COMPETENCY APPRAISAL 1

Nursing Practice Test 1

1st Semester, SY 2020-2021

Name: Bondad, Shehada .M Date: October 15, 2020

Year/Group: BSN IV-B
Kind words can be short and easy to speak, but their echoes are truly endless.- Mother Theresa

Instruction: Choose the letter of the BEST option, use CAPITAL LETTERS ONLY. Avoid erasures. The

Preconception Client

1. After the nurse instruct a 22-year-old nulligravid client on how to perform a breast self-
examination, which of the following client statements indicates that the teaching has
been successful?
A. “I should perform breast self-examination on the day my menstrual flow begins.”
B. “It’s important that I perform breast self-examination on the same day each month.”
C. “If I notice that one of my breasts is much smaller than the other, I shouldn’t worry.”
D. “If there is some discharge from my nipples, I should avoid squeezing them.”
2. Assessment of a 16-year-old nulligravid client who visits the clinic and asks information on
contraceptive reveals a menstrual cycle of 28 days. The nurse formulates a nursing diagnosis of
Deficient Knowledge related to ovulation and fertility management. Which of the following
would be important to include in the teaching plan for the client?
A. The ovum survives for 96 hours after ovulation, making conception possible during this time.
B. The basal body temperature falls at least 0.2 degrees Fahrenheit after ovulation has
occurred.
C. Ovulation usually occurs on day 14, plus or minus 2 days, before the onset of the
menstrual cycle.
D. Most women can tell they have ovulated because of severe pain and thick, scant
cervical mucus.
3. Which of the following instructions about activities during menstruation would the nurse
include when counseling an adolescent who has just began to menstruate?
A. Take a mild analgesic if needed for menstrual pain.
B. Avoid cold foods if menstrual pain persist.
C. Stop exercise while menstruating.
D. Avoid sexual intercourse during menstruation.
4. After conducting a class for female adolescents about human reproduction, which of
the following statements indicates that the school nurse’s teaching has been efficient?

BCU – College of Nursing Prepared by: Ernaline A. Fermin, RM, RN ,MAN

 A. “Under ideal conditions, sperm can reach the ovum in 15 to 30 minutes, resulting in
pregnancy.”
B. “I won’t become pregnant if I abstain from intercourse during the last 14 days of
my menstrual cycle.”
C. “Sperm from a healthy male usually remain viable in the female reproductive tract for 96
hours.”
D. “After an ovum is fertilized by a sperm, the ovum then contains 21 pairs of chromosomes.”
5. A 22-year-old nulligravid client expresses a desire to learn more about the symptothermal
method of family planning. Which of the following would nurse include in the teaching plan?
A. This method has a 50% failure rate during the first year of use.
B. Couples must abstain from coitus for 5 days after the menses.
C. Cervical mucus is carefully monitored for changes.
D. The male partner uses condoms for significant effectiveness.
6. Before advising a 25-year-old client desiring oral contraceptives for family planning, the
nurse would assess the client for signs and symptoms of which of the following?
A. Anemia
B. Hypertension
C. Dysmenorrhea
D. Acne vulgaris
7. After instructing a 22-year-old nulligravid client about side effects of oral contraceptives, the
nurse determines that further instruction is needed when the client states which of the
following as a side effect?
A. Weight gain
B. Nausea
C. Headache
D. Ovarian cancer
8. While discussing reproductive health with a group of female adolescents one of the
adolescents asks the nurse, “where is the ovum fertilized?’ The nurse responds by stating that
fertilization normally occurs at which of the following sites?
A. Uterus
B. Vagina
C. Fallopian tube
D. Cervix
9. A 23-year-old nulligravid client tells the nurse that she and her husband have been considering
using condoms for family planning. Which of the following instructions would the nurse
include about the use of condoms as a method for family planning?
A. Using spermicide with the condom offers added protection against pregnancy.
B. Natural skin condoms protect against sexually transmitted disease.
C. The typical failure rate for couples using condoms is about 25%.
D. Condom users frequently report penile gland sensitivity.
10. Which of the following would the nurse include in the teaching plan for a 33-year-old female
client requesting information about using a diaphragm for family planning?
A. Douching with an acidic solution after intercourse is recommended.
B. Diaphragms should not be used if the client develops acute cervicitis.
C. The diaphragm should be washed in a weak solution of bleach and water.
D. The diaphragm should be left in place for 2 hours after intercourse.
11. After being examined and fitted for a diaphragm, a 25-year-old client receives instructions about
its use. Which of the following client statements indicates a need for further teaching?
A. “I continue to use the diaphragm for about 2 to 3 years if I keep it protected in the case.”
B. “If I get pregnant, I will have to be refitted for another diaphragm after the delivery.”
C. “Before inserting the diaphragm I should coat the rim with contraceptive jelly.”
D. “If I gain or lose 20 pounds, I can still use the same diaphragm.”
12. A 21-year-old clients tells the nurse that she and her husband are trying to conceive a baby.
When teaching the client about reducing the incidence of neural tube defects in newborns,
the nurse would emphasize the need for intake of which of the following nutrients?
A. Iron
B. Folic acid
C. Calcium
D. Magnesium
13. When describing a vasectomy to a couple inquiring about his procedure, the nurse
would explain that which of the following is clamped or excised?
A. Ejaculatory duct
B. Seminiferous tubules
C. Seminal vesicles
D. Vas deferens
14. A 38-year-old multigravida client asks the nurse for information about female sterilization with a
tubal ligation. Which of the following client statements indicates effective teaching?
A. “My fallopian tubes will be tied off through a small abdominal incision.”
B. “Reversal of a tubal ligation is easily done, with a pregnancy success rate of 80%.”
C. “After this procedure, I must abstain from intercourse for at least 3 weeks.”
D. “Both of my ovaries will be removed during the tubal ligation procedure.”
15. When discussing sexual arousal and orgasm with a 26-year-old nulliparous client, which of
the following would the nurse include as the primary anatomic female structure involved?
A. Vaginal wall
B. Clitoris
C. Mons pubis
D. Vulvovaginal glands
 16. A 21-year-old woman desiring to use cervical cap for family planning is instructed on its
use. Which of the following client statements would indicate to the nurse that the client
needs further instruction?
A. “Cervical caps can be left in place longer than a diaphragm.”
B. “Using a cervical cap may increase the risk of irritation.”
C. “Cervical caps usually fit better than a diaphragm.’
D. “Many women are unable to use cervical caps.”
17. A 24-year-old nulliparous client visiting the clinic for a routine examination tells the nurse that
she desires to use the basal body temperature method for family planning. The nurse should
instruct the client to do which of the following?
A. Check the cervical mucus to see if it is thick and sparse.
B. Take her temperature at the same time every morning.
C. Document ovulation when the temperature decreases to 1 degrees Fahrenheit
D. Avoid coitus for 10 days after a slight rise in temperature.
18. A couple visiting he fertility clinic for the first time asks the nurse, “What causes infertility in a
woman?” Which of the following would the nurse include in the response as one of the most
common factors?
A. Absence of an ovary
B. Overproduction of prolactin
C. Anovulation
D. Immunologic factors
19. A couple visiting the infertility clinic for the first time state that they have been trying to
conceive for the past 2 years without success. After a history and physical examination of
both partners, the nurse determines that an appropriate outcome for the couple would be to
accomplish which of the following by the end of this visit?
A. Choose an appropriate infertility treatment method.
B. Acknowledge that only 50% of infertile couples achieve a pregnancy.
C. Discuss alternative methods of having a family, such as adoption.
D. Describe each of the potential causes and possible treatment modalities.
20. A client is scheduled to have in vitro fertilization (IVF) as an infertility treatment. Which of
the following client statements about IVF indicates that the client understands this
procedures?
A. “IVF requires supplemental estrogen to enhance the implantation process.”
B. “The pregnancy rate with IVF is higher than that with gamete intrafallopian transfer (GIFT).
C. “IVF involves bypassing the blocked or absent fallopian tubes.”
D. “Both ova and sperm are instilled into the open end of a fallopian tube.”

The Pregnant Client Receiving Prenatal Care

21. When preparing a 22-year-old client who reports missing one menstrual period and suspects
that she is pregnant for a radioimmunoassay pregnancy test, which of the followingwould
the nurse need to keep in mind about this test?
A. It has a high degree of accuracy within 1 week after ovulation.
B. It is identical in nature to an over-the-counter home pregnancy test.
 C. A positive result is considered a presumptive sign of pregnancy.
D. A urine sample is needed to obtain quicker results.
22. After instructing a female client about the radioimmunoassay pregnancy test, the nurse
determines that the client understands the instructions when the client states that which of
the following hormones is evaluated by this test?
A. Prolactin
B. Follicle-stimulating hormone
C. Luteinizing hormone
D. Human Chorionic gonadotropin (hCG)
23. After instructing a primigravid client about the functions of the placenta, the nurse determines
that the client needs additional teaching when she says that which of the following hormones is
produced by the placenta?
A. Estrogen
B. Progesterone
C. hCG
D. testosterone
24. A client about 8 weeks pregnant, asks the nurse when she will be able to hear the fetal
heartbeat. The nurse would respond by telling the client that the fetal heartbeat can be
heard with a Doppler ultrasound device when the gestation is as early as which of the
following?
A. 4 weeks
B. 8 weeks
C. 15 weeks
D. 18 weeks
25. A primiparous client at 10 weeks gestation questions the nurse about the need for an
ultrasound. She states “I don’t have health insurance and I can’t afford it, I feel fine, so why
should I have the test?” The nurse would incorporate which statement as the underlying reason
for performing the ultrasound now,
A. Identification of fetal parts and possible Down syndrome.
B. Determination of gestational age.
C. View the heart beating to indicate that fetus is healthy.
D. Determination of fetal position.
26. A 22-year-old married client with a positive pregnancy test states, “It is really true? I can’t
believe I’m going to have a baby!” which of the following responses by the nurse would be most
appropriate at this time?
A. “Would you like some booklets on the pregnancy experience?”
B. “Yes it is true. How does that make you feel?”
C. “You should be delighted that you are pregnant.”
D. “Weren’t you and your husband trying to have a baby?”
27. A newly diagnosed pregnant client tells the nurse, “If I’m going to have all of these discomforts,
I’m not sure I want to be pregnant!” The nurse interprets the client’s statement as an indication
of which of the following?’
 A. Fear of pregnancy outcome
B. Rejection of the pregnancy.
C. Normal ambivalence.
D. Inability to care for the newborn.
28. When caring for newly diagnosed primigravid client at 10 weeks’ gestation who is experiencing
breast tenderness, amenorrhea, nausea and vomiting, and urinary frequency, which of the
following would the nurse identify as a priority nursing diagnosis?
A. Readiness for Enhanced Family Coping related to pregnancy confirmation.
B. Ineffective Sexuality Patterns related to fear of spontaneous abortion.
C. Compromised Family Coping related to the discomforts of pregnancy.
D. Imbalance Nutrition: Less than Body Requirements related to increased demands of
pregnancy.
29. A client approximately 11 weeks pregnant, and her husband are seen in the antepartal clinic.
The client’s husbands tells the nurse that he has been experiencing nausea and vomiting and
fatigue along with his wife. The nurse interprets these findings as suggesting that the client’s
husband is experiencing which of the following?
A. Ptyalism
B. Mittelschmerz
C. Couvad syndrome
D. Pica
30. A pimigravid client asks the nurse if she can continue to have a glass of wine with dinner
during her pregnancy. Which of the following would be the nurse’s best response?
A. “The effects of alcohol on a fetus during pregnancy are unknown.”
B. “You should limit your consumption to beer and wine.”
C. “You should abstain from drinking alcoholic beverages.”
D. “You may have 1 drink or 2 ounces of alcohol per day.”
31. Examination of a primigravid client complaining of increased vaginal secretions since becoming
pregnant reveals clear, highly acidic vaginal secretions. The client denies any perineal itching
or burning. The nurse interprets these findings as a response related to which of the following?
A. A decrease in vaginal glycogen stores.
B. Development of a sexually transmitted disease.
C. Prevention of expulsion of the cervical mucus.
D. Control of the growth of pathologic bacteria.
32. When measuring the fundal height of a primigravid client at 20 weeks gestation, the
nurse would anticipate locating the fundal height at which of the following points?
A. Halfway between the client’s symphysis pubis.
B. At about the level of the client’s umbilicus.
C. Between the client’s umbilicus and xyphoid process.
D. Near the client’s xyphoid process and compressing the diaphragm.
33. A primigravid client visiting the antenatal clinic at 8 weeks gestation tells the nurse that she
wants an amniocentesis because there is a history of hemophilia A in her family. The nurse
instructs the client that newer techniques now allow amniocentesis to be performed as early
as which of the following?
A. 8 weeks gestation
B. 10 weeks gestation
C. 12 weeks gestation
D. 14 weeks gestation
34. After instructing a primigravid client about desired weight gain during pregnancy, the nurse
determines that the teaching has been successful when the client states which of the following?
A. “A total weight gain of approximately 20 pounds (9kg) is recommended.”
B. “A weight gain of 6.5 pounds (3kg) in the second and third trimesters is considered normal.”
C. “A weight gain of about 12 pounds (5.5kg) every trimester is recommended.”
D. “Although it varies, a gain of 25 to 35 pounds (11.4 to 14.5kg) is about average.”
35. When developing a teaching plan for a client who is 8 weeks pregnant, which of the following
foods would the nurse suggest to meet the client’s need for increased folic acid?
A. Spinach
B. Bananas
C. Seafood
D. Yogurt
36. The nurse instructs a primigravid client about the importance of sufficient vitamin A in her diet.
The nurse knows that the instructions have been effective when the client indicates that she
should include which of the following in her diet?
A. Buttermilk and cheese
B. Strawberries and cantaloupe
C. Egg yolks and squash
D. Oranges and tomatoes
37. When developing a meal- planning guide about foods rich in riboflavin for a primigravid client,
the nurse would expect to instruct the client to include at least two daily servings which of
the following foods?
A. Fresh fruits
B. Prunes
C. Potatoes
D. Enriched cereals
38. The nurse instructs a primigravid client to increase her intake of foods high in magnesium
because of its role which of the following?
A. Prevention of demineralization of the mother’s bones.
B. Synthesis of proteins, nucleic acids and fats.
C. Amino acid metabolism.
D. Synthesis of neural pathways in the fetus.
39. Which of the following statements by a primigravid client scheduled for chorionic villi
sampling indicates effective teaching about the procedure?
A. “A fiberoptic fetoscope will be inserted through a small incision into my uterus.”
B. “I can’t have anything to eat or drink after midnight on the day of the procedure.”
C. “The procedure involves the insertion of a thin catheter into my uterus.”
D. “I need to drink 32 to 40 ounces of fluid 1 to 2 hours before the procedure.”
40. A 35-year-old multigravida client at 16 weeks’ gestation who received regular prenatal care for
all of her previous pregnancies tells the nurse that she has already felt the baby move. The
nurse interprets this as which of the following?
A. The possibility that the client is carrying twins.
B. Unusual because most multiparous clients do not experience quickening until 30 weeks
gestation.
C. Evidence that the client’s estimated date of delivery is probably off by a few weeks.
D. Normal because multiparous clients can experience quickening between 14 and 20 weeks
gestation.
41. A desire for which of the following diagnostic tests would be most important to ascertain for
a primigravid client in the second trimester of her pregnancy?
A. Culdocentesis to detect abnormalities.
B. Chorionic villus sampling.
C. Ultrasound testing.
D. α-Fetoprotein (AFP) testing
42. When performing Leopold’s maneuvers, which of the following would the nurse ask the client
to do to ensure optimal comfort and accuracy?
A. Breathe deeply foo 1 minute.
B. Empty her bladder.
C. Drink a full glass of water.
D. Lie on her left side.
43. The nurse is assessing fetal position for a 33-year-old client in her 8 th month of pregnancy. As
shown below, the fetal position can be described as which of the following?
A. Left occipital transverse
B. Left occipital anterior
C. Right occipital transverse
D. Right occipital anterior
 figure 1

44. Which of the following statements by the nurse would be most appropriate when responding
to a primigravid client who asks, “What should I do about this brown discoloration across my
nose and cheeks?”
A. “This usually disappears after delivery.’
B. “It is a sign of skin melanoma.”
C. “The discoloration is due to dilated capillaries.”
D. “It will fade if you use a prescribed cream.”
45. A 37-year-old primigravid client at 22 weeks gestation without any complications to date is
being seen in the clinic for a routine visit. The nurse expects to assess the client’s fundal height
for which of the following reasons?
A. Determine the level of uterine activity.
B. Identify the need for increased weigh gain.
C. Assess the location of the placenta.
D. Estimate the fetal gestational age.
46. After reviewing the physician explanation of amniocentesis with a multigravida client, which
of the following, if reported by the client as a primary risk of the procedure, would indicate
successful teaching?
A. Premature rupture of the membranes.
B. Possible premature labor.
C. Fetal limb malformations.
D. Fetal organ malformations.
47. A primigravid client at 28 weeks’ gestation tells the nurse that she and her husband wish
to drive visit relatives who live several hundred miles away: Which of the following
recommendations by the nurse would be best?
A. “Try to avoid traveling anywhere in the car during your third trimester.”
B. “Limit the time you spend in the car to a maximum of 4 to 5 hours.”
 C. “Taking the trip is okay if you stop every 1 to 2 hours and walk.”
D. “Avoid wearing your seat belt in the car to prevent injury to the fetus.”
48. Which of the following recommendations would be most helpful to suggest to a primigravid
client at 37 weeks gestation who is complaining of leg cramps?
A. Change positions frequently throughout the day.
B. Alternately flex and extend the legs.
C. Straighten the knee and push upward on the toes.
D. Lie prone in bed with the legs elevated.
49. Which of the following recommendations would be the most appropriate preventive measure
suggest to a primigravid client at 30 weeks’ gestation who is experiencing occasional heartburn?
A. Eat smaller and more frequent meals during the day.
B. Take a pinch of baking soda with water before meals.
C. Decrease fluid intake to four glasses daily.
D. Drink several cups of regular tea throughout the day.
50. When performing leopolds maneuvers on a primigravid client at 22 weeks gestation, the
nurse performs the first maneuver to do which of the following?
A. Locate the fetal back and spine.
B. Determine what is in the fundus.
C. Determine whether the fetal head is at the pelvic inlet.
D. Identify the degree of fetal descent and flexion.

The Pregnant Client in Childbirth Preparation Classes

51. When preparing a series of preparation for parenting classes for pirmigravid clients and their
partners about endocrine changes that normally occur during pregnancy, which of the following
would be included?
A. Human placental lactogen maintains the corpus luteum.
B. Progesterone is responsible for hyperpigmentation and vascular skin changes.
C. Estrogen relaxes smooth muscle in the respiratory tract.
D. The thyroid enlarges with an increase in basal metabolic rate.
52. When developing a series of parent classes on fetal development, which of the following would
the nurse include as being developed by the end of the third month (9 to 12 weeks)?
A. External genitalia.
B. Myelinization of nerves.
C. Brown fat stores.
D. Air ducts and alveoli.
53. During a 2-hour childbirth preparation class focusing on the labor and delivery process for
primigarvid clients, the nurse describes the first maneuver that the fetus goes through during
the labor process when the head is the presenting part as which of the following?
A. Engagement
B. Flexion
C. Descent
D. Internal rotation
 54. During a childbirth preparation class, a primigravid client at 36 weeks gestation tells the
nurse, “My lower back has really been bothering me lately.” Which of the following exercises
suggested by the nurse would be most helpful?
A. Pelvic rocking
B. Deep breathing
C. Tailor sitting
D. Squatting
55. During childbirth preparation classes for a group of adolescent primigravid clients, one of the
clients asks, “How does the baby breathe inside of me?” The nurse responds by explaining fetal
circulation, stating that circulation of oxygenated blood from the placenta begins with which of
the following?
A. Umbilical artery
B. Foramen ovale
C. Ductus arteriosus
D. Umbilical vein
56. Which of the following would be important for the nurse to include in the teaching plan?
A. Decreased plasma volume.
B. Increased risk for urinary tract infections.
C. Increased peripheral vascular resistance.
D. Increased hemoglobin levels.

The Pregnant Client with Risk Factors

57. After conducting a presentation to a group of adolescent parents on the topic of adolescent
pregnancy, the nurse determines that one of the parents needs further instructions when the
parent says that adolescents are at greater risk for which of the following?
A. Denial of the pregnancy.
B. Low-birth-weight infant.
C. Cephalopelvic disproportion
D. Congenital anomalies
58. A dilatation and curettage (D&C) is scheduled for a primigravid client admitted to the hospital at
10 weeks gestation with abdominal cramping, bright red vaginal spotting, and passage of some
of the products of conception. The nurse anticipates that the client will most likely express
which of the following feelings?
A. Ambivalence
B. Anxiety
C. Fear
D. Guilt
59. When providing care to the client who has undergone a D&C after a spontaneous abortion, the
nurse administers hydroxyzine (Vistaril) as ordered, primarily for which of the following
reasons?
A. To counteract nausea.
B. To reduce pain.
 C. To decrease urine cramping.
D. To promote uterine contractility.

60. On entering the room of a client who has undergone a D&C for a spontaneous abortion, the
nurse finds the client crying. Which of the following comments by the nurse would be most
appropriate?
A. “Are you having a great deal of uterine pain?”
B. “Often spontaneous abortion means a defective embryo.”
C. “I’m truly sorry you lost your body.”
D. “You should try to get pregnant again as soon as possible.”

End