions
Q1) In what form do families tend to be the most socially vulnerable?
A) Married-blended family
B) Extended family
C) Nuclear family
D) Single-parent family
Answer: D
Q2) A Native-American woman gave birth to a baby girl 12 hours ago.The nurse notes that the woman keeps her baby in the bassinet except for bottle feeding and states that she will wait until she gets home to begin breastfeeding.The nurse recognizes that this behavior is most likely a reflection of what?
A) Delayed attachment
B) Embarrassment
C) Disappointment in the sex of the baby
D) Belief that babies should not be fed colostrum
Answer: D
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4
Chapter 3: Nursing and Genomics
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Sample Questions
Q1) Which type of genetic tests in clinical practice are most often offered to clients with a family history of disease?
A) Single-gene disorders
B) Carrier screening
C) Predictive value testing
D) Predispositional testing
Answer: A
Q2) Which condition or treatment reduces the risk of morbidity in women with the inherited factor V Leiden disorder?
A) Anticoagulant therapy
B) Pregnancy
C) Oral contraceptives
D) Hormone replacement therapy
Answer: A
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Chapter 4: Assessment and Health Promotion
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Sample Questions
Q1) Which statement best describes Kegel exercises?
A) Kegel exercises were developed to control or reduce incontinent urine loss.
B) Kegel exercises are the best exercises for a pregnant woman because they are so pleasurable.
C) Kegel exercises help manage stress.
D) Kegel exercises are ineffective without sufficient calcium in the diet.
Q2) What is the goal of a long-term treatment plan for an adolescent with an eating disorder?
A) Managing the effects of malnutrition
B) Establishing sufficient caloric intake
C) Improving family dynamics
D) Restructuring client perception of body image
Q3) Once and then a booster every 10 years
A)Tetanus-diphtheria-pertussis (Tdap)
B)Measles, mumps, rubella
C)Herpes zoster
D)Hepatitis B
E)Influenza
F)Human papillomavirus (HPV)
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Page 6
Chapter 5: Violence Against Women
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Q1) Which statement is the most comprehensive description of sexual violence?
A) Sexual violence is limited to rape.
B) Sexual violence is an act of force during which an unwanted and uncomfortable sexual act occurs.
C) Sexual violence encompasses a number of sexual acts.
D) Sexual violence includes degrading sexual comments and behaviors.
Q2) What are the responsibilities of the nurse who suspects or confirms any type of violence against a woman?
(Select all that apply).
A) Report the incident to legal authorities.
B) Provide resources for domestic violence shelters.
C) Call a client advocate who can assist in the client's decision about what actions to take.
D) Accurately and concisely document the incident (or findings) in the client's record.
E) Reassure and support the client.
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Chapter 6: Reproductive System Concerns
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Q1) Which statement related to the condition of endometriosis is most accurate?
A) Endometriosis is characterized by the presence and growth of endometrial tissue inside the uterus.
B) It is found more often in African-American women than in Caucasian or Asian women.
C) Endometriosis may worsen with repeated cycles or remain asymptomatic and disappear after menopause.
D) It is unlikely to affect sexual intercourse or fertility.
Q2) Management of primary dysmenorrhea often requires a multifaceted approach.Which pharmacologic therapy provides optimal pain relief for this condition?
A) Acetaminophen
B) Oral contraceptive pills (OCPs)
C) Nonsteroidal antiinflammatory drugs (NSAIDs)
D) Aspirin
Q3) The female athlete triad includes which common menstrual disorder?
A) Amenorrhea
B) Dysmenorrhea
C) Menorrhagia
D) Metrorrhagia
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8
Chapter 7: Sexually Transmitted and Other Infections
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Q1) Which condition is the most life-threatening virus to the fetus and neonate?
A) Hepatitis A virus (HAV)
B) Herpes simplex virus (HSV)
C) Hepatitis B virus (HBV)
D) Cytomegalovirus (CMV)
Q2) Five different viruses (A,B,C,D,and E)account for almost all cases of hepatitis infections.Which statement regarding the various forms of hepatitis is most accurate?
A) Vaccine exists for hepatitis C virus (HCV) but not for HBV.
B) HAV is acquired by eating contaminated food or drinking polluted water.
C) HBV is less contagious than HIV.
D) Incidence of HCV is decreasing.
Q3) Which sexual behaviors are associated with exposure to an STI?
(Select all that apply).
A) Fellatio
B) Unprotected anal intercourse
C) Multiple sex partners
D) Dry kissing
E) Abstinence
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9
Chapter 8: Contraception and Abortion
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Sample Questions
Q1) Although reported in small numbers,toxic shock syndrome (TSS)can occur with the use of a diaphragm.If a client is interested in this form of conception control,then the nurse must instruct the woman on how best to reduce her risk of TSS.Which comment by the nurse would be most helpful in achieving this goal?
A) "You should always remove your diaphragm 6 to 8 hours after intercourse. Don't use the diaphragm during menses, and watch for danger signs of TSS, including a sudden onset of fever over 38.4° C, hypotension, and a rash."
B) "You should remove your diaphragm right after intercourse to prevent TSS."
C) "It's okay to use your diaphragm during your menstrual cycle. Just be sure to wash it thoroughly first to prevent TSS."
D) "Make sure you don't leave your diaphragm in for longer than 24 hours, or you may get TSS."
Q2) Which benefit regarding FAMs makes it an appealing choice for some women?
A) Adherence to strict recordkeeping
B) Absence of chemicals and hormones
C) Decreased involvement and intimacy of partner
D) Increased spontaneity of coitus
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Chapter 9: Infertility
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Sample Questions
Q1) Women who have undergone an oophorectomy,have ovarian failure,or a genetic defect may be eligible to receive donor oocytes (eggs).Which statements regarding oocyte donation are accurate?
(Select all that apply).
A) Donor is inseminated with semen from the parent.
B) Donor eggs are fertilized with the male partner's sperm.
C) Donors are under 35 years of age.
D) Recipient undergoes hormonal stimulation.
E) Ovum is placed into a surrogate.
Q2) A couple comes in for an infertility workup,having attempted to achieve pregnancy for 2 years.The woman,37 years of age,has always had irregular menstrual cycles but is otherwise healthy.The man has fathered two children from a previous marriage and had a vasectomy reversal 2 years ago.The man has had two normal semen analyses,but the sperm seem to be clumped together.What additional testing is needed?
A) Testicular biopsy
B) Antisperm antibodies
C) FSH level
D) Examination for testicular infection
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Chapter 10: Problems of the Breast
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Sample Questions
Q1) A nurse is providing breast care education to a client after mammography.Which information regarding fibrocystic changes in the breast is important for the nurse to share?
A) Fibrocystic breast disease is a disease of the milk ducts and glands in the breasts.
B) It is a premalignant disorder characterized by lumps found in the breast tissue.
C) Healthy women with fibrocystic breast disease find lumpiness with pain and tenderness in varying degrees in the breast tissue during menstrual cycles.
D) Lumpiness is accompanied by tenderness after menses.
Q2) A nurse is providing education to a support group of women newly diagnosed with breast cancer.It is important for the nurse to discuss which factor related to breast cancer with the group?
A) Genetic mutations account for 50% of women who will develop breast cancer.
B) Breast cancer is the leading cause of cancer death in women.
C) In the United States, 1 in 10 women will develop breast cancer in her lifetime.
D) The exact cause of breast cancer remains unknown.
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Chapter 11: Structural Disorders and Neoplasms of the Reproductive System
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Sample Questions
Q1) Which condition is the most common malignancy of the reproductive system?
A) Endometrial cancer
B) Cervical cancer
C) Ovarian cancer
D) Vulvar and vaginal cancer
Q2) A 48-year-old woman has just had a hysterectomy for endometrial cancer.Which statement alerts the nurse that further teaching is needed?
A) "I can't wait to go on the cruise that I have planned for this summer."
B) "I know that the surgery saved my life, but I will miss having sexual intercourse with my husband."
C) "I have asked my daughter to come and stay with me next week after I am discharged from the hospital."
D) "Well, I don't have to worry about getting pregnant anymore."
Q3) The nurse should be aware that a pessary is most effective in the treatment of which disorder?
A) Cystocele
B) Uterine prolapse
C) Rectocele
D) Stress urinary incontinence
Page 13
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Chapter 12: Conception and Fetal Development
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Sample Questions
Q1) Congenital disorders refer to those conditions that are present at birth.These disorders may be inherited and caused by environmental factors or maternal malnutrition.Toxic exposures have the greatest effect on development between 15 and 60 days of gestation.For the nurse to be able to conduct a complete assessment of the newly pregnant client,he or she should be knowledgeable regarding known human teratogens.Which substances might be considered a teratogen? (Select all that apply).
A) Cytomegalovirus (CMV)
B) Ionizing radiation
C) Hypothermia
D) Carbamazepine
E) Lead
Q2) What kind of fetal anomalies are most often associated with oligohydramnios?
A) Renal
B) Cardiac
C) Gastrointestinal
D) Neurologic
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Chapter 13: Anatomy and Physiology of Pregnancy
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Sample Questions
Q1) Why might it be more difficult to diagnose appendicitis during pregnancy?
A) The appendix is displaced upward and laterally, high and to the right.
B) The appendix is displaced upward and laterally, high and to the left.
C) The appendix is deep at the McBurney's point.
D) The appendix is displaced downward and laterally, low and to the right.
Q2) A pregnant client tells her nurse that she is worried about the blotchy,brownish coloring over her cheeks,nose,and forehead.The nurse can reassure her that this is a normal condition related to hormonal changes.What is the correct term for this integumentary finding?
A) Melasma
B) Linea nigra
C) Striae gravidarum
D) Palmar erythema
Q3) Numerous changes in the integumentary system occur during pregnancy.Which change persists after birth?
A) Epulis
B) Chloasma
C) Telangiectasia
D) Striae gravidarum
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Page 15
Chapter 14: Nursing Care of the Family During Pregnancy
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Sample Questions
Q1) What is important for the nurse to recognize regarding the new father and his acceptance of the pregnancy and preparation for childbirth?
A) The father goes through three phases of acceptance of his own.
B) The father's attachment to the fetus cannot be as strong as that of the mother because it does not start until after the birth.
C) In the last 2 months of pregnancy, most expectant fathers suddenly get very protective of their established lifestyle and resist making changes to the home.
D) Typically, men remain ambivalent about fatherhood right up to the birth of their child.
Q2) Which statement regarding multifetal pregnancy is incorrect?
A) The expectant mother often develops anemia because the fetuses have a greater demand for iron.
B) Twin pregnancies come to term with the same frequency as single pregnancies.
C) The mother should be counseled to increase her nutritional intake and gain more weight.
D) Backache and varicose veins often are more pronounced with a multifetal pregnancy.
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16
Chapter 15: Maternal and Fetal Nutrition
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Sample Questions
Q1) Which nutrient's recommended dietary allowance (RDA)is higher during lactation than during pregnancy?
A) Energy (kcal)
B) Iron
C) Vitamin A
D) Folic acid
Q2) The BMI for a woman who is 51 kg before pregnancy and 1.57 m tall is _________.
Q3) After the nurse completes nutritional counseling for a pregnant woman,she asks the client to repeat the instructions to assess the client's understanding.Which statement indicates that the client understands the role of protein in her pregnancy?
A) "Protein will help my baby grow."
B) "Eating protein will prevent me from becoming anemic."
C) "Eating protein will make my baby have strong teeth after he is born."
D) "Eating protein will prevent me from being diabetic."
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Chapter 16: Labor and Birth Processes
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Sample Questions
Q1) When assessing the fetus using Leopold's maneuvers,the nurse feels a round,firm,and movable fetal part in the fundal portion of the uterus and a long,smooth surface in the mother's right side close to midline.What is the position of the fetus?
A) ROA
B) LSP
C) RSA
D) LOA
Q2) Which description of the four stages of labor is correct for both the definition and the duration?
A) First stage: onset of regular uterine contractions to full dilation; less than 1 hour to 20 hours
B) Second stage: full effacement to 4 to 5 cm; visible presenting part; 1 to 2 hours
C) Third stage: active pushing to birth; 20 minutes (multiparous woman), 50 minutes (nulliparous woman)
D) Fourth stage: delivery of the placenta to recovery; 30 minutes to 1 hour
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18
Chapter 17: Maximizing Comfort for the Laboring Woman
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Q1) According to professional standards (the Association of Women's Health,Obstetric and Neonatal Nurses [AWHONN],2007),which action cannot be performed by the nonanesthetist registered nurse who is caring for a woman with epidural anesthesia?
A) Monitoring the status of the woman and fetus
B) Initiating epidural anesthesia
C) Replacing empty infusion bags with the same medication and concentrate
D) Stopping the infusion, and initiating emergency measures
Q2) What is the role of the nurse as it applies to informed consent?
A) Inform the client about the procedure, and ask her to sign the consent form.
B) Act as a client advocate, and help clarify the procedure and the options.
C) Call the physician to see the client.
D) Witness the signing of the consent form.
Q3) What is the rationale for the use of a blood patch after spinal anesthesia?
A) Hypotension
B) Headache
C) Neonatal respiratory depression
D) Loss of movement
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Chapter 18: Fetal Assessment During Labor
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Q1) During labor a fetus displays an average FHR of 135 beats per minute over a 10-minute period.Which statement best describes the status of this fetus?
A) Bradycardia
B) Normal baseline heart rate
C) Tachycardia
D) Hypoxia
Q2) In assessing the immediate condition of the newborn after birth,a sample of cord blood may be a useful adjunct to the Apgar score.Cord blood is then tested for pH,carbon dioxide,oxygen,and base deficit or excess.Which clinical situation warrants this additional testing?
(Select all that apply).
A) Low 5-minute Apgar score
B) Intrauterine growth restriction (IUGR)
C) Maternal thyroid disease
D) Intrapartum fever
E) Vacuum extraction
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20
Chapter 19: Nursing Care of the Family During Labor and Birth
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Sample Questions
Q1) A primigravida at 39 weeks of gestation is observed for 2 hours in the intrapartum unit.The FHR has been normal.Contractions are 5 to 9 minutes apart,20 to 30 seconds in duration,and of mild intensity.Cervical dilation is 1 to 2 cm and uneffaced (unchanged from admission).Membranes are intact.What disposition would the nurse anticipate?
A) Admitted and prepared for a cesarean birth
B) Admitted for extended observation
C) Discharged home with a sedative
D) Discharged home to await the onset of true labor
Q2) What is the primary rationale for the thorough drying of the infant immediately after birth?
A) Stimulates crying and lung expansion
B) Removes maternal blood from the skin surface
C) Reduces heat loss from evaporation
D) Increases blood supply to the hands and feet
Q3) The first 1 to 2 hours after birth is sometimes referred to as what?
A) Bonding period
B) Third stage of labor
C) Fourth stage of labor
D) Early postpartum period
Page 21
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Chapter 20: Postpartum Physiologic Changes
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Sample Questions
Q1) The breast-feeding mother should be taught to expect which changes to the condition of the breasts?
(Select all that apply).
A) Breast tenderness is likely to persist for approximately 1 week after the start of lactation.
B) As lactation is established, a mass may form that can be distinguished from cancer by its positional shift from day to day.
C) In nonlactating mothers, colostrum is present for the first few days after childbirth.
D) If suckling is never begun or is discontinued, then lactation ceases within a few days to a week.
E) Little change occurs to the breasts in the first 48 hours.
Q2) Excessive use of oxytocin
A)Elevated temperature within the first 24 hours
B)Rapid pulse
C)Elevated temperature at 36 hours postpartum
D)Hypertension
E)Hypoventilation
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Chapter 21: Nursing Care of the Family During the
Postpartum Period
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Sample Questions
Q1) Many new mothers experience some type of nipple pain during the first weeks of initiating breastfeeding.Should this pain be severe or persistent,it may discourage or inhibit breastfeeding altogether.Which factors might contribute to this pain?
(Select all that apply).
A) Improper feeding position
B) Large-for-gestational age infant
C) Fair skin
D) Progesterone deficiency
E) Flat or retracted nipples
Q2) The trend in the United States is for women to remain hospitalized no longer than 1 or 2 days after giving birth.Which scenario is not a contributor to this model of care?
A) Wellness orientation model of care rather than a sick-care model
B) Desire to reduce health care costs
C) Consumer demand for fewer medical interventions and more family-focused experiences
D) Less need for nursing time as a result of more medical and technologic advances and devices available at home that can provide information
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Chapter 22: Transition to Parenthood
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Q1) A parent who has a hearing impairment is presented with a number of challenges in parenting.Which nursing approaches are appropriate for working with hearing-impaired new parents?
(Select all that apply).
A) Using devices that transform sound into light
B) Assuming that the client knows sign language
C) Speaking quickly and loudly
D) Ascertaining whether the client can read lips before teaching
E) Writing messages that aid in communication
Q2) A primiparous woman is in the taking-in stage of psychosocial recovery and adjustment after childbirth.Recognizing the needs of women during this stage,how should the nurse respond?
A) Foster an active role in the baby's care.
B) Provide time for the mother to reflect on the events of her labor and delivery.
C) Recognize the woman's limited attention span by giving her written materials to read when she gets home rather than doing a teaching session while she is in the hospital.
D) Promote maternal independence by encouraging her to meet her own hygiene and comfort needs.
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24
Chapter 23: Physiologic and Behavioral Adaptations of the Newborn
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Q1) Which statements regarding physiologic jaundice are accurate? (Select all that apply).
A) Neonatal jaundice is common; however, kernicterus is rare.
B) Appearance of jaundice during the first 24 hours or beyond day 7 indicates a pathologic process.
C) Because jaundice may not appear before discharge, parents need instruction on how to assess for jaundice and when to call for medical help.
D) Jaundice is caused by reduced levels of serum bilirubin.
E) Breastfed babies have a lower incidence of jaundice.
Q2) Which newborn reflex is elicited by stroking the lateral sole of the infant's foot from the heel to the ball of the foot?
A) Babinski
B) Tonic neck
C) Stepping
D) Plantar grasp
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25
Chapter 24: Nursing Care of the Newborn and Family
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Q1) The nurse is using the New Ballard Scale to determine the gestational age of a newborn.Which assessment finding is consistent with a gestational age of 40 weeks?
A) Flexed posture
B) Abundant lanugo
C) Smooth, pink skin with visible veins
D) Faint red marks on the soles of the feet
Q2) As part of the infant discharge instructions,the nurse is reviewing the use of the infant car safety seat.Which information is the highest priority for the nurse to share?
A) Infant carriers are okay to use until an infant car safety seat can be purchased.
B) For traveling on airplanes, buses, and trains, infant carriers are satisfactory.
C) Infant car safety seats are used for infants only from birth to 15 pounds.
D) Infant car seats should be rear facing and placed in the back seat of the car.
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Chapter 25: Newborn Nutrition and Feeding
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Q1) According to demographic research,which woman is least likely to breastfeed and therefore most likely to need education regarding the benefits and proper techniques of breastfeeding?
A) Between 30 and 35 years of age, Caucasian, and employed part time outside the home
B) Younger than 25 years of age, Hispanic, and unemployed
C) Younger than 25 years of age, African-American, and employed full time outside the home
D) 35 years of age or older, Caucasian, and employed full time at home
Q2) A new mother wants to be sure that she is meeting her daughter's needs while feeding the baby commercially prepared infant formula.The nurse should evaluate the mother's knowledge about appropriate infant feeding techniques.Which statement by the client reassures the nurse that correct learning has taken place?
A) "Since reaching 2 weeks of age, I add rice cereal to my daughter's formula to ensure adequate nutrition."
B) "I warm the bottle in my microwave oven."
C) "I burp my daughter during and after the feeding as needed."
D) "I refrigerate any leftover formula for the next feeding."
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Page 27
Chapter 26: Assessment of High Risk Pregnancy
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Q1) A 39-year-old primigravida woman believes that she is approximately 8 weeks pregnant,although she has had irregular menstrual periods all her life.She has a history of smoking approximately one pack of cigarettes a day; however,she tells the nurse that she is trying to cut down.Her laboratory data are within normal limits.What diagnostic technique would be useful at this time?
A) Ultrasound examination
B) Maternal serum alpha-fetoprotein (MSAFP) screening
C) Amniocentesis
D) Nonstress test (NST)
Q2) The nurse sees a woman for the first time when she is 30 weeks pregnant.The client has smoked throughout the pregnancy,and fundal height measurements now are suggestive of intrauterine growth restriction (IUGR)in the fetus.In addition to ultrasound to measure fetal size,what is another tool useful in confirming the diagnosis?
A) Doppler blood flow analysis
B) Contraction stress test (CST)
C) Amniocentesis
D) Daily fetal movement counts
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Chapter 27: Hypertensive Disorders
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Q1) The nurse has evaluated a client with preeclampsia by assessing DTRs.The result is a grade of 3+.Which DTR response most accurately describes this score?
A) Sluggish or diminished
B) Brisk, hyperactive, with intermittent or transient clonus
C) Active or expected response
D) More brisk than expected, slightly hyperactive
Q2) A pregnant woman has been receiving a magnesium sulfate infusion for treatment of severe preeclampsia for 24 hours.On assessment,the nurse finds the following vital signs: temperature 37.3° C,pulse rate 88 beats per minute,respiratory rate 10 breaths per minute,BP 148/90 mm Hg,absent deep tendon reflexes (DTRs),and no ankle clonus.The client complains,"I'm so thirsty and warm." What is the nurse's immediate action?
A) To call for an immediate magnesium sulfate level
B) To administer oxygen
C) To discontinue the magnesium sulfate infusion
D) To prepare to administer hydralazine
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29
Chapter 28: Hemorrhagic Disorders
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Q1) With regard to hemorrhagic complications that may occur during pregnancy,what information is most accurate?
A) An incompetent cervix is usually not diagnosed until the woman has lost one or two pregnancies.
B) Incidences of ectopic pregnancy are declining as a result of improved diagnostic techniques.
C) One ectopic pregnancy does not affect a woman's fertility or her likelihood of having a normal pregnancy the next time.
D) Gestational trophoblastic neoplasia (GTN) is one of the persistently incurable gynecologic malignancies.
Q2) A 26-year-old pregnant woman,gravida 2,para 1-0-0-1,is 28 weeks pregnant when she experiences bright red,painless vaginal bleeding.On her arrival at the hospital,which diagnostic procedure will the client most likely have performed?
A) Amniocentesis for fetal lung maturity
B) Transvaginal ultrasound for placental location
C) Contraction stress test (CST)
D) Internal fetal monitoring
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Chapter 29: Endocrine and Metabolic Disorders
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Sample Questions
Q1) Step 6
A)Without adding air, withdraw the correct dose of NPH insulin.
B)Gently rotate the insulin to mix it, and wipe the stopper.
C)Inject air equal to the dose of NPH insulin into the vial, and remove the syringe.
D)Inject air equal to the dose of regular insulin into the vial, and withdraw the medication.
E)Check the insulin bottles for the expiration date.
F)Wash hands.
Q2) A woman with gestational diabetes has had little or no experience reading and interpreting glucose levels.The client shows the nurse her readings for the past few days.Which reading signals the nurse that the client may require an adjustment of insulin or carbohydrates?
A) 75 mg/dl before lunch. This is low; better eat now.
B) 115 mg/dl 1 hour after lunch. This is a little high; maybe eat a little less next time.
C) 115 mg/dl 2 hours after lunch. This is too high; it is time for insulin.
D) 50 mg/dl just after waking up from a nap. This is too low; maybe eat a snack before going to sleep.
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31
Chapter 30: Medical-Surgical Disorders
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Q1) Increased risk of acidosis
A)Increased oxygen consumption
B)Increased heart rate
C)Decreased gastric motility
D)Displacement of abdominal viscera
E)Increase in clotting factors
Q2) When caring for a pregnant woman with cardiac problems,the nurse must be alert for the signs and symptoms of cardiac decompensation.Which critical findings would the nurse find on assessment of the client experiencing this condition?
A) Regular heart rate and hypertension
B) Increased urinary output, tachycardia, and dry cough
C) Shortness of breath, bradycardia, and hypertension
D) Dyspnea, crackles, and an irregular, weak pulse
Q3) Increased risk of aspiration
A)Increased oxygen consumption
B)Increased heart rate
C)Decreased gastric motility
D)Displacement of abdominal viscera
E)Increase in clotting factors
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Chapter 31: Mental Health Disorders and Substance Abuse
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Sample Questions
Q1) Screening questions for alcohol and drug abuse should be included in the overall assessment during the first prenatal visit for all women.The 4 Ps Plus is a screening tool specifically designed to identify the need for a more in-depth assessment.Which are the correct components of the 4 Ps Plus?
(Select all that apply).
A) Parents
B) Partner
C) Present
D) Past
E) Pregnancy
Q2) Which substance used during pregnancy causes vasoconstriction and decreased placental perfusion,resulting in maternal and neonatal complications?
A) Alcohol
B) Caffeine
C) Tobacco
D) Chocolate
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Chapter 32: Labor and Birth Complications
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Q1) Which nursing intervention should be immediately performed after the forceps-assisted birth of an infant?
A) Assessing the infant for signs of trauma
B) Administering prophylactic antibiotic agents to the infant
C) Applying a cold pack to the infant's scalp
D) Measuring the circumference of the infant's head
Q2) A woman in preterm labor at 30 weeks of gestation receives two 12-mg intramuscular (IM)doses of betamethasone.What is the purpose of this pharmacologic intervention?
A) To stimulate fetal surfactant production
B) To reduce maternal and fetal tachycardia associated with ritodrine administration
C) To suppress uterine contractions
D) To maintain adequate maternal respiratory effort and ventilation during magnesium sulfate therapy
Q3) What is a maternal indication for the use of vacuum-assisted birth?
A) Wide pelvic outlet
B) Maternal exhaustion
C) History of rapid deliveries
D) Failure to progress past station 0
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Page 34
Chapter 33: Postpartum Complications
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Q1) The most effective and least expensive treatment of puerperal infection is prevention.What is the most important strategy for the nurse to adopt?
A) Large doses of vitamin C during pregnancy
B) Prophylactic antibiotics
C) Strict aseptic technique, including hand washing, by all health care personnel
D) Limited protein and fat intake
Q2) Which medications are used to manage PPH?
(Select all that apply).
A) Oxytocin
B) Methergine
C) Terbutaline
D) Hemabate
E) Magnesium sulfate
Q3) Arterial pulses
A)Palpation
B)Auscultation
C)Inspection
D)Observation
E)Measurement
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Page 35
Chapter 34: Nursing Care of the High Risk Newborn
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Q1) During the assessment of a preterm infant,the nurse notices continued respiratory distress even though oxygen and ventilation have been provided.In this situation,which condition should the nurse suspect?
A) Hypovolemia and/or shock
B) Excessively cool environment
C) Central nervous system (CNS) injury
D) Pending renal failure
Q2) A premature infant never seems to sleep longer than an hour at a time.Each time a light is turned on,an incubator closes,or people talk near her crib,she wakes up and inconsolably cries until held.What is the correct nursing diagnosis beginning with "ineffective coping,related to"?
A) Severe immaturity
B) Environmental stress
C) Physiologic distress
D) Behavioral responses
Q3) The corrected age of an infant who was born at 25 1/7 weeks and is preparing for discharge 124 days past delivery is ______________.
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Chapter 35: Acquired Problems of the Newborn
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Q1) A number of common drugs of abuse may cross into the breast milk of a mother who is currently using these substances,which may result in behavioral effects in the newborn.Which substances are contraindicated if the mother elects to breastfeed her infant?
(Select all that apply).
A) Cocaine
B) Marijuana
C) Nicotine
D) Methadone
E) Morphine
Q2) What information regarding a fractured clavicle is most important for the nurse to take into consideration when planning the infant's care?
A) Prone positioning facilitates bone alignment.
B) No special treatment is necessary.
C) Parents should be taught range-of-motion exercises.
D) The shoulder should be immobilized with a splint.
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Chapter 36: Hemolytic Disorders and Congenital
Anomalies
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Q1) Which statement regarding hemolytic diseases of the newborn is most accurate?
A) Rh incompatibility matters only when an Rh-negative child is born to an Rh-positive mother.
B) ABO incompatibility is more likely than Rh incompatibility to precipitate significant anemia.
C) Exchange transfusions are frequently required in the treatment of hemolytic disorders.
D) The indirect Coombs' test is performed on the mother before birth; the direct Coombs' test is performed on the cord blood after birth.
Q2) Most congenital anomalies of the CNS result from defects in the closure of the neural tube during fetal development.Which factor has the greatest impact on this process?
A) Maternal diabetes
B) Maternal folic acid deficiency
C) Socioeconomic status
D) Maternal use of anticonvulsant
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Chapter 37: Perinatal Loss, Bereavement, and Grief
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Q1) After giving birth to a stillborn infant,the woman turns to the nurse and says,"I just finished painting the baby's room.Do you think that caused my baby to die?" What is the nurse's most appropriate response?
A) "That's an old wives' tale; lots of women are around paint during pregnancy, and this doesn't happen to them."
B) "That's not likely. Paint is associated with elevated pediatric lead levels."
C) Silence.
D) "I can understand your need to find an answer to what caused this. What else are you thinking about?"
Q2) Which finding would indicate to the nurse that the grieving parents have progressed to the reorganization phase of grieving?
A) The parents say that they "feel no pain."
B) The parents are discussing sex and a future pregnancy, even if they have not yet sorted out their feelings.
C) The parents have abandoned those moments of "bittersweet grief."
D) The parents' questions have progressed from "Why?" to "Why us?"
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