MATERNAL & CHILD NURISNG 1.

Which of the following patterns of weight gain is normal for a client who weighed 100 pounds before becoming pregnant? A. 110 pounds by 10 weeks' gestation B. 112 pounds by 20 weeks' gestation C. 115 pounds by 30 weeks' gestation D. 135 pounds by 40 weeks' gestation 2. Which of the following nursing diagnoses would be most appropriate for a woman in her third trimester who tells her husband that she does not want to go out in public "while I'm this pregnant"? A. Altered Role Performance B. Anxiety C. Body Image Disturbance D. Ineffective Family Coping 3. Which of the following contraceptive methods would the nurse identify as the least effective in preventing conception? A. Coitus interruptus B. Condoms with spermicides C. Intrauterine devices D. Hormonal contraceptives 4. Which of the following behaviors would the nurse expect to observe in a primipara client by the third postpartum day? A. Greater interest in learning about infant care B. Requests for help with her activities of daily living C. Sleeping most of the time when the infant is not in the room D. Very talkative about the birth experience to friends 5. Which of the following would the nurse use to explain the term quickeningto a client who is at 18 weeks' gestation? A. A light fluttering sensation when the fetus moves B. A vaginal infection caused by yeast C. Descent of the fetus into the pelvis D. Vascular congestion and tenderness of the breast tissue 6. Which of the following terms <i>best describes the conscious process by which a couple decides on the number and spacing of children and the timing of births?

A. Emergency contraception B. Family planning C. Infertility management D. Preconception planning 7. Which of the following would be <i>most</i> important for the nurse to determine if the prenatal blood panel of a primigravida reveals that she is Rh negative? A. Blood type of the father of the baby B. Hemoglobin and hematocrit levels C. Her religious preference D. Previous administration of RhoGAM 8. A client, who is 8 weeks pregnant, tells the nurse, "We wanted a baby, but I'm not sure this is the best time." The nurse would interpret that the client is expressing feelings of which of the following? A. Acceptance B. Ambivalence C. Apathy D. Attachment 9. Which of the following factors would be most influential to the outcome of a class on human sexuality that includes both males and females ranging in age from adolescence through middle-aged adults? A. Availability of written handouts to reinforce the content B. Cognitive level of the information to be presented C. Environmental setting where the class will take place D. The nurse's comfort level in discussing the subject matter 10. For which of the following clients would the nurse understand that oral contraceptive agents are contraindicated? A. A 29-year-old female with alcohol abuse B. A 30-year-old female who had three spontaneous abortions C. A 36-year-old female with a history of thrombophlebitis D. A teenager with regular menses for the past 4 years 11. Which of the following areas would be the priority for client education in the first trimester? A. Constipation B. Danger signs

C. Lactation D. Leg cramps 12. When questioning a client about the number of extra calories eaten per day, the nurse knows the client is receiving adequate calories when she states the following? A. 1,000 B. 300 C. 500 D. 750 13. The nurse determines that a client understands the natural cervical mucus contraceptive method when the client describes the cervical mucus during her fertile period as which of the following? A. Clear, wet, and sticky B. Cloudy, white, and sticky C. Thick and cloudy D. Yellow and sticky 14. Teenagers in a health class ask the nurse educator, "Do spermicidal jellies ever work?" Which of the following would be the nurse's best reply? A. "Spermicides are effective for repeated intercourse for 24 hours." B. "They are not effective unless used with a male or female condom." C. "They are the least effective of all contraceptives." D. "They must be placed within 30 minutes before intercourse to be effective." 15. Which of the following denotes the correct technique for fundal massage for a postpartum client exhibiting a large amount of blood on the perineal pad? A. Compressing the fundus on one side while supporting the other side of the uterus B. Massaging above the symphysis pubis while one hand supports the uterine fundus C. Pressing deeply into the abdomen while compressing the fundus with both hands D. Supporting the fundus while massaging the uterus just above the symphysis pubis

16. When teaching a childbirth education class on infection prevention after delivery, the nurse would instruct the woman to perform perineal care how often? A. After each voiding or defecation B. Every 8 hours C. Once each day D. When she has perineal pain 17. A client tells the nurse, "I had my tubes tied 5 years ago. I want to get pregnant now. Is it possible to reverse the sterilization?" The nurse bases her response on the knowledge of which of the following? A. Female reversal produces a pregnancy rate of 90% B. Male sterilization reversal is easier than a female's C. Reversal is possible with tubal reconstruction D. Reversal of bilateral tubal ligation is not possible 18. Which of the following is the primary factor to consider when assisting a client in choosing the optimum contraceptive method? A. Compatibility with cultural values B. Consistent and correct use C. Few side effects D. Lowest failure rate 19. Which of the following would the nurse include in a client's teaching plan about the danger signs of pregnancy? A. Backache B. Blurred vision C. Edematous feet D. Quickening 20. Using the five-digit system, which of the following denotes the correct obstetric history for a client who is 6 weeks pregnant, and has a son born at 36 weeks' gestation and a daughter born at 40 weeks' gestation? A. G2 T1 P1 A0 L2 B. G2 T2 P0 A0 L2 C. G3 T1 P1 A0 L2 D. G3 T2 P0 A0 L2 21. Which of the following would the nurse include in the teaching plan for a high school class on human sexuality as a positive sign of pregnancy?

A. Abdominal enlargement B. Persistent amenorrhea C. Positive urine HCG D. Presence of fetal heart tones 22. A client calls the clinic because she has forgotten to take her oral contraceptive for the past 2 days. Which of the following should the nurse advise the to do? A. Continue to take the remaining pills for the rest of the cycle B. Discontinue the pills for the rest of the cycle and use condoms C. Take two pills for the next 2 days and use condoms the rest of the cycleTake two pills immediately and change to condoms for the rest of the cycle 23. The nurse informs the client who comes to the clinic for a subdermal implant of progesterone (Norplant) about its advantages. Which would the nurse include? A. Effectiveness for 3 months B. Noninvasive technique for insertion C. Reversible and inexpensive D. Very few complications or side effects 24. A client asks, "How will sitting in a sitz bath help me?" The nurse's best response would be which of the following? A. "It is the best way to prevent you from getting a uterine and episiotomy infection." B. "It will increase urinary bladder muscle tone and facilitate bladder emptying." C. "Sitting in the water promotes muscle contraction and prevents hemorrhaging." D. "The warmth of the water will help to facilitate the healing process." 25. The nurse asks a client who is using the basal body temperature (BBT) method of contraception, "When do you and your partner have intercourse?" Which of the following replies is consistent with the BBT method? A. "During the first few days after my period ends." B. "From the last day of menses to the first day of temperature elevation."

C. "From the third day of temperature elevation until menses start." D. "On any day my temperature is not elevated more than 1." 26. For which of the following contraceptive methods would the health care provider obtain a signed informed consent? A. Cervical cap B. Diaphragm C. Symptothermal method D. Vasectomy 27. At what point in the pregnancy would the nurse expect to administer a 1-hour, 50-gram glucose-screening test to low to moderate risk clients? A. 12 and 20 weeks' gestation B. 24 and 28 weeks' gestation C. 34 and 38 weeks' gestation D. 8 and 12 weeks' gestation 28. Which of the following would be included in the teaching plan for a client who has just had an intrauterine device (IUD) implanted? A. Consistent douching immediately after intercourse B. Need to check for correct placement periodically C. The estimated rate of pregnancy is 0% during the first year 29. Which of the following statements about the female sheath/condom is accurate? A. A success rate of 99% if used consistently and correctly B. Need to leave in place for at least 6 hours after intercourse C. Provides female protection against sexually transmitted diseasesReusable after cleaning and inspecting for tears 30. Which of the following would the nurse include in a teaching plan on sexuality and the major physiologic effects of hormonal contraceptives for teens in a local high school? A. Decrease in sperm motility B. Inhibition of the release of an ovum C. Prevention of implantation D. Production of thin cervical mucus 31. The nurse should recommend which of the following contraceptive methods for a 16-year-old female prostitute who has a history of tobacco, alcohol, and intravenous drug abuse?

A. Female condoms B. Intrauterine device (IUD) C. Oral contraceptives D. Subdermal implants 32. The nurse recognizes that the client understands how to take her oral contraceptive when the nurse hears the client tell her friend which of the following? A. "I have to take one pill each day at the same time." B. "I will need to have a complete physical every 3 months." C. "If I take antibiotics, I should stop taking my pills." D. "The pills have practically few serious side effects." 33. Which of the following should the nurse recommend to a client experiencing nausea and vomiting during the first trimester? A. Consuming a few crackers before arising B. Eating chicken noodle soup three times a day C. Eating three regular large meals per day D. Skipping meals when the nausea is present 34. Which of the following questions would be most important to ask when obtaining a client's prenatal history? A. "Are your immunizations up to date?" B. "Do you regularly take any medication?" C. "Have you ever had a sexually transmitted disease?" D. "What is your usual prepregnant weight?" 35. A client who is 24 hours postpartum has the following morning vital signs: Temperature 100 F; BP 124/78; P58; R16. The nurse should do which of the following? A. Assess the vital signs hourly instead of every 4 hours.Recognize the client's vital signs are normal. B. Report the changes in vital signs to the physician. C. Retake the pulse rate after the client ambulates. D. Recognize the client's vital signs are normal. 36. When explaining to a client about the <i>primary</i> cause of constipation during pregnancy, the nurse would include which of the following? A. Decreased water reabsorption

B. Delayed gastric emptying time C. Increased peristalsis D. Relaxation of GI tract muscle 37. While preparing a primigravida for her first pelvic exam, the client expresses fear and begins to cry. Which of the following would be the nurse's best response? A."Can you tell me what is making you so afraid?" B. "I will make sure that you are covered with a sheet at all times." C. "The physician will tell you exactly what he is going to do." D. "We'll postpone the exam until you are more comfortable." 38. When teaching a class at a clinic for homeless males, which of the following would the nurse relate as the most effective contraceptive for the prevention of sexually transmitted diseases (STDs)? A. Condoms B. Diaphragm C. Sterilization D. Vaginal Sponge 39. When planning a teaching session for teenage girls on the use of a diaphragm for contraconception, which of the following would be included? A. Having the diaphragm refitted after a weight loss or gain of 20 pounds B. Inserting the diaphragm at least 8 hours prior to intercourse C. Leaving the diaphragm in place for 24 hours after intercourse D. Using a spermicidal jelly in the center and around the rim 40. When obtaining an intake history from a new client in the antepartum clinic, which of the following factors, if found in the multigravida's history, would identify her as being at increased risk for gestational diabetes? A. Age of 25 B. Five living children C. Prior birth of a large infant D. Smoking two packs a day 41. Which of the following would be the nurse's best response to a client who asks the nurse to explain the purpose of a nonstress test (NST)? A. "It determines how the baby's heart responds to uterine contractions."

B. "The test demonstrates the fetus's response to oxytocin." C. "The test helps to give an accurate estimate of the gestational age." D. "The test provides information about the size of the baby." 42. When advising the client who wants to discontinue hormonal contraceptives in order to become pregnant, the nurse would recommend stopping the hormonal contraceptive at least 3 months before conception for which of the following reasons? A. To allow the client's hormone levels to return to normal B. To permit healing of the uterine scar tissue C. To prevent teratogenic effects on the fetus D. To promote normalization of the endometrial lining 43. Which of the following would be included in the nurse's explanation about the natural calendar method for a client whose religious preferences prevent the use of artificial contraception? A. Including irregular bleeding episodes as menses B. Planning for intercourse during her fertile periods C. Practicing abstinence for 1 year D. Recording the menstrual cycle for several months 44. During the initial interview of a pregnant client, the nurse uses Nigele's rule to determine the estimated date of delivery (EDD). Which of the following questions would be essential to ask? A. "On what day did your previous menstrual period stop?" B. "What type of contraception are you using at this time?" C. "When was the first day of your last menstrual period?" D. "When was the last time that you had sexual intercourse?"

45. For which of the following would the nurse be alert if the client is receiving medroxyprogesterone (Depo-Provera) injections? A. Hepatitis B B. Myocardial infarction C. Venous thrombosis D. Pelvic inflammatory disease 46. When explaining to a male client about the advantages and disadvantages of vasectomy as a method of contraception, which of the following would be appropriate to include?

A. A vasectomy can be performed in the physician's office. B. Contraception is 100% effective.Sperm in the semen are immediately eliminated. C. Sperm in the semen are immediately eliminated. D. Voluntary reversal is impossible. 47. When measuring the fundal height of a client during a prenatal visit, the nurse finds the fundus at the level of the umbilicus. The nurse would document the approximate gestational age of the fetus as which of the following? A. 10 weeks B. 20 weeks C. 30 weeks D. 40 weeks 48. Which of the following instructions would be included for a client who is scheduled to have an abdominal ultrasound? A. Bathing with an antibacterial soap to remove bacteria from the skin B. Drinking a quart or more of fluids 2 hours before the test and not voiding C. Remaining in a fasting state from midnight until after the test is completed D. Taking 2 ounces of mineral oil to facilitate bowel evacuation 49. Which of the following statements by the nurse would be most appropriate for a client who smokes 1/2 to 1 pack of cigarettes per day? A. "Here's some information on effective ways to quit smoking." B. "Try to reduce the number of cigarettes you smoke per day." C. "You should quit smoking immediately." D. "Your smoking is harmful to you and to the infant." 50. A client reports swelling of her feet and hands on arising each morning. A 24-hour dietary recall reveals a salt intake in excess of 2 g/day. Which of the following should the nurse recommend? A. Avoidance of high-sodium foods B. Elimination of all salt from her diet C. Request to the physician for a diuretic D. Restriction of fluid intake