Maternal/OB drill 7

Question 1. Which of the following would denote a positive maternal-infant bonding interaction during the first 3 days?

1. Calling the infant "he" or "she" on the day of discharge
2. Carrying the infant slightly away from own body
3. Holding the infant in the "en-face" position
4. Laying the infant at the foot of the bed

Question 2. After giving birth at 37 weeks' gestation, a new mother is transferred to the postpartum unit. The nursing action that best promotes attachment process between the mother and baby is:

1. Teaching the client to breastfeed the baby
2. Allowing the client extra visiting privileges in the newborn nursery
3. Encourage the client to room-in with her infant on a 24-hou basis
4. Arranging staffing so that one nurse is assigned to care for the client and her baby

Question 3. A client in the midphase of labor becomes very uncomfortable and asks for medication.
Mepreidine (Demerol) 50 mg is ordered. This medication:

1. Acts to produce amnesia
2. Act as a preliminary anesthetic
3. Induces sleep until the time of delivery
4. Increases the client's pain threshold, resulting in pain reduction

Question 4. A pregnant client develops thrombophlebitis of the left leg and is admitted to the hospital for bed rest and anticoagulant theraphy. The anticoagulant the nurse should expect to administer is:

1. Heparin
2. Dicumarol
3. Diphenadione (Dipaxin)
4. Warfarin (Coumadin)

Question 5. A client who had a postpartum hemorrhage is to receive 1 unit of packed red blood cells. When observing the staff nurse administering the packed red blood cells without wearing gloves, the nurse manager correctly comes to the conclusion that the:

1. Client does not have an infection
2. Donor blood is free of bloodborne pathogens
3. Nurse should have worn gloves for self-protection
4. Nurse was skilled enough to prevent exposure to the blood

Question 6. The nurse correctly teaches that the most frequent side effect associated with the use of IUD's is:

1. Ectopic pregnancy
2. Expulsion of the IUD
3. Rupture of the uterus
4. Excessive menstrual flow

Question 7. A client begins preterm labor and the physician orders terbutaline sulfate (Brethine). After its administration, the nurse assesses the client for the therapeutic effect of:

1. Reduction of pain in the perineal area
2. Decrease in blood pressure from 120/80 to 90/60
3. Decrease in frequency and duration of contractions
4. Dilation of the cervix from 1 to 1.5 cm for every hour of labor

Question 8. A client at 26 weeks' gestation is admitted with an influenza infection. She is in labor. The physician's order that the nurse should question would be:

1. Bethamethasone 12 mg IV at 12am and 12pm
2. Vital signs and fetal heart tones every 30 minutes
3. Start IV loading dose of mangesium sulfate per protocol
4. Intake and output and IV Ringer's lactate at 500mL/24 hrs

Question 9. A pregnant client with severe abdominal pain and heavy bleeding is prepared for a cesarean birth. Nursing care should include:

1. Teaching coughing and deep-breathing techniques
2. An abdominal prep and administration of a Fleet enema
3. Obtaining an informed consent and assessment of drug allergies
4. Inserting and indwelling catheter and administering a tap-water enema

Question 10. At 9pm visiting hours are officially over, but the relatives of one postpartum client remain at the bedside. The nurse's most appropriate intervention should be to

1. Firmly remind the client and visitors that visiting hours are over.
2. Call the evening nursing supervisor to tactfully handle the situation
3. Encourage the family members to participate in care as much s the client wishes.
4. Get written permission from the client's husband for the family members to remain.

Question 11. The nurse recognizes that an expected change in the hematologic system that occurs during the second trimester of pregnancy is:

1. A decrease in WBCs
2. An icrease in blood volume
3. An increase in blood volume
4. A decrease in sedimanation rate

Question 12In the 12th week of gestation, a client completely expels the products of conception. Because the client is Rh-negative, the nurse must:

1. Administer RhoGAM within 72 hours
2. Make certain she recieves RhoGAM on her first clinic visit
3. Not give RhoGAM, since it is not used with the birth of a stillborn
4. Make certain the client does not receive RhoGAM, since the gestation lasted only 12 weeks

Question 13. During prenatal development, fetal weight gain is greatest in the:

1. First Trimester
2. Third Trimester
3. Second Trimester
4. Implantation Period

Question 14. A client at 38 weeks' gestation is admitted for induction of labor. She has a history of ruptured membranes for the past 12 hours. She has no other symptoms of labor. The nurse is aware that if the proper conditions exist, the physician will prescribe:

1. Progesterone
2. Oxytocin (Pitocin)
3. Lututrin (Lutrexin)
4. Ergonovine maleate

Question 15. A client, whose husband is overseas in the military, is admitted to the hospital with vaginal staining but no pain. The client's history reveals amenorrhea for the last 2 months and pregnancy confirmation by her physician after her first missed period. She is admitted for observation with a possible diagnosis of :

1. Missed abortion
2. Ectopic pregnancy
3. Inevitable abortion
4. Threatened abortion

Question 16. At about 5 cm dilation, a laboring client receives medication for pain. The nurse is aware that one of the medications given to women in labor that could cause respiratory depression of the newborn is:

1. Scopolamine
2. Promazine (Sparine)
3. Meperidine (Demerol)
4. Promethazine (Phenergan)

Question 17. When caring for a client who is having a prolonged labor, the nurse must be aware that the client is very concerned when her labor deviates from what she sees as the norm. A response conveying acceptance of the client's expressions of frustration and hostility would be:

1. "I'll rub your back; tell me if it helps."
2. "I'll leave as you can talk to your husband."
3. "All women get weary and frustrated during labor."
4. "Would you like to talk about what's bothering you?"



Question 18. A pregnant woman is at term is admitted to the birthing unit in active labor. The client is excited about the anticipated birth because has three sons and the amniocentesis indicates that she will have a girl. The nurse recognizes that there are implications for newborn observations and care when the nursing history reveals that:

1. The membranes ruptured 2 hours ago
2. Her first child was diagnozed with hemophilia
3. She has taken NSAIDs for frequent sinus headaches
4. There was a placenta previa in a previous pregnancy

Question 19. A 16-year-old comes to the prenatal clinic because she has missed three menstrual periods. Before her physical examination, the client says. "I don't know what the problem is, but I can't be pregnant." The nurse's most therapeutic response to this statement would be:

1. "The doctor will let you know shortly."
2. "What brought you to the prenatal clinic then?"
3. "Many young women are irregular at your age."
4. "If you have had intercourse, you are probably pregnant."

Question 20. After an 8-hour, uneventful labor a client gives birth to a baby boy spontaneously under epidural block anesthesia. As the nurse places the baby in the mother's arms immediately after the birth, the mother asks, "is he normal?" The most appropriate response by the nurse would be:

1. "Most babies are normal; of course he is"
2. "He must be all right, he has such a good strong cry."
3. "Yes, because your pregnancy and labor were so normal."
4. "Shall we unwrap him so you can look him over for yourself?"

Question 21. A young couple attends the prenatal clinic. The wife is 8 weeks' pregnant and asks the clinic nurse for information about an abortion. The nurse expresses the opinion that abortion is immoral and that many women have long-term guilt feelings after an abortion. The couple leave the clinic in a very disturbed state. Legally, the:

1. Client had a right to receive correct, unbiased information
2. Nurse's statements need not be based on scientific knowledge
3. Physician should have been called in, since nurses should not discuss abortion
4. Nurse had a right to state feelings as long as they were identified as the nurse's own

Question 22. A newly delivered mother with three young children at home comment to the nursery nurse that she cannot hold the baby for feedings once she gets home. She has just too much to do, and anyhow, it spoils the baby. The best response for the nurse to make is:

1. "You seem concerned about time. Let's talk about it."
2. "That's entirely up to you; you have to do what works for you."
3. "Holding the baby when feeding is important for development."
4. "It is very unsafe to prop a bottle. The baby could aspirate the fluid."

Question 23. Which of the following is the most important nursing action when caring for a client who is 6 hours post cesarean birth?

1. Turning, coughing, and deep breathing every 4 hours
2. Applying anesthetic spray to her perineum
3. Assisting the client to the bathroom for a shower
4. Encouraging a sitz bath three times a day

Question 24. The husband of a client who is in the transitional phase of labor becomes very tense and nervous during this period and asks the nurse, "Do you think it is best for me to leave, since I don't seem to do my wife much good?" The most appropriate response by the nurse would be:

1. "This is the time your wife needs you. Don't run out on her now."
2. "This is hard for you. Let me try to help you coach her during this difficult phase."
3. "I know this is hard for you. Why don't you go have a cup of coffee and relax and come back later if you feel like it?"
4. "If you feel that way, you'd bes go out and sit in the father's waitingroom for a while because you may transmit your anxiety to your wife."

Question 25. A decision to withhold "extraordinary care" for a newborn with severe abnormalities is actually:

1. A decision to let the newborn die
2. The same as pediatric euthanasia
3. Presuming that the newborn has no rights
4. Unethical and illegal medical nursing practice

Question 26. In dealing with a couple identified as having an infertility problem, the nurse knows that:

1. Infertility is usually psycholigic in origin
2. Infertility and sterilty are essentially the same problem
3. The couple have been unable to have a child after trying for a year
4. One partner has a problem that makes that person unable to have children

Question 27. Which of the following assessment findings about the uterus would the nurse expect to find in a primipara client 6 hours post delivery of an average-for-gestational-age infant?

1. Fundus firm, midline, 2 fingerbreadths below the umbilicus
2. Fundus firm, midline, at the level of the umbilicus
3. Fundus firm, to the right of the midline, at the umbilical level
4. Fundus soft, to the right of the midline, 2 fingerbreadths above the umbilicus

Question 28. An amniocentesis done on a client at 16 weeks' gestation reveals a fetus with Down syndrome. The client and her husband elect to have the pregnancy terminated. The nurse giving care to a client whose pregnancy is surgically terminated should be aware that:

1. The client is emotionally unstable at this time
2. There is a high risk for a postoperative infection
3. Contraceptive counseling should be deferred to a later time
4. The client needs to express her feeling of guilt, anger, and frustration

Question 29. A couple in the fertility clinic have become very discouraged regarding their efforts to conceive. The nurse can best support them by understanding that the most stressful aspect of the process is:

1. Obtaining the necessary specimens
2. Visitng the fertility clinic frequently
3. Discovering which partner is infertile
4. Planning when intercourse should take place

Question 30. During the taking-hold phase, the nurse would expect the new mother to:

1. Talk about the baby
2. Call the baby by name
3. Touch the baby with her fingertips
4. Be passively involved with the baby

Question 31. An infant is born with a bilateral cleft palate. Plans are made to begin reconstruction immediately. Nursing intervention to promote parent-infant bonding should include:

1. Demonstrating a positive acceptance of the infant.
2. Placing the baby in a nursery away from view of the general public.
3. Explaining to the parents that the infant will look normal after the surgery.
4. Encouraging the parents to limit contact with the infant until after surgery.

Question 32. A pregnant client's labor is to be induced at 39 week's gestation. The nurse is aware that several drugs are currently utilized for inducing labor. Select all that apply.

1. Oxytocin (Pitocin)
2. Misprostol (Cytotec)
3. Ergonovine (Ergotrate)
4. Carboprost (Hemabate)
5. Dinoprostone (Prepidil)

Question 33. It is important for the nurse to support the parent's decision to abort a fetus with a birth defect because:

1. Supporting them will eliminate feelings of guilt
2. The parents are legally responsible for the decision
3. It is essential for maintenance of family equilibrium
4. The nurse's support will relieve the pressure associated with decision making


Question 34. During the first hours following delivery, the postpartum client is given intravenous fluids with oxytocin (Pitocin) added to them. The nurse understands the primary reason for this is:

1. To facilitate elimination
2. To prevent infection
3. To promote analgesia
4. To promote uterine contraction

Question 35. During the postpartum period, while considering nursing measures to help parent-child relationships, the nurse should be aware that the most important factor at this time is the:

1. Anesthesia during labor
2. Duration and difficulty of labor
3. Physical condition of the infant
4. Health status during pregnancy

Question 36. The uterus rise out of the pelvis and becomes an abdominal organ at about the:

1. 10th week of pregnancy
2. 8th week of pregnancy
3. 12th week of pregnancy
4. 18th week of pregnancy

Question 37. A client suspects that she is pregnant, but because she is the only wage earner in her family, she is ambivalent about continuing the pregnancy. The nurse recognizes that the client is in crisis and also remembers that pregnancy and birth are considered crises because:

1. There are mood changes during pregnancy
2. They are periods of change and adjustment to change
3. There are hormonal and physiologic changes in the mother
4. Narcissism is the mother affects the husband wife relationship

Question 38. When caring for a family on a postpartum unit, the nurse must be aware that all the tasks, responsibilities, and attitudes that make up child care can be called parenting and that either parent can exhibit these qualities. A person is able to perform parenting because of:

1. A marriage with flexible roles
2. An inborn ability based on instinct
3. Positive childhood roles and concepts
4. A good education in growth and development

Question 39. During labor a client who has been receiving epidural anesthesia has a sudden episode of severe nausea, and her skin becomes pale and clammy. The nurse's immediate reaction should be to:

1. Notify the physician
2. Elevate the client's legs
3. Check for vaginal bleeding
4. Monitor the FHR every 3 minutes

Question 40. After ovulation has occurred, the ovum is believed to remain viable for:

1. 1 to 6 hours
2. 12 to 18 hours
3. 24 to 36 hours
4. 48 to 72 hours

Question 41. Supportive nursing care in the beginning mother-infant relationship should include:

1. Requiring the mother to assist with simple aspects of her infant's care
2. Encouraging the mother to decide between breastfeeding and formula feeding
3. Allowing the mother ample time to undress and to carefully inspect her infant
4. Unobtrusive observation of the mother and her infant to watch for a disturbed relationship

Question 42. A client undergoing treatment for infertility is diagnosed as having endometriosis. The nurse is aware that one of the drugs that may be used to treat this condition is:

1. Relaxin (Releasin)
2. Leuprolide (Lupron)
3. Ergonovine (Ergotrate)
4. Esterfied estrogen (Climestrone)

Question 43. Research concerning the emotional factors of pregnancy indicates:

1. A rejected pregnancy will result in a rejeted infant
2. Ambivalence and anxiety about mothering are common
3. Maternal love is fully developed within the first week after birth
4. An effective mother experiences neither ambivalence nor anxiety about mothering

Question 44. Which of the following instructions would be included in a client's postpartum teaching plan about performing Kegel exercises to restore perineal muscle tone?

1. Alternately flexing and extending each foot while raising her leg 6 inches off the bed
2. Contracting and relaxing perineal muscles as if stopping and starting a urinary stream
3. Contracting the abdominal muscles while raising her legs 1 inch off the bed
4. Taking deep breaths and slowly exhaling while compressing the buttocks together

Question 45. A client visiting the prenatal clinic for the first time asks the nurse about the probability of having twins because her husband is one of a pair of fraternal twins. The nurse should explain that:

1. The probability of having twins is 25%
2. She will be monitored closely for the presence of twins
3. Her husband's history of being a twin raises the probability of having twins
4. There is no greater probability of having twins than in the general population

Question 46. During the process of gametogenesis, the male and female sex cells divide, and each mature sex cell contains:

1. 24 pairs of autosomes in their nuclei
2. 46 pairs of chromosomes in their nuclei
3. A diploid number of chromosomes in their nuclei
4. A haploid number of chromosomes in their nuclei

Question 47. During the postpartum period, a cardiac client with type 2 diabetes asks the nurse, "Which contraceptives will I be able to use to prevent pregnancy in the near future?" The nurse's best response would be:

1. "You may use oral contraceptives. They are almost 100% effective in preventing pregnancy."
2. "You may want to use a foam and a condom to prevent pregnancy until you consult with your doctor at your postpartum visit."
3. "The intrauterine device is best for you because it does not allow a fertilized ovum to become implanted in the urerine lining."
4. "You do not need to worry about becoming pregnant in the near future. Clients with cardiac conditions usually become infertile."

Question 48. A client at 6 weeks' gestation is receiving antibiotic theraphy for pyelonephritis. The nurse is aware that the safest antibitioc for administration during pregnancy is:

1. Gantrisin
2. Ampicillin
3. Tetracycline
4. Nitrofurantoin

Question 49. A client with multiple sclerosis has just confirmed her pregnancy. She states she is taking ACTH and wonders whether she can continue taking it. The best response by the nurse would be:

1. ACTH is safe to take during pregnancy
2. ACTH may make you prone to nausea and vomiting
3. This medication is untested in pregnancy. Check with your physician.
4. This is used during plasmapheresis and should be safe to continue taking.

Question 50. After the first 3 months of pregnancy, the chief source of estrogen and progesterone is the:

1. Placenta
2. Adrenal Cortex
3. Corpus luteum
4. Anterior hypophysis

ANSWERS