Prepared by: Dennis N. Muñoz, PT, RN, RM, MANc

MATERNAL AND CHILD NURSING

(ANTEPARTUM PERIOD)

1) The nurse is caring for a 15-year-old primigravida who visits the clinic for the first time a 20 weeks’ gestation. A priority goal for this patient is that she’ll be able to:

a. Maintain a steady weight gain until termb. Record the number of fetal movements four times dailyc. Attend prenatal care appointment on a regular basisd. Explain the process of fetal development

2) The nurse is caring for a primigravida who is scheduled for a fetal acoustic stimulation test (FAST). The nurse should explain to the patient that the primary purpose of this test is to:

a. Induce contractionsb. Induce fetal heart rate accelerationc. Shorten the contraction stress testd. Determine fluid volume

3) In response to an expectant couple’s questions, the nurse is explaining various hormones and their functions during pregnancy. Which of the following should the nurse include in the discussion?

a. Human chorionic gonadotropin ensures continued production of progesterone and estrogenb. Estrogen maintains the growth of the endometrial lining of the uterusc. Progesterone contributes to mammary gland development and uterine growthd. Human placental lactogen maintains the development of the uterus lining

4) When describing fetal development to a group of expectant parents, the nurse should instruct the couples that the normal umbilical cord has:

a. Striated muscles in the arteriesb. Two arteries and one veinc. A nerve supply that is severed at birthd. Two vein and one artery

5) A 20-year-old primigravida at 8 weeks’ gestation visits the clinic with symptoms of slight reddish vaginal bleeding and an occasional uterine cramp. The pregnancy test is positive. The patient states that no tissue has been passed. The nurse should explain to the patient that these symptoms are indicative of a type of abortion termed:

a. Missedb. Inevitablec. Incomplete d. Threatened

6) The nurse is caring for a multigravida at 39 weeks’ gestation who is diagnosed with oligohydramnios. When anticipating the delivery, the nurse recognizes that a priority newborn assessment will involve the neonate’s:

a. Kidney functionb. Gastrointestinal function c. Cardiac functiond. Neurological function

7) A primigravida at 34 weeks’ gestation is diagnosed with hydramnios. After delivery of the newborn, a priority for the nurse is to assess the newborn for:

a. Diabetes mellitusb. Esophageal atresiac. Kidney disordersd. Cardiac defects

8) A 30-year-old primigravida at 12 weeks’ gestation asks the nurse, ”What is the purpose of an alpha-fetoprotein test?” the best response by the nurse is to instruct the patient that this test can detect fetal:

a. Cardiac defectsb. Kidney defectsc. Urinary tract defects d. Neural tube defects

9) A multigravida at 37 weeks’ gestation is scheduled to undergo amniocentesis. The nurse determines that the patient needs further explanation when the patient says:

a. “About 3 teaspoons of amniotic fluid will be removed”b. “A sonogram will be done during the procedure”c. “I may feel pressure when the needle is inserted”d. “I should have a full bladder before the procedure”

10) A diabetic multigravida is scheduled for amniocentesis at 39 weeks’ gestation to determine the fetal lecithin-sphingomyelin (L/S) ratio. The nurse should instruct the patient that the L/s ratio is a useful indicator of the maturity of the fetal:

a. Heartb. Central nervous systemc. Kidney d. Lung

11) A 35-year-old multigravida at 16 weeks’ gestation tells the nurse that she has had frequent mood swings during this pregnancy. The nurse should suggest that the patient:

a. Seek professional counselingb. Keep her feelings to herselfc. Try to avoid fatigue and stressd. Decrease her narcissistic behaviors

12) A multigravida tells the nurse that her husband has been experiencing nausea and vomiting and backaches that are similar to the patient’s discomforts during this pregnancy. The nurse should explain to the patient that this is termed:

a. Neurosisb. Psychosisc. Mimicry d. Couvades

13) A primigravida at 6 weeks’ gestation tells the nurse that a friend of hers had a baby that was born with spina bifida. The nurse should instruct the patient that to reduce the possibility of neural tube defects, most doctors prescribe multivitamins and:

a. Niacinb. Folic acid c. Iron d. Zinc

14) During a home visit the patient, a single multigravida at 32 weeks’ gestation, tells the nurse that she craves and often eats laundry starch for lunch and usually has a bowl of soup for supper. Total weight gain to data has been 12 lb (5kg). A priority nursing diagnosis for the patient is:

a. Altered parenting, related to single statusb. Ineffective individual coping, related to pregnancy c. Altered nutrition, less than body requirements, related to picad. Noncompliance, related to insufficient resources

15) A primigravida at 10 weeks’ gestation tells the nurse that she continues to have urinary frequency. The nurse should instruct the patient to:

a. Decrease her amount of fluid intake during the dayb. Drink tea or coffee only in the morningc. Avoid wearing panty liners during the nightd. Empty her bladder frequently throughout the day

16) A multigravida at 32 weeks’ gestation tells the nurse that she ”gets dizzy once in a while” the nurse should instruct the patient to:

a. Avoid sudden position changesb. Avoid being in a cold roomc. Stand with her head loweredd. Discontinue moderate exercise

17) A primigravida at 36 weeks’ gestation tells the nurse that she has moderate breast tenderness. After providing the patient with some suggestions for relief measures, the nurse determines that the patient needs further instructions when the patient says:

a. “I should wear a supportive bra at all times”b. “I should cleanse my nipples with soap”c. “I should change my sleeping positions”d. “I should clean up the colostrums with water”

18) A primigravida at 35 weeks’ gestation tells the nurse that she gets an occasional cramp in her legs. The nurse should assess the patient’s intake of:

a. Xincb. Ironc. Calcium d. Niacin

19) A multigravida at 37 weeks’ gestation tells the nurse that she has frequent heartburn. After providing the patient with suggestions for obtaining relief from the heartburn, the nurse determines that the patient has understood the instructions when the patient says:

a. “I can take a teaspoon of baking soda in water occasionally”b. “I should eat only three large meals and drink plenty of fluids”c. “it’s all right for me to have a fried

hamburger and friesd. “I should eat smaller, more frequent

meals with fluids”

20) A primigravida at 20 weeks’ gestation asks the nurse, “How can I begin to strengthen my pelvic muscles?” the nurse should instruct the patient that she should practice an exercise such as:

a. Pelvic tiltb. “mini” sit-upsc. Kegel’s exercise d. Leg lifts

21) A primigravida at 27 weeks’ gestation visits the clinic. After a routine examination, the nurse determines that the patient is experiencing round ligament pain. The nurse should instruct the patient to:

a. Apply heat to the areab. Exercise strenuously c. Apply ice to the area d. Kneel on all fours

22) A primigravida at 8 weeks’ gestation tells the nurse that she has been experiencing excessive saliva production since becoming pregnant. The nurse should instruct the patient to:

a. Eat starchy foods such as potatoesb. Use an astringent mouthwash dailyc. Suck on popsicles or ice creamd. Eat only three large meals daily

23) A 30-year-old primigravida tells the nurse that her hemorrhoids have become itchy and painful. After instructing the patient about relief measures, the nurse determines that the patient needs further instructions when she says:

a. “I shouldn’t sit in a warm sitz bath daily”b. “I can use a topical ointment for relief”c. “I should apply an ice pack at night”d. I should decrease my fluid intake”

24) A primigravida at 16 weeks’ gestation tells the nurse that she’s having a hard time quitting smoking while pregnant. The nurse should encourage the patient to quit smoking because during pregnancy is associated with:

a. Low-birth-weight infantsb. Large-for-gestational-age infantsc. Placenta previa in the third trimesterd. Early deceleration during labor

25) The nurse is caring for Holly Jones, a primigravida who spontaneously aborted an 8-week-old fetus. Mrs. Jones is sobbing and moaning after expulsion of the fetus. A priority goal for this patient is that she’ll:

a. Verbalize her feelings related to the pregnancy lossb. Express decreased pain and increased comfortc. Discuss the causes of the spontaneous abortion d. Avoid sexual intercourse for at least 2 days

26) Irene Stepanski is a multigravida who has undergone a cerclage procedure for incompetent cervix.before Mrs. Stepanski is discharged from the hospital, the nurse should instruct her to immediately report to the health care provider if she experiences:

a. One episode of nausea and bomitingb. Elevated temperaturec. Back pain while standingd. Heartburn after eating

27) A 28-year-old multigravida tells the nurse that she’s scheduled for a magnetic resonance imaging procedure 1 week after having had an ultrasound. The nurse anticipates that the purpose of the magnetic resonance imaging procedure is to:

a. Determine amniotic fluid volumeb. Estimate the fetal gestational agec. Confirm the presence of an abnormalityd. Determine the gender of the fetus

28) A 24-year-old primigravida visits the emergency room with severe abdominal pain and is diagnosed as having a ruptured ectopic pregnancy. After reviewing the doctor’s orders, the nurse should first:

a. Ask the patient if a family member is presentb. Begin I.V. therapy as prescribedc. Ask the patient to sign a surgical

consentd. Determine the first day of the last

menstrual period

29) The nurse is caring for a 34-year-old multipara during the immediate post-operative period after evacuation of a molar pregnancy. The nurse should instruct the patient to avoid pregnancy for at least 12 to 18 months to firm the absence of:

a. Fibroid tumorsb. Amniotic fluid embolismc. Chorioamnionitis d. Choriocarcinoma

30) A primigravida has been diagnosed with a fetal demise at 24 weeks’ gestation and is scheduled for an induction. The nurse anticipate that the purpose of the induction is to prevent the patient from developing:

a. Disseminated intravascular coagulationb. Chronic hypertensionc. Chorioamnionitisd. Hyperemesis gravidarum

31) A 24-year-old primigravida is diagnosed as having twins at 16 weeks’ gestation. After explaining the risks of multiple pregnancy, the nurse determines that the patient needs further instruction when she says that multiple pregnancies are associated with:

a. Pregnancy-induced hypertensionb. Preterm labor and deliveryc. Twin-to-twin transfusiond. Higher incidence of Down syndrome

32) An Rh-negative, nonsensitized primigravida is scheduled to receive Rh0 (D) immune globulin (Rh0GAM) at 28 weeks’ gestation. The nurse should instruct the patient that Rh0 (D) immune globulin:

a. Prevents sensitization for the next pregnancyb. Needs to be given only during the

pregnancyc. Has serve adverse effects such as

eczemad. Should be given within 1 week after delivery

33) A 16-year-old primigravida at 32 weeks’ gestation visits the clinic and tells the nurse that she has had flank pain, dysuria, and backache for the past 2 days. The nurse should further assess the patient for:

a. Symptoms of preeclampsia b. Preterm labor c. Abruption placentae d. Placenta previa

34) A primigravida is diagnosed with a chlamydial infection at 30 weeks’ gestation. The nurse should instruct the patient about the side effects of the medication:

a. Tetracyclineb. Doxycyclinec. Penicillin d. Erythromycin

35) A primigravida at 34 weeks’ gestation is diagnosed with gonorrhea. The nurse should explain to the patient that treatment is necessary to prevent fetal:

a. Preterm birthb. Cardiac anomaliesc. Kidney failure d. Spinal anomalies

37) Carrie Cameron asks the nurse what topics are discussed in early preparation for parenthood classes. The nurse should instruct the patient that early preparation for parenthood classes usually discuss:

a. Fetal developmentb. Postpartum self-carec. Fetal monitoringd. Types of anesthesia for labor

38) One of the patients asks the nurse, “When can I hear my baby’s heartbeat?” the nurse should explain to the patient that the fetal heartbeat can be heard with Droppler ultrasound as early as the:

a. 10th to 12th weekb. 14th to 16th weekc. 18th to 20th week d. 22nd to 24th week

39) When the teaching plan includes exercises that encourage the laboring patient to relax and tense various parts of the body, the nurse is instructing the patients in a type of relaxation termed:

a. Dissociationb. Effleuragec. Touch d. Progressive

40) After explaining to the patient about Lamaze classes, the nurse determines that the patient has understood the instructions when that patient says that the:

a. Classes promote birth in a tub of warm waterb. Framework for the Lamaze method is the fear-tension-pain cyclec. Lamaze method promotes vaginal birth after cesarean section deliveryd. Lamaze method relies on the patient receiving an epidural anesthetic

41) The nurse should explain to the patient that one component of Lamaze classes is:

a. Childbirth in darkness and silenceb. Sibling visitation during the delivery processc. Relaxation techniques to relieve the discomfort of labord. Preparation for grandparents after delivery

42) One of the patients tells the nurse that she would like to attend breast-feeding classes. The nurse should suggest that the patient include her significant other in the class primarily because fathers:

a. Need an understanding of nutritional needs of breast-feeding patientsb. Will be less reluctant to encourage

bottle - feeding if they attend the classes

c. Are often confused about why women want to breast-feed their newbornsd. Need to be included in the decision- making process because their support is vital

43) A 40-year-old multigravida with class III heart disease visits the clinic at 34 weeks’ gestation. The nurse should instruct the patient to:

a. Maintain bed rest through the remainder of the pregnancyb. Continue taking prescribed warfarin tablets dailyc. Plan for a cesarean section delivery before termd. Contact the doctor if pulse is more than 80 beats per minutes

44) A multigravida with class II heart disease visits the clinic at 10 weeks’ gestation. The nurse has instructed the patient about management of class II heart disease during pregnancy. The nurse determines that the patient needs further instruction when the patient says:

a. “I should eat food that are high in iron”

b. “I should stay away from people with colds”c. “I don’t need to restrict my salt intake”d. “I may need antibiotics during labor”

SITUATION: Virginia Weigner is a 20-year-old patient who visits the clinic because she suspects she’s pregnant. The patient’s last menstrual period was April 10.

(Questions 45 to 48 refer to this SITUATION)

45) After the pregnancy is confirmed, the nurse calculates Ms. Weigner’s estimated date of confinement (EDC) using Nagele’s rule. The nurse should instruct the patient that her EDC is:

a. January 17b. January 3c. February 17 d. February 3

46) Ms. Weigner prescribed prenatal vitamins with iron once a day. For maximum iron absorption, the nurse should instruct tha patient to take the medication with:

a. Orange juiceb. Meals c. Milk d. water

47) Ms. Weigner returns to the clinic several weeks later for a prenatal visit. She tells the nurse that she has had nausea and vomiting every morning for the last week. The nurse should instruct the patient to:

a. Restrict fluid intake during the afternoonb. Drink a glass of juice before bedtimec. Eat a high-protein snack after arisingd. Eat dry crackers before arising

48) Ms. Weigner returns to the clinic at 20 weeks’ gestation for a routine visit. While preparing to measure the fundal height, the nurse anticipates that the top of Ms. Weigner’s fundus will be at the :

a. Symphysis pubisb. Xyphoid process (sternum)c. Diaphragm d. Umbilicus

SITUATION: Ann Kolb is a 33-year-old multigravida at 37 weeks’ gestation. She visits the outpatient center for a contraction, stress test (CST). The nurse has instructed the patient about breast self-stimulated to obtain a CST.

(Questions 49 to 50 refer to this SITUATION)

49) The nurse determines that Mrs. Kolb has understood the instructions when she says that stimulation of the breasts or nipples for a CST produces endogenous:

a. Oxytocinb. Estrogenc. Progesterone d. Prolactin

50) Results of Mrs. Kolb’s CST revealed no fetal heart rate deceleration during three contractions each lasting 40 seconds over a 10-minute period. The nurse should document Mrs. Kolb’s CST as:

a. Positive b. Reactivec. Negative d. Nonreactive

SITUATION: Regina O’Brien is a 30-year-old insulin-dependent primigravida who is scheduled for a nonstress test (NST) at 32 weeks’ gestation. Her blood pressure is 128/78.

(Questions 51 to 52 refer to this SITUATION)

51) Which factor in Mrs. O’Brien’s history indicates that she’s a good candidate for for nonstress testing?

a. Ageb. Gravidac. Diabetes d. Blood pressure

52) Mrs. O’Brien returns for another NST. She tells the nurse that she had a reactive NST 1 week ago and asks THE NURSE, “What does that mean?” the best response by the nurse is to instruct the patient that the reactive NST indicates fetal:

a. Well-beingb. Heart rate decelerationc. Demise d. Growth

SITUATION: The nurse is planning a “Preparation for Parenthood” class for a group of couples experiencing their first pregnancy.

(Questions 53 to 56 refer to this SITUATION)

53) The class should include which accurate statement related to fetal development? After fertilization:

a. Fusion of the ovum and spermatozoa results in a zygoteb. The zygote reaches the body of the uterus in 24 hoursc. Trophoblast cells later form the embryod. Implantation occurs within 4 to 5 days

54) The nurse plan to describe the development of the chorionic villi. Which accurate statement should be included in the nurse’s discussion? Early in pregnancy. The chorionic villi:

a. Are surrounded by fetal capillaries and deciduasb. Protect the embryo from certain infectious agentsc. Secrete the hormone testosteroned. Are surrounded by ectodermal tissue

55) During the class, the nurse should explain that vitamin K levels are low at birth in term newborns because before birth the:

a. Fetal GI is sterileb. Fetal liver is only partially functionalc. Maternal estrogen inhibits vitamin K productiond. Fetal swallowing reflexes aren’t mature

56) When describing the development of the fetal reproduction system, the nurse should explain that in male fetuses, the testes begin to descend into the scrotal sac as early as:

a. 18 to 22 weeks’ gestationb. 23 to 27 weeks’ gestationc. 28 to 32 weeks’ gestationd. 33 to 37 weeks’ gestation

SITUATION: Beverly Anderson is an insulin-dependent diabetes multigravida who visits the clinic at 28 weeks’ gestation.

(Questions 57 to 59 refer to this SITUATION)

57) The nurse should instruct Mrs. Anderson that for most pregnant patients with insulin-dependent diabetes mellitus:

a. Weekly fetal movement counts are made by the motherb. Contraction stress testing is performed weeklyc. Induction of labor is begun at 34

weeks’ gestationd. Nonstress testing is performed weekly until 32 weeks’ gestation

58) Mrs. Anderson has been hospitalized at 37 weeks’ gestation for stabilization of her diabetes mellitus. A priority nursing diagnosis for this patient at this time is:

a. Fear related to a high risk pregnancy and medical therapiesb. Ineffective coping related to possible deliveryc. Anxiety related to high-risk pregnancy and hospitalizationd. Risk for altered nutrition related to hypoglycemia or hyperglycemia

59) Mrs. Anderson is scheduled for induction of labor before term. The nurse should explain to Mrs. Anderson that labor is usually induced to prevent neonatal:

a. Hyperglycemiab. Stillbirthc. Hyperkalemia d. Ketoacidosis

SITUATION: Shirley Woods is a gravid 3 para 2 at 35 weeks’ gestation. She has been coming to the antepartum clinic regularly for checkups.

(Questions 60 to 62 refer to this SITUATION)

60) Mrs. Woods tells the nurse that she has been experiencing backaches after standing all day at her job as a grocery clerk. The nurse should suggest to the patient that she practice an exercise such as:

a. Pelvic tiltb. Squattingc. Stretching d. Walking

61) Mrs. Woods tells the clinic nurse that she has also been experiencing shortness of breath. This patient had no history of heart or lung disease before the pregnancy. The nurse should instruct the patient to:

a. March in place regularly and dailyb. Apply a heating pad to her chestc. Use proper posture when standingd. Sleep on her back without a pillow

62) Mrs. Woods tells the clinic nurse that she plans to breast-feed and wants to know how to prepare her nipples. She has no history of preterm labor. The nurse should instruct the patient to:

a. Rub the nipples with a coarse cloth twice dailyb. Wash the nipples with soap four times dailyc. Wear a supportive bra continuouslyd. Gently roll the nipples between the thumb and forefinger

SITUATION: Barbara Shimp is a primigravida at 8 weeks’ gestation. She’s attending a “Preparation for Parenthood” class. She has questions about bathing and hygiene while pregnant.

(Questions 63 to 65 refer to this SITUATION)

63) The nurse determines that Ms. Shimp needs further instruction when she says:

a. “It’s okay to sit in a hot tub or sauna once a day”b. “I can take a daily shower or a tub bath”c. “Tub baths should be avoided if my membranes are ruptured”d. “I should use extra caution during a tub bath to avoid accidents”

64) Ms. Shimp also raises a question about travel during pregnancy in the “Preparation for Parenthood” class. The nurse determines that Ms. Shimp needs further instruction about traveling while she’s pregnant when she says:

a. “Travel by airplane or train is recommended for long distances”b. “Most traveling during pregnancy

should be done by automobile”c. “I should wear a seat belt when traveling by automobile”d. Travel should be avoided if multiple births are anticipate”

65) When the nurse instructs Ms. Shimp about the use of ultrasound during pregnancy, which of the following statements should be included in the nurse’s teaching plan? Ultrasound is:

a. Useful during nonstress testingb. Similar to radiographyc. Able to detect gross fetal defectsd. Performed when the bladder is empty

SITUATION: Gretchen Fleck is a 19-year-old nulliparous woman who tells the nurse practitioner at the clinic that she has missed one menstrual period. She took an over-the-counter home pregnancy test, which had positive results.

(Questions 66 to 69 refer to this SITUATION)

66) The nurse recognizes that which one of the following is a positive sign of pregnancy?

a. Results of a home pregnancy testb. Ultrasound visualization of a fetusc. Amenorrhea lasting more than 2 monthsd. Daily nausea and vomiting for 2 weeks

67) When the nurse practitioner examines Ms. Fleck she determines that her vagina has a violet tinge. The nurse practitioner should explain to Ms. Fleck that this probable sign of pregnancy is termed:

a. Hegar’s signb. Chadwick’s signc. Goodell’s sign d. Braxton Hick sign

68) Ms. Fleck admits that she has missed one menstrual period and has had urinary frequency, breast tenderness, and daily nausea and vomiting. The nurse practitioner should explain to the patient that these symptoms are considered:

a. Presumptionb. Positivec. Probable d. Preliminary

69) After her pregnancy is confirmed, Ms. Fleck tells the nurse practitioner, “I just registered for my first semester of college courses. I can’t believe I’m pregnant. I’ve always wanted children, but I’m not sure now is a good time.” The nurse evaluates the patient’s response to the confirmation is:

a. Denial b. Ambivalencec. Anger d. Sadness

SITUATION: The nurse is conducting a genetics clinic for obstetric patients whose current or past pregnancies were complicated by a genetic disorder.

(Questions 70 to 72 refer to this SITUATION)

70) A multigravida visits the clinic for a routine examination at 8 weeks’ gestation. While giving the nurse her history, the patient says that her last child was born with phenylketonuria. The nurse should explain to the patient that this genetic disorder is considered an:

a. Autosomal recessive disorderb. Autosomal dominant disorderc. X-linked recessive disorderd. X-linked dominant disorder

71) A 39-year-old multigravida at 12 weeks’ gestation tells the nurse that her last child was born with Down syndrome. The nurse should explain to the patient that Down syndrome is most often due to a chromosomal disorder termed:

a. Trisomy 13b. Trisomy 18c. Trisomy 21 d. Trisomy 25

72) A 41-year-old multigravida is diagnosed through genetic testing as carrying a fetus with Klinefelter’s syndrome. After instructing the patient about this condition, the nurse determines that she needs further instructions when the patient says:

a. “The characteristics of this condition will be evident at birth.”b. “The baby may be mentally retarded at birth.”c. “This means the baby has extra female chromosomes.”d. “The baby will most likely have an

infertility problem.”

SITUATION: Stephanie Reagan is a multigravida at 36 weeks gestation. She has arrived at the clinic for routine prenatal visit.

(Questions 73 and 74 refer to this SITUATION.)

73) While assessing Mrs. Regan, the nurse observes that she has many varicosities. The nurse should instruct Mrs. Reagan to:

a. Have these surgically removed after delivery.b. Elevate her legs frequently throughout the day.c. Avoid wearing supportive hosiery

during the day.d. Wear a maternity girdle for better

support.

74) Mrs. Reagan tells the nurse that she has recently had serve constipation. The nurse should suggest to Mrs. Reagan that she:

a. Take a teaspoon of mineral oil daily.b. Discontinue her iron supplements.c. Avoid strenuous exercise programs.d. Increase her fluid intake to 8 glasses daily.

SITUATION: The obstetric clinic nurse is conducting a class nutrition for prenatal patients.

75) A 30- year old primigravida at 8 weeks gestation tells the nurse that she’s a vegetarian. The nurse should instruct the patient to increase her phosphorus intake by eating:

a. Cheese b. Breadc. Apples d. Wheat bran

76) A primigravida asks the nurse, “ how can I increase my dietary intake of folic acid?” the best response of the nurse is to instruct the patient to eat:

a. Peasb. Carrots c. Potatoes d. Broccoli

77) A 19-year-old patient tells the nurse that the doctor told her that that she needed to increase intake of thiamine in her diet. The nurse should instruct the patient to consume more:

a. Milkb. Ricec. Asparagus d. Beef

78) A 24-year-old primigravida at 12 weeks gestation tells the nurse that she’s a strict vegetarian. To increase the patient’s dietary intake of iron, the nurse should suggest to the patient’s dietary intake of iron, the nurse should suggest to the patient that she consume more:

a. Fish b. Milk c. Talbos ng kamote d. Tomatoes

79) A 16-year-old primigravida at 12 weeks gestation tells the nurse that she needs to increase the intake of foods high in vitamin K. the nurse should instruct the patient to consume more:

a. Whole-grain riceb. Green leafy vegetables c. Enriched breads d. Corn oil

SITUATION: Carla Richardson is a 39-yeal-old multigravida at 8 weeks gestation who tells the nurse that she has a family history of sickle cell anemia.

(Questions 80 and 81 refer to this SITUATION.)

80) The nurse should tell Mrs. Richardson that the earliest diagnostic procedure that can be used to detect sickle cell anemia in the fetus is.

a. Fetoscopyb. Amniocentesisc. Chorionic villus sampling d. Alpha-fetoprotien testing

81) The nurse determines that Mrs. Richardon understands the risk of the procedure when she says that one of the risk is:

a. Fetal limb reduction b. Rupture of the membrane c. Prefer labor d. Fetal bradycardia

SITUATION: Maureen Ferguson is an Rh-negative multigravida at 38 weeks gestation who is scheduled for Rh sensitization.

Question 82 and 83 refer to this SITUATION.

82) The nurse should explain to Mrs. Ferguson that the purpose of the amniocentesis is to test for the presence of.

a. Lecithin and sphingomyelinb. Anemia c. Antibiodiesd. Bilirubin

83) After giving instructions about the risk of amniocentesis, the nurse determines that Mrs. Ferguson needs further instructions when she says that one of the risk of amniocentisis:

a. Perforation of the placenta b. Increased oligohydramniosc. Preterm labor and deliveryd. Increased Rh sensitization

SITUATION: Gina Calderone is a 36-year-old multigravida who visits the clinic at 34 weeks gestation. Her baseline blood pressure has routinely been 120 to 124/ 78to82. At this visit, she has gained 2 pounds in 1 week, her blood pressure is now 138/94, and she has a trace of proteinuria.

84) The nurse anticipates that the doctor will instruct Mrs. Calderone to:

a. Maintain bed rest until delivery b. Decrease fluid intakec. Maintain a high protein dietd. Decrease calcium intake

85) Mrs. Calderone is now at 37 weeks gestation. She’s newly admitted with severe preeclampsia. Her blood pressure is 160/98, and some clonus is present. While caring for this patient the nurse should plan to:

a. Monitor the patient’s blood pressure every 4 hours b. Auscultate breath sounds every 8 hours c. Monitor for proteinuria every 2 hours d. Assess the fetal heart rate every 8 hours

86) The doctor has ordered I.V magnesium sulfate for Mrs. Calderone. Before beginning the I.V infusion, the nurse should have at the bedside:

a. Diazpamb. Calcium gluconate c. Phenytoin d. Nifedepine

87) The nurse has assessed the deep tendon patellar reflexes of Mrs. Calderone, When the nurse observes that the reflexes are hyperactive with minimal foot jerking after the reflex testing, how should she documents the patient’s.

a. 1+b. 2+c. 3+ d. 4+

88) Mrs. Calderone tells the nurse she’s having sharp epigastric pain immediately after that the patient begins to have a seizure. The first nursing action by the nurse should be to:

a. Turn the patient to her right sideb. Pad the side rails of the bedc. Call for assistance in the roomd. Increase the I.V fluid rate