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    Exam Review

    1. Which women should undergo prenatal testing for the human immunodeficiency virus (HIV)?
      A)
      All women, regardless of risk factors
      B)
      Women who have had a sexually transmitted infection (STI)
      C)
      Women who have had more than one sexual partner
      D)
      Woman who are monogamous with their partner
    2. A nurse in a prenatal clinic is caring for a client who is at 7 weeks of gestation. The client reports urinary frequency and asks if this will continue until delivery. Which of the following responses should the nurse make?
      A)
      "It occurs during the first trimester and near the end of the pregnancy."
      B)
      "There is no way to predict how long it will last."
      C)
      "It sounds like you have a urinary tract infection and you need antibiotics."
      D)
      "In most cases it only lasts until the 12th week."
    3. A nurse is assessing a client at 34 weeks' gestation who is receiving magnesium sulfate to treat preeclampsia. Which of the following findings should the nurse report to the provider?
      A)
      Blood Pressure 120/90
      B)
      Respiratory rate 16
      C)
      Fetal heart rate baseline 158/min
      D)
      Urinary output 40 mL in 2 hours
    4. A client is admitted to the labor and birth unit at 32 weeks' gestation with gestational hypertension. Which of the following assessment findings may be signs that the client is developing preeclampsia?
      A)
      Right upper quadrant pain
      B)
      Blood Pressure 135/88
      C)
      Pulse 80 beats/min
      D)
      Decrease in liver enzymes
    Page 1 of 19

    Exam Review

    1. A nurse is caring for a client in the third stage of labor. The healthcare provider orders an IV infusion of Oxytocin. What is the primary purpose of administering oxytocin in this stage?
      A)
      To prevent infection
      B)
      To relieve maternal pain after birth
      C)
      To facilitate rest and relaxation of the uterus
      D)
      To stimulate uterine contractions to prevent hemorrhage
    2. A nurse is assessing a newborn the day after delivery. The nurse notes a raised, bruised area on the left side of the scalp that does not cross the suture line and feels firm. How should the nurse document this finding?
      A)
      Caput succedaneum
      B)
      Molding
      C)
      Anterior fontanelle
      D)
      Cephalhematoma
    3. A nurse on the labor and delivery unit is caring for a client. Following a vaginal examination by the provider which is documented as: 6/90% / -1. Which of the following interpretations of this finding should the nurse make?
      A)
      The presenting part is 1 cm above the ischial spines.
      B)
      The cervix is 1 cm dilated.
      C)
      The presenting part is 1 cm below the ischial spines.
      D)
      The cervix is effaced 70%.
    4. A nurse in a prenatal clinic is providing education to a client who is 7 weeks of gestation. The client states., "I don't like to drink milk." Which of the following foods should the nurse recommend as a good source of calcium?
      A)
      Deep red or orange vegetables
      B)
      White breads and rice
      C)
      Meat, poultry, and fish
      D)
      Dark green leafy vegetables
    Page 2 of 19

    Exam Review

    1. A newborn is jaundiced and is receiving phototherapy. What is the most appropriate nursing intervention when caring for an infant with hyperbilirubinemia and receiving phototherapy?
      A)
      Limit fluid intake to prevent diarrhea
      B)
      Apply eye shields to protect the infant's eyes
      C)
      Applying an oil-based lotion to the newborn's skin to prevent dying and cracking
      D)
      Changing the newborn's position every 12 hours
    2. A nurse in a prenatal clinic is caring for a client who is suspected of having hydatidiform mole. Which of the following findings should the nurse expect to observe in this client?
      A)
      Profuse, clear vaginal discharge
      B)
      Irregular fetal heart rate
      C)
      Rapid decline in human chorionic gonadotropin (hCG) levels
      D)
      Excessive uterine enlargement
    3. A breastfeeding mother is being educated on a safe method to remove her breast from her baby's mouth. Which intervention is most appropriate?
      A)
      Elicit the Moro reflex to wake the baby and remove the breast when the baby cries.
      B)
      Pull the breast and nipple from the baby's mouth.
      C)
      Break the suction by inserting your finger into the corner of the infant's mouth.
      D)
      A popping sound occurs when the breast is correctly removed from the infant's mouth.
    4. A pregnant client at 28 weeks gestation comes for her prenatal visit. The nurse obtains her OB history. She delivered her infant at 40.4 weeks, delivered at 37 weeks but the infant died at 2 months old, another infant born at 34 weeks. Using the GTPAL system, the nurse will list the client's OB history in the prenatal chart as?
      A)
      G4 T3 PO AO L2
      B)
      G4 T2 P1 AO L2
      C)
      G4 T2 P1 AO L3
      D)
      G4 T1 P2 AO L3
    Page 3 of 19

    Exam Review

    1. A nurse in a provider's office is caring for a client who is at 36 weeks of gestation and scheduled for an amniocentesis. The client asks why she is having an ultrasound prior to the procedure. Which of the following is an appropriate response by the nurse?
      A)
      This is a screening tool for spina bifida."
      B)
      "It is useful for estimating fetal age."
      C)
      "It assists in identifying the location of the placenta and fetus."
      D)
      "This will determine if there is more than one fetus."
    2. A 36 weeks gestation client at risk for preterm labor presents to the clinic. The nurse understands the indication to perform an amniocentesis at this time is to assess for what?
      A)
      Fetal lung maturity
      B)
      Fetal size and weight
      C)
      Fetal glucose levels
      D)
      Genetic abnormalities
    3. Which of the following assessments would be suspicious for hyperemesis gravidarum?
      A)
      Weight loss of more than 5% of pre-pregnancy body weight, higher than normal HCG levels
      B)
      Light, pale straw colored urine
      C)
      Moist mucous membranes
      D)
      Increased skin turgor, lower than normal HCG
    4. The nurse is performing an assessment on a client who thinks she may be experiencing preterm labor. Which information is most important for the nurse to understand and share with the client?
      A)
      Preterm labor occurs when the cervix remains closed.
      B)
      A woman with symptoms can wait several days before contacting the primary caregiver.
      C)
      The client can ambulate for 2 hours.
      D)
      Diagnosis of preterm labor is based on gestational age, uterine activity, and progressive cervical change.
    Page 4 of 19

    Exam Review

    1. A nurse is caring for a newborn in the delivery room. Which of the following nursing actions is most effective in preventing heat loss via conduction?
      A)
      Drying the newborn thoroughly and removing wet linens
      B)
      Placing the newborn under a radiant warmer immediately after birth
      C)
      Placing the newborn directly on the scale to obtain weight
      D)
      Placing the newborn on a prewarmed blanket over the scale
    2. A pregnant client at 28 weeks has been diagnosed with gestational diabetes. Which statement by the client indicates a need for further teaching?
      A)
      "I may need insulin if diet alone doesn't control my levels."
      B)
      "I will monitor my blood sugar as instructed."
      C)
      "My baby could grow larger than normal if my blood sugar stays high."
      D)
      "Since this only happens during pregnancy, I don't need follow-up after delivery."
    3. A nurse is assessing a postpartum client who had a spontaneous vaginal delivery of a baby girl. The client has a firm, midline fundus after palpation and steady trickle of bright red blood from the vagina. What is the most likely cause?
      A)
      Retained placental fragments
      B)
      Perineal laceration
      C)
      Subinvolution
      D)
      Hematoma
    4. A nurse is completing the admission assessment of a client who is at 39 weeks of gestation and has severe preeclampsia. Which of the following is an expected assessment finding of severe preeclampsia?
      A)
      Normal reflexes and no headache
      B)
      Trace protein in urine
      C)
      Blood pressure 107/70 mm Hg and trace proteinuria
      D)
      Blood pressure 170/110 mm Hg and +3 proteinuria
    Page 5 of 19

    Exam Review

    1. A 33-year-old woman is in active labor. What should the nurse's next action be if the client's white blood cell (WBC) count is 25,000/mm3?
      A)
      Normal WBC Range: 5,000-10,000/mm3
      B)
      Immediately inform the health care provider
      C)
      Repeat CBC STAT
      D)
      Immediately begin antibiotic therapy
      E)
      Recognize that this count is an acceptable range for labor and continue to monitor
    2. A nurse is caring for a client during a nonstress test (NST). At the end of a 30-min period of observation, the nurse notes the following findings: The fetal heart rate baseline is 120/min with minimal variability and no accelerations. There are two variable decelerations in the fetal heart rate, each lasting 20 seconds. Which of the following interpretations of these findings should the nurse make?
      A)
      A reactive test
      B)
      A positive test
      C)
      A negative test
      D)
      A nonreactive test
    3. The nurse is evaluating the new mother's knowledge about appropriate infant bottle feeding techniques. Which statement by the client reassures the nurse that correct learning has taken place?
      A)
      "I burp my daughter during and after the feeding and as needed."
      B)
      "Since reaching 2 weeks of age, I add rice cereal to my daughter's formula to ensure adequate nutrition."
      C)
      "I warm the bottle in my microwave oven."
      D)
      "I refrigerate any leftover formula for the next feeding."
    4. The nurse prepares a client at 41 weeks gestation for placement of cervical ripening medication followed by oxytocin. The client is not in labor. This plan of care represents:
      A)
      Induction because the client is already dilated
      B)
      Augmentation because the cervix is unripe
      C)
      Induction because labor has not begun naturally
      D)
      Augmentation because contractions will become stronger
    Page 6 of 19