Maternal And Child Health MCQ Quiz Questions And Answers
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Pregnancy is a beautiful phase of life. Today, we have designed an interesting quiz that consists of multiple-choice questions on maternal and child health. After giving childbirth, there are some necessary measures that must be taken to ensure the good health of mother and child. In this quiz, we'll be asking questions based on maternal and child health during both post and pre-pregnancy periods. So, get ready to take this quiz. Hope that you'll score well.
This quiz aims to enhance your knowledge and understanding of various health practices and medical guidelines that are critical during the prenatal and postnatal Read moreperiods. It covers a wide range of topics including nutritional needs, common complications, recommended health screenings, and newborn care essentials. Each question is designed to not only test your knowledge but to also provide educational feedback based on your answers.
Maternal And Child Health Questions and Answers
- 1.
For the patient who is using oral contraceptives, the nurse informs the client about the need to take the pill at the same time each day to accomplish which of the following?
- A.
Decrease the incidence of nausea
- B.
Maintain hormonal levels
- C.
Reduce side effects
- D.
Prevent drug interactions
Correct Answer
B. Maintain hormonal levelsExplanation
Taking the oral contraceptive pill at the same time each day helps to maintain hormonal levels in the body. Hormonal contraceptives work by suppressing ovulation and altering the cervical mucus, which prevents fertilization. It is important to take the pill consistently and at the same time every day to ensure a steady level of hormones in the body, which is necessary for the contraceptive to be effective. Deviating from the regular schedule may result in hormonal fluctuations and decrease the effectiveness of the contraceptive.Rate this question:
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- 2.
When teaching a client about contraception. Which of the following would the nurse include as the most effective method for preventing sexually transmitted infections?
- A.
Spermicides
- B.
Diaphragm
- C.
Condoms
- D.
Vasectomy
Correct Answer
C. CondomsExplanation
Condoms are the most effective method for preventing sexually transmitted infections (STIs). They act as a barrier method, preventing the exchange of bodily fluids and reducing the risk of STIs. Spermicides, diaphragms, and vasectomy do not provide the same level of protection against STIs as condoms do. Spermicides only kill sperm, diaphragms only prevent pregnancy, and vasectomy is a permanent method of male sterilization that does not protect against STIs. Therefore, condoms are the best option for preventing STIs while practicing contraception.Rate this question:
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- 3.
When preparing a woman who is 2 days postpartum for discharge, recommendations for which of the following contraceptive methods would be avoided?
- A.
Diaphragm
- B.
Female condom
- C.
Oral contraceptives
- D.
Rhythm method
Correct Answer
A. DiapHragmExplanation
The diaphragm is a barrier method of contraception that requires proper fitting and placement. Since the woman is only 2 days postpartum, her cervix and vaginal walls may still be healing, making it difficult to properly fit and place the diaphragm. Therefore, it is recommended to avoid using the diaphragm as a contraceptive method at this time.Rate this question:
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- 4.
For which of the following clients would the nurse expect that an intrauterine device would not be recommended?
- A.
Woman over age 35
- B.
Nulliparous woman
- C.
Promiscuous young adult
- D.
Postpartum client
Correct Answer
C. Promiscuous young adultExplanation
An intrauterine device (IUD) is a form of long-acting reversible contraception that is inserted into the uterus to prevent pregnancy. It is generally safe and effective for most women, but there are certain situations where it may not be recommended. In the case of a promiscuous young adult, the nurse may not recommend an IUD due to an increased risk of sexually transmitted infections (STIs). IUDs do not protect against STIs, and individuals who engage in risky sexual behaviors may be at a higher risk of contracting an STI. Therefore, other forms of contraception that provide protection against STIs may be more appropriate for this client.Rate this question:
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- 5.
A client in her third trimester tells the nurse, “I’m constipated all the time!” Which of the following should the nurse recommend?
- A.
Daily enemas
- B.
Laxatives
- C.
Increased fiber intake
- D.
Decreased fluid intake
Correct Answer
C. Increased fiber intakeExplanation
Increased fiber intake is the recommended option for a client who is experiencing constipation during the third trimester of pregnancy. Fiber helps to soften the stool and promote regular bowel movements. It is a safe and effective way to relieve constipation without the need for medications or invasive procedures like enemas. Increasing fluid intake is also important to prevent dehydration and aid in digestion, but decreasing fluid intake would not be beneficial for constipation. Therefore, the nurse should recommend increased fiber intake to alleviate the client's symptoms.Rate this question:
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- 6.
Which of the following would the nurse use as the basis for the teaching plan when caring for a pregnant teenager concerned about gaining too much weight during pregnancy?
- A.
10 pounds per trimester
- B.
1 pound per week for 40 weeks
- C.
½ pound per week for 40 weeks
- D.
A total gain of 25 to 30 pounds
Correct Answer
D. A total gain of 25 to 30 poundsExplanation
The nurse would use a total gain of 25 to 30 pounds as the basis for the teaching plan when caring for a pregnant teenager concerned about gaining too much weight during pregnancy. This is because a weight gain within this range is considered healthy and appropriate for a pregnant teenager. It allows for the normal growth and development of the fetus while also considering the teenager's own nutritional needs.Rate this question:
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- 7.
The client tells the nurse that her last menstrual period started on January 14 and ended on January 20. Using Nagele’s rule, the nurse determines her EDD to be which of the following?
- A.
September 27
- B.
October 21
- C.
November 7
- D.
December 27
Correct Answer
B. October 21Explanation
Using Nagele's rule, the nurse can estimate the expected due date (EDD) by adding 7 days to the first day of the last menstrual period (LMP), subtracting 3 months, and adding 1 year. In this case, the client's LMP started on January 14. Adding 7 days gives January 21. Subtracting 3 months gives October 21. Adding 1 year gives the EDD of October 21.Rate this question:
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- 8.
What is the recommended folic acid supplementation for pregnant women to prevent neural tube defects in the developing fetus?
- A.
200 micrograms per day
- B.
400 micrograms per day
- C.
600 micrograms per day
- D.
800 micrograms per day
Correct Answer
B. 400 micrograms per dayExplanation
The recommended folic acid supplementation for pregnant women is 400 micrograms per day. Adequate folic acid intake during the early stages of pregnancy is crucial in preventing neural tube defects (NTDs) in the developing fetus. NTDs, such as spina bifida and anencephaly, can occur in the first few weeks of pregnancy when the neural tube is forming. Therefore, it is advised that women of childbearing age, and especially those planning to conceive, consume 400 micrograms of folic acid daily to reduce the risk of these birth defects. It is often recommended to start supplementation before conception and continue through the early weeks of pregnancy.Rate this question:
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- 9.
When preparing to listen to the fetal heart rate at 12 weeks’ gestation, the nurse would use which of the following?
- A.
Stethoscope placed midline at the umbilicus
- B.
Doppler placed midline at the suprapubic region
- C.
Fetoscope placed midway between the umbilicus and the xiphoid process
- D.
External electronic fetal monitor placed at the umbilicus
Correct Answer
B. Doppler placed midline at the suprapubic regionExplanation
At 12 weeks' gestation, the fetal heart rate is best heard using a Doppler placed midline at the suprapubic region. This is because the Doppler uses ultrasound technology to detect and amplify the sound of the fetal heart, which may not be audible with a stethoscope or fetoscope at this early stage of pregnancy. Placing the Doppler midline at the suprapubic region ensures that the sound waves can accurately pick up the fetal heart rate. Using an external electronic fetal monitor or placing the stethoscope midline at the umbilicus would not provide the same level of accuracy in detecting the fetal heart rate at this stage.Rate this question:
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- 10.
When developing a plan of care for a client newly diagnosed with gestational diabetes, which of the following instructions would be the priority?
- A.
Dietary intake
- B.
Medication
- C.
Exercise
- D.
Glucose monitoring
Correct Answer
A. Dietary intakeExplanation
The priority instruction for a client newly diagnosed with gestational diabetes would be dietary intake. This is because managing blood sugar levels through proper nutrition is crucial in controlling gestational diabetes. By providing specific dietary instructions, the client can make necessary changes to their eating habits and ensure they are consuming the right types and amounts of food to maintain stable blood sugar levels. This instruction would lay the foundation for the client's overall treatment plan and help them manage their condition effectively.Rate this question:
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- 11.
A client at 24 weeks gestation has gained 6 pounds in 4 weeks. Which of the following would be the priority when assessing the client?
- A.
Glucosuria
- B.
Depression
- C.
Hand/face edema
- D.
Dietary intake
Correct Answer
C. Hand/face edemaExplanation
The priority when assessing the client would be to evaluate hand/face edema. This symptom could indicate preeclampsia, a serious condition characterized by high blood pressure and organ damage. Preeclampsia can be life-threatening for both the mother and the baby, so it is crucial to identify and manage it promptly. Glucosuria and dietary intake are important aspects to consider during pregnancy but do not pose an immediate threat to the client's health. Depression, while a valid concern, is not directly related to the client's current physical condition.Rate this question:
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- 12.
A client 12 weeks pregnant came to the emergency department with abdominal cramping and moderate vaginal bleeding. Speculum examination reveals 2 to 3 cm cervical dilation. The nurse would document these findings as which of the following?
- A.
Threatened abortion
- B.
Imminent abortion
- C.
Complete abortion
- D.
Missed abortion
Correct Answer
B. Imminent abortionExplanation
Imminent abortion is the correct answer because the client is experiencing abdominal cramping, moderate vaginal bleeding, and cervical dilation, which indicate that she is at risk of having a miscarriage in the near future.Rate this question:
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- 13.
Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?
- A.
Risk for infection
- B.
Pain
- C.
Knowledge Deficit
- D.
Anticipatory Grieving
Correct Answer
B. PainExplanation
The priority nursing diagnosis for a client with an ectopic pregnancy would be pain. Ectopic pregnancy is a potentially life-threatening condition where the fertilized egg implants outside of the uterus, usually in the fallopian tube. This can cause severe abdominal pain due to the stretching and possible rupture of the fallopian tube. Managing the client's pain is crucial in order to provide comfort and prevent complications. While the other options may also be relevant, addressing the client's pain takes precedence in this situation.Rate this question:
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- 14.
Before assessing the postpartum client’s uterus for firmness and position in relation to the umbilicus and midline, which of the following should the nurse do first?
- A.
Assess the vital signs
- B.
Administer analgesia
- C.
Ambulate her in the hall
- D.
Assist her to urinate
Correct Answer
D. Assist her to urinateExplanation
The nurse should assist the postpartum client to urinate before assessing the uterus for firmness and position. This is because a full bladder can displace the uterus and make it difficult to accurately assess its firmness and position. By assisting the client to urinate, the nurse ensures that the bladder is empty and the uterus can be properly assessed. Assessing the vital signs, administering analgesia, or ambulating the client can be done after assisting her to urinate.Rate this question:
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- 15.
Which of the following should the nurse do when a primipara who is lactating tells the nurse that she has sore nipples?
- A.
Tell her to breastfeed more frequently
- B.
Administer a narcotic before breastfeeding
- C.
Encourage her to wear a nursing brassiere
- D.
Use soap and water to clean the nipples
Correct Answer
A. Tell her to breastfeed more frequentlyExplanation
The nurse should tell the primipara to breastfeed more frequently. Breastfeeding more frequently can help to relieve sore nipples by ensuring that the baby is latching on properly and emptying the breasts more effectively. This can prevent engorgement and reduce the risk of nipple damage.Rate this question:
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- 16.
The nurse assesses the vital signs of a client, 4 hours’ postpartum that are as follows: BP 90/60; temperature 100.4ºF; pulse 100 weak, thready; R 20 per minute. Which of the following should the nurse do first?
- A.
Report the temperature to the physician
- B.
Recheck the blood pressure with another cuff
- C.
Assess the uterus for firmness and position
- D.
Determine the amount of lochia
Correct Answer
D. Determine the amount of lochiaExplanation
The nurse should first determine the amount of lochia. This is important because postpartum hemorrhage is a potential complication after childbirth, and assessing the amount of lochia can help determine if there is excessive bleeding. It is a priority to rule out any immediate life-threatening conditions before addressing other vital signs or reporting the temperature to the physician. Rechecking the blood pressure with another cuff and assessing the uterus for firmness and position may be necessary, but determining the amount of lochia should be the first step in assessing the client's condition.Rate this question:
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- 17.
The nurse assesses the postpartum vaginal discharge (lochia) on four clients. Which of the following assessments would warrant notification of the physician?
- A.
A dark red discharge on a 2-day postpartum client
- B.
A pink to brownish discharge on a client who is 5 days postpartum
- C.
Almost colorless to creamy discharge on a client 2 weeks after delivery
- D.
A bright red discharge 5 days after delivery
Correct Answer
D. A bright red discharge 5 days after deliveryExplanation
A bright red discharge 5 days after delivery may indicate a potential problem such as postpartum hemorrhage. Normally, the discharge should transition from dark red to pink/brownish and then to almost colorless/creamy as the healing process progresses. However, a bright red discharge at this stage could suggest active bleeding and should be reported to the physician for further evaluation and intervention.Rate this question:
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- 18.
A postpartum client has a temperature of 101.4ºF, with a uterus that is tender when palpated, remains unusually large, and not descending as normally expected. Which of the following should the nurse assess next?
- A.
Lochia
- B.
Breasts
- C.
Incision
- D.
Urine
Correct Answer
A. LochiaExplanation
In a postpartum client with a temperature of 101.4ºF and a uterus that remains unusually large and tender, assessing lochia is the next step. Lochia refers to the vaginal discharge that occurs after childbirth, and changes in its color, amount, or odor can indicate an infection or other complications. By assessing the lochia, the nurse can gather important information about the client's postpartum recovery and identify any potential issues that may require further intervention or treatment.Rate this question:
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- 19.
Which of the following is the priority focus of nursing practice with the current early postpartum discharge?
- A.
Promoting comfort and restoration of health
- B.
Exploring the emotional status of the family
- C.
Facilitating safe and effective self-and newborn care
- D.
Teaching about the importance of family planning
Correct Answer
C. Facilitating safe and effective self-and newborn careExplanation
The priority focus of nursing practice with the current early postpartum discharge is to facilitate safe and effective self-and newborn care. This is important because after childbirth, the mother and newborn need proper guidance and support to ensure their well-being and safety at home. The nurse plays a crucial role in educating and assisting the mother in caring for herself and her newborn, including topics such as breastfeeding, bathing, diapering, and recognizing signs of complications. By promoting safe and effective care, the nurse helps to prevent potential health risks and promotes the overall health and well-being of both the mother and newborn.Rate this question:
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- 20.
Which of the following actions would be least effective in maintaining a neutral thermal environment for the newborn?
- A.
Placing infant under radiant warmer after bathing
- B.
Covering the scale with a warmed blanket prior to weighing
- C.
Placing crib close to nursery window for family viewing
- D.
Covering the infant’s head with a knit stockinette
Correct Answer
C. Placing crib close to nursery window for family viewingExplanation
Placing the crib close to a nursery window for family viewing would be the least effective action in maintaining a neutral thermal environment for the newborn. This is because the nursery window can expose the infant to drafts and temperature fluctuations, which can disrupt the baby's body temperature regulation. To maintain a neutral thermal environment, it is important to keep the baby away from any potential sources of heat or cold that can affect their body temperature.Rate this question:
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- 21.
A newborn who has an asymmetrical Moro reflex response should be further assessed for which of the following?
- A.
Talipes equinovarus
- B.
Fractured clavicle
- C.
Congenital hypothyroidism
- D.
Increased intracranial pressure
Correct Answer
B. Fractured clavicleExplanation
.Rate this question:
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- 22.
During the first 4 hours after a male circumcision, assess which of the following is the priority?
- A.
Infection
- B.
Hemorrhage
- C.
Discomfort
- D.
Dehydration
Correct Answer
B. HemorrhageExplanation
Hemorrhage is a potential risk following any surgical procedure. Although the infant has been given vitamin K to facilitate clotting, the prophylactic dose is often not sufficient to prevent bleeding. Although infection is a possibility, signs will not appear within 4 hours after the surgical procedure. The primary discomfort of circumcision occurs during the surgical procedure, not afterward. Although feedings are withheld prior to the circumcision, the chances of dehydration are minimal.Rate this question:
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- 23.
The mother asks the nurse. “What’s wrong with my son’s breasts? Why are they so enlarged?” Which of the following would be the best response by the nurse?
- A.
“The breast tissue is inflamed from the trauma experienced with birth”
- B.
“A decrease in material hormones present before birth causes enlargement,”
- C.
“You should discuss this with your doctor. It could be a malignancy”
- D.
“The tissue has hypertrophied while the baby was in the uterus”
Correct Answer
B. “A decrease in material hormones present before birth causes enlargement,”Explanation
The presence of excessive estrogen and progesterone in the maternal fetal blood followed by prompt withdrawal at birth precipitates breast engorgement, which will spontaneously resolve in 4 to 5 days after birth. The trauma of the birth process does not cause inflammation of the newborn’s breast tissue. Newborns do not have breast malignancy. This reply by the nurse would cause the mother to have undue anxiety. Breast tissue does not hypertrophy in the fetus or newborns.Rate this question:
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- 24.
Immediately after birth, the nurse notes the following on a male newborn: respirations 78; apical hearth rate 160 BPM, nostril flaring; mild intercostal retractions; and grunting at the end of expiration. Which of the following should the nurse do?
- A.
Call the assessment data to the physician’s attention
- B.
Start oxygen per nasal cannula at 2 L/min.
- C.
Suction the infant’s mouth and nares
- D.
Recognize this as normal first period of reactivity
Correct Answer
D. Recognize this as normal first period of reactivityExplanation
The first 15 minutes to 1 hour after birth is the first period of reactivity involving respiratory and circulatory adaptation to extrauterine life. The data given reflect the normal changes during this time period. The infant’s assessment data reflect normal adaptation. Thus, the physician does not need to be notified and oxygen is not needed. The data do not indicate the presence of choking, gagging or coughing, which are signs of excessive secretions. Suctioning is not necessary.Rate this question:
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- 25.
The nurse hears a mother telling a friend on the telephone about umbilical cord care. Which of the following statements by the mother indicates effective teaching?
- A.
“Daily soap and water cleansing is best”
- B.
‘Alcohol helps it dry and kills germs”
- C.
“An antibiotic ointment applied daily prevents infection”
- D.
“He can have a tub bath each day”
Correct Answer
B. ‘Alcohol helps it dry and kills germs”Explanation
Application of 70% isopropyl alcohol to the cord minimizes microorganisms (germicidal) and promotes drying. The cord should be kept dry until it falls off and the stump has healed. Antibiotic ointment should only be used to treat an infection, not as a prophylaxis. Infants should not be submerged in a tub of water until the cord falls off and the stump has completely healed.Rate this question:
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- 26.
A newborn weighing 3000 grams and feeding every 4 hours needs 120 calories/kg of body weight every 24 hours for proper growth and development. How many ounces of 20 cal/oz formula should this newborn receive at each feeding to meet nutritional needs?
- A.
2 ounces
- B.
3 ounces
- C.
4 ounces
- D.
6 ounces
Correct Answer
B. 3 ouncesExplanation
To determine the amount of formula needed, do the following mathematical calculation. 3 kg x 120 cal/kg per day = 360 calories/day feeding q 4 hours = 6 feedings per day = 60 calories per feeding: 60 calories per feeding; 60 calories per feeding with formula 20 cal/oz = 3 ounces per feeding. Based on the calculation. 2, 4 or 6 ounces are incorrect.Rate this question:
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- 27.
The post-terms neonate with meconium-stained amniotic fluid needs care designed to especially monitor for which of the following?
- A.
Respiratory problems
- B.
Gastrointestinal problems
- C.
Integumentary problems
- D.
Elimination problems
Correct Answer
A. Respiratory problemsExplanation
Intrauterine anoxia may cause relaxation of the anal sphincter and emptying of meconium into the amniotic fluid. At birth some of the meconium fluid may be aspirated, causing mechanical obstruction or chemical pneumonitis. The infant is not at increased risk for gastrointestinal problems. Even though the skin is stained with meconium, it is noninfectious (sterile) and non-irritating. The post-term meconium-stained infant is not at additional risk for bowel or urinary problems.Rate this question:
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- 28.
When measuring a client’s fundal height, which of the following techniques denotes the correct method of measurement used by the nurse?
- A.
From the xiphoid process to the umbilicus
- B.
From the symphysis pubis to the xiphoid process
- C.
From the symphysis pubis to the fundus
- D.
From the fundus to the umbilicus
Correct Answer
C. From the sympHysis pubis to the fundusExplanation
The nurse should use a nonelastic, flexible, paper measuring tape, placing the zero point on the superior border of the symphysis pubis and stretching the tape across the abdomen at the midline to the top of the fundus. The xiphoid and umbilicus are not appropriate landmarks to use when measuring the height of the fundus (McDonald’s measurement).Rate this question:
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- 29.
A client with severe preeclampsia is admitted with BP 160/110, proteinuria, and severe pitting edema. Which of the following would be most important to include in the client’s plan of care?
- A.
Daily weights
- B.
Seizure precautions
- C.
Right lateral positioning
- D.
Stress reduction
Correct Answer
B. Seizure precautionsExplanation
Women hospitalized with severe preeclampsia need decreased CNS stimulation to prevent a seizure. Seizure precautions provide environmental safety should a seizure occur. Because of edema, daily weight is important but not the priority. Preeclampsia causes vasospasm and therefore can reduce uteroplacental perfusion. The client should be placed on her left side to maximize blood flow, reduce blood pressure, and promote diuresis. Interventions to reduce stress and anxiety are very important to facilitate coping and a sense of control, but seizure precautions are the priority.Rate this question:
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- 30.
A postpartum primipara asks the nurse, “When can we have sexual intercourse again?” Which of the following would be the nurse’s best response?
- A.
“Anytime you both want to.”
- B.
“As soon as possible, choose a contraceptive method.”
- C.
“When the discharge has stopped and the incision is healed.”
- D.
“After your 6-weeks examination.”
Correct Answer
C. “When the discharge has stopped and the incision is healed.”Explanation
Cessation of the lochial discharge signifies healing of the endometrium. The risk of hemorrhage and infection is minimal 3 weeks after a normal vaginal delivery. Telling the client anytime is inappropriate because this response does not provide the client with the specific information she is requesting. The choice of a contraceptive method is important, but not the specific criteria for the safe resumption of sexual activity. Culturally, the 6-week examination has been used as the time frame for resuming sexual activity, but it may be resumed earlier.Rate this question:
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- 31.
When preparing to administer the vitamin K injection to a neonate, the nurse would select which of the following sites as appropriate for the injection?
- A.
Deltoid muscle
- B.
Anterior femoris muscle
- C.
Vastus lateralis muscle
- D.
Gluteus maximus muscle
Correct Answer
C. Vastus lateralis muscleExplanation
The middle third of the vastus lateralis is the preferred injection site for vitamin K administration because it is free of blood vessels and nerves and is large enough to absorb the medication. The deltoid muscle of a newborn is not large enough for a newborn IM injection. Injections into this muscle in a small child might cause damage to the radial nerve. The anterior femoris muscle is the next safest muscle to use in a newborn but is not the safest. Because of the proximity of the sciatic nerve, the gluteus maximus muscle should not be until the child has been walking 2 years.Rate this question:
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- 32.
When performing a pelvic examination, the nurse observes a red swollen area on the right side of the vaginal orifice. The nurse would document this as enlargement of which of the following?
- A.
Clitoris
- B.
Parotid gland
- C.
Skene’s gland
- D.
Bartholin’s gland
Correct Answer
D. Bartholin’s glandExplanation
Bartholin’s glands are the glands on either side of the vaginal orifice. The clitoris is female erectile tissue found in the perineal area above the urethra. The parotid glands are open into the mouth. Skene’s glands open into the posterior wall of the female urinary meatus.Rate this question:
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- 33.
To differentiate as a female, the hormonal stimulation of the embryo that must occur involves which of the following?
- A.
Increase in maternal estrogen secretion
- B.
Decrease in maternal androgen secretion
- C.
Secretion of androgen by the fetal gonad
- D.
Secretion of estrogen by the fetal gonad
Correct Answer
D. Secretion of estrogen by the fetal gonadExplanation
The fetal gonad must secrete estrogen for the embryo to differentiate as a female. An increase in maternal estrogen secretion does not affect the differentiation of the embryo, and maternal estrogen secretion occurs in every pregnancy. Maternal androgen secretion remains the same as before pregnancy and does not affect differentiation. Secretion of androgen by the fetal gonad would produce a male fetus.Rate this question:
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- 34.
A client at 8 weeks’ gestation calls complaining of slight nausea in the morning hours. Which of the following client interventions should the nurse question?
- A.
Taking 1 teaspoon of bicarbonate of soda in an 8-ounce glass of water
- B.
Eating a few low-sodium crackers before getting out of bed
- C.
Avoiding the intake of liquids in the morning hours
- D.
Eating six small meals a day instead of three large meals
Correct Answer
A. Taking 1 teaspoon of bicarbonate of soda in an 8-ounce glass of waterExplanation
Using bicarbonate would increase the amount of sodium ingested, which can cause complications. Eating low-sodium crackers would be appropriate. Since liquids can increase nausea, avoiding them in the morning hours when nausea is usually the strongest is appropriate. Eating six small meals a day would keep the stomach full, which often decreases nausea.Rate this question:
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- 35.
The nurse documents positive ballottement in the client’s prenatal record. The nurse understands that this indicates which of the following?
- A.
Palpable contractions on the abdomen
- B.
Passive movement of the unengaged fetus
- C.
Fetal kicking felt by the client
- D.
Enlargement and softening of the uterus
Correct Answer
B. Passive movement of the unengaged fetusExplanation
Ballottement indicates passive movement of the unengaged fetus. Ballottement is not a contraction. Fetal kicking felt by the client represents quickening. Enlargement and softening of the uterus is known as Piskacek’s sign.Rate this question:
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- 36.
During a pelvic exam the nurse notes a purple-blue tinge of the cervix. The nurse documents this as which of the following?
- A.
Braxton-Hicks sign
- B.
Chadwick’s sign
- C.
Goodell’s sign
- D.
McDonald’s sign
Correct Answer
B. Chadwick’s signExplanation
Chadwick’s sign refers to the purple-blue tinge of the cervix. Braxton Hicks contractions are painless contractions beginning around the 4th month. Goodell’s sign indicates softening of the cervix. Flexibility of the uterus against the cervix is known as McDonald’s sign.Rate this question:
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- 37.
During a prenatal class, the nurse explains the rationale for breathing techniques during preparation for labor based on the understanding thatbreathing techniques are most important in achieving which of the following?
- A.
Eliminate pain and give the expectant parents something to do
- B.
Reduce the risk of fetal distress by increasing uteroplacental perfusion
- C.
Facilitate relaxation, possibly reducing the perception of pain
- D.
Eliminate pain so that less analgesia and anesthesia are needed
Correct Answer
C. Facilitate relaxation, possibly reducing the perception of painExplanation
Breathing techniques can raise the pain threshold and reduce the perception of pain. They also promote relaxation. Breathing techniques do not eliminate pain, but they can reduce it. Positioning, not breathing,
increases uteroplacental perfusion.Rate this question:
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- 38.
After 4 hours of active labor, the nurse notes that the contractions of a primigravida client are not strong enough to dilate the cervix. Which of the following would the nurse anticipate doing?
- A.
Obtaining an order to begin IV oxytocin infusion
- B.
Administering a light sedative to allow the patient to rest for several hour
- C.
Preparing for a cesarean section for failure to progress
- D.
Increasing the encouragement to the patient when pushing begins
Correct Answer
A. Obtaining an order to begin IV oxytocin infusionExplanation
The client’s labor is hypotonic. The nurse should call the physical and obtain an order for an infusion of oxytocin, which will assist the uterus to contract more forcefully in an attempt to dilate the cervix. Administering light sedatives would be done for hypertonic uterine contractions. Preparing for the cesarean section is unnecessary at this time. Oxytocin would increase the uterine contractions and hopefully progress labor before a cesarean would be necessary. It is too early to anticipate client pushing with contractionsRate this question:
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- 39.
A multigravida at 38 weeks gestation is admitted with painless, bright red bleeding and mild contractions every 7 to 10 minutes. Which of the following assessments should be avoided?
- A.
Maternal vital sign
- B.
Fetal heart rate
- C.
Contraction monitoring
- D.
Cervical dilation
Correct Answer
D. Cervical dilationExplanation
The signs indicate placenta previa and vaginal exam to determine cervical dilation would not be done because it could cause hemorrhage. Assessing maternal vital signs can help determine maternal physiologic status. Fetal heart rate is important to assess fetal well-being and should be done. Monitoring the contractions will help evaluate the progress of labor.Rate this question:
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- 40.
Which of the following would be the nurse’s most appropriate response to a client who asks why she must have a cesarean delivery if she has acomplete placenta previa?
- A.
“You will have to ask your physician when he returns.”
- B.
“You need a cesarean to prevent hemorrhage.”
- C.
“The placenta is covering most of your cervix.”
- D.
“The placenta is covering the opening of the uterus and blocking your baby.”
Correct Answer
D. “The placenta is covering the opening of the uterus and blocking your baby.”Explanation
A complete placenta previa occurs when the placenta covers the opening of the uterus, thus blocking the passageway for the baby. This response explains what a complete previa is and the reason the baby cannot come out except by cesarean delivery. Telling the client to ask the physician is a poor response and would increase the patient’s anxiety. Although a cesarean would help to prevent hemorrhage, the statement does not explain why the hemorrhage could occur. With a complete previa, the placenta is covering all the cervix, not just most of it.Rate this question:
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- 41.
The nurse understands that the fetal head is in which of the following positions with a face presentation?
- A.
Completely flexed
- B.
Completely extended
- C.
Partially extended
- D.
Partially flexed
Correct Answer
B. Completely extendedExplanation
With a face presentation, the head is completely extended. With a vertex presentation, the head is completely or partially flexed. With a brow (forehead) presentation, the head would be partially extended.Rate this question:
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- 42.
With a fetus in the left-anterior breech presentation, the nurse would expect the fetal heart rate would be most audible in which of the following areas?
- A.
Above the maternal umbilicus and to the right of midline
- B.
In the lower-left maternal abdominal quadrant
- C.
In the lower-right maternal abdominal quadrant
- D.
Above the maternal umbilicus and to the left of midline
Correct Answer
D. Above the maternal umbilicus and to the left of midlineExplanation
With this presentation, the fetal upper torso and back face the left upper maternal abdominal wall. The fetal heart rate would be most audible above the maternal umbilicus and to the left of the middle. The other positions would be incorrect.Rate this question:
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- 43.
The amniotic fluid of a client has a greenish tint. The nurse interprets this to be the result of which of the following?
- A.
Lanugo
- B.
Hydramnio
- C.
Meconium
- D.
Vernix
Correct Answer
C. MeconiumExplanation
The greenish tint is due to the presence of meconium. Lanugo is the soft, downy hair on the shoulders and back of the fetus. Hydramnios represents excessive amniotic fluid. Vernix is the white, cheesy substance covering the fetus.Rate this question:
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- 44.
A patient is in labor and has just been told she has a breech presentation. The nurse should be particularly alert for which of the following?
- A.
Quickening
- B.
Ophthalmia neonatorum
- C.
Pica
- D.
Prolapsed umbilical cord
Correct Answer
D. Prolapsed umbilical cordExplanation
In a breech position, because of the space between the presenting part and the cervix, prolapse of the umbilical cord is common. Quickening is the woman’s first perception of fetal movement. Ophthalmia neonatorum usually results from maternal gonorrhea and is conjunctivitis. Pica refers to the oral intake of nonfood substances.Rate this question:
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- 45.
When describing dizygotic twins to a couple, on which of the following would the nurse base the explanation?
- A.
Two ova fertilized by separate sperm
- B.
Sharing of a common placenta
- C.
Each ova with the same genotype
- D.
Sharing of a common chorion
Correct Answer
A. Two ova fertilized by separate spermExplanation
Dizygotic (fraternal) twins involve two ova fertilized by separate sperm. Monozygotic (identical) twins involve a common placenta, same genotype, and common chorion.Rate this question:
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- 46.
Which of the following refers to the single cell that reproduces itself after conception?
- A.
Chromosome
- B.
Blastocyst
- C.
Zygote
- D.
Trophoblast
Correct Answer
C. ZygoteExplanation
The zygote is the single cell that reproduces itself after conception. The chromosome is the material that makes up the cell and is gained from each parent. Blastocyst and trophoblast are later terms for the embryo after zygote.Rate this question:
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- 47.
In the late 1950s, consumers and healthcare professionals began challenging the routine use of analgesics and anesthetics during childbirth. Which of the following was an outgrowth of this concept?
- A.
Labor, delivery, recovery, postpartum (LDRP)
- B.
Nurse-midwifery
- C.
Clinical nurse specialist
- D.
Prepared childbirth
Correct Answer
D. Prepared childbirthExplanation
Prepared childbirth was the direct result of the 1950s challenging the routine use of analgesics and anesthetics during childbirth. The LDRP was a much later concept and was not a direct result of the challenging routine use of analgesics and anesthetics during childbirth. Roles for nurse midwives and clinical nurse specialists did not develop from this challenge.Rate this question:
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- 48.
A client has a mid pelvic contracture from a previous pelvic injury due to a motor vehicle accident as a teenager. The nurse is aware that this could prevent a fetus from passing through or around which structure during childbirth.
- A.
Symphysis pubis
- B.
Sacral promontory
- C.
Ischial spines
- D.
Pubic arch
Correct Answer
C. Ischial spinesExplanation
The ischial spines are located in the mid-pelvic region and could be narrowed due to the previous pelvic injury. The symphysis pubis, sacral promontory, and pubic arch are not part of the mid-pelvis.Rate this question:
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- 49.
When teaching a group of adolescents about variations in the length of the menstrual cycle, the nurse understands that the underlying mechanism isdue to variations in which of the following phases?
- A.
Menstrual phase
- B.
Proliferative phase
- C.
Secretory phase
- D.
Ischemic phase
Correct Answer
B. Proliferative pHaseExplanation
Variations in the length of the menstrual cycle are due to variations in the proliferative phase. The menstrual, secretory and ischemic phases do not contribute to this variation.Rate this question:
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- 50.
When teaching a group of adolescents about male hormone production, which of the following would the nurse include as being produced by the Leydig cells?
- A.
Follicle-stimulating hormone
- B.
Testosterone
- C.
Leuteinizing hormone
- D.
Gonadotropin releasing hormone
Correct Answer
B. TestosteroneExplanation
Testosterone is produced by the Leyding cells in the seminiferous tubules. Follicle-stimulating hormone and luteinizing hormone are released by the anterior pituitary gland. The hypothalamus is responsible for releasing gonadotropin-releasing hormone.Rate this question:
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