PRACTICE TEST 1: High Risk Pregnancy
Infections
1. The nurse is caring for a pregnant
woman with herpes zoster or, shingles.
What should the nurse expect to find during
the initial assessment?
A. Rhinorrhea, small red lesions including
some with vesicles that are widespread over
the face and body
B. A painful vesicular eruption following a
nerve pathway
C. Blisters on the lips and in the corners of
the mouth
D. Painful fluid-filled vesicles in the genital
area
2. The nurse is assessing a pregnant
woman for sexually transmitted diseases.
Which symptom would be most apt to be
present in a woman with a Trichomonas
vaginalis vaginal infection?
A. A profuse bubbly yellowish-gray discharge
B. White cheese-like patches in the vagina
C. Perineal deformity
D. An ulcer or lesion of the vulva or vagina
3. A clinic nurse is caring for a pregnant
client with herpes genitalis. The nurse
provides instructions to the mother regarding
treatment modalities that may be necessary
for treatment of this condition. Which of the
following statements if made by the mother
indicates an understanding of these
treatment measures?
A. “ I need to abstain from sexual intercourse
until after delivery.”
B. “I need to use vaginal creams after the
douche everyday.”
C. “I need to douche and perform a Sitz bath
three times a day.”
D. “It may be necessary to have a Cesarean
section for delivery.”
4. A pregnant client has been diagnosed
with a vaginal infection from the organism
Candida albicans. Which findings would the
nurse expect to note on assessment of the
client?
A. Absence of any signs and symptoms
B. Pain, itching, and vaginal discharge
C. Proteinuria, hematuria, edema, and
hypertension
D. Costovertebral angle pain
5. A nurse is caring for a pregnant client
with a history of human immunodeficiency
virus (HIV). Which nursing diagnosis, if
formulated by the nurse, has the highest
priority for this client?
A. Self care deficit C.
Nutrition deficit
B. Risk for infection D.
Activity intolerance
6. A nurse performs an initial assessment
on a pregnant client and determines that the
client is at risk for toxoplasmosis. The nurse
8. Which of the following statements made
by a pregnant client with a chlamydial
infection indicates understanding of the
potential complications
A. “I need to prepare myself and my family
for a baby with congenital anomalies.”
B. “I hope this medicine works before this
disease gets into my urine and destroys my
kidneys.”
C. “I can have a normal vaginal delivery.”
D. “I need to treat this infection so it doesn’t
spread into my pelvis because I want to have
more children someday.”
9. A pregnant client tests positive for the
Hepatitis B virus. The client asks the nurse if
she will be able to breastfeed her baby as
planned after delivery. Which of the
following responses by the nurse is most
appropriate?
A. “You will not be able to breastfeed the
baby until 6 months after delivery.”
B. “Breastfeeding is not a problem and you
will be able to breastfeed immediately after
delivery.”
C. “Breastfeeding is allowed if the baby
receives prophylaxis at birth and remains on
the scheduled immunization.”
D. “Breastfeeding is not advised, and you
should seriously consider bottle-feeding the
baby.”
10. A hepatitis B screen is performed on a
pregnant client, and the results indicate the
presence of antigens in the maternal blood.
Which of the following would the nurse
anticipate to be prescribed?
A. Repeat hepatitis screen
B. Retesting the mother in 1 week
C. Administration of hepatitis vaccine and
hepatitis B immune globulin to the neonate
within 12 hours after birth
D. Administration of antibiotics during
pregnancy
11. A nurse is instructing a client with
hepatitis about measures to control fatigue.
The nurse avoids telling the client to
A. Plan rest periods after meals
B. Rest in-between activities
C. Perform personal hygiene if not fatigued
D. Complete all daily activities in the
morning when the client is most rested
12. A pregnant client is treated for syphilis
during the first trimester with intramuscular
injections of penicillin. Her baby’s diagnosis
at birth would most likely be
A. Congenital syphilis C. Normal
newborn
B. Stillborn D. Premature
newborn
Hematologic
13. Which of the following conditions is the
would teach the client which of the following
to prevent exposure to this disease?
A. Wash hands only before meals
B. Eat raw meats
C. Avoid exposure to litter boxes used by
cats
D. Use topical corticosteroid treatments
prophylactically
7. A client with gonorrhea asks the nurse if
it can cause cancer. The nurse tells her that
the organism associated with up to 90% of
cervical malignancies and may be linked to
other genital cancers is
A. Neisseria gonorrhoea C. Human
papilloma virus
B. Chlamydia trachomatis D. Herpes
simplex virus
15. A pregnant client is taking iron
supplements to correct iron-deficiency
anemia. The nurse teaches the client which
of the following special considerations while
on iron therapy?
A. Avoid taking iron with milk or antacids
B. Limit intake of meat, fish, and poultry
C. Eat a low-fiber diet
D. Limit intake of fluids
16. A nurse is preparing to teach a
pregnant client about the dietary sources of
iron that are easy for the body to absorb.
Which of the following food items would the
nurse include in the teaching plan?
A. Cereals C. Fruits
B. Poultry D.
Vegetables
17. A clinic nurse instructs a pregnant
adolescent with iron deficiency anemia about
the administration of oral iron preparations.
The nurse instructs the adolescent that it is
best to take the iron with
A. Water C. Tomato
juice
B. Soda D. Cola
18. During a nutritional counseling session,
a pregnant woman asks why a person needs
more iron during pregnancy. The nurse
answers that increased demand for iron
during pregnancy is most likely caused by
A. A decrease in red blood cell formation
occurring in the third trimester
B. The rise in blood cell concentration
occurring between 24 and 32 weeks’
gestation.
C. An increase in total blood cell volume and
hemoglobin mass by approximately 25% to
50% during pregnancy.
D. A decreased efficiency of iron absorption
during pregnancy and fetal inability to
absorb the mineral
19. A nurse is administering iron dextran to
a client by the intravenous route. The nurse
most common cause of anemia in
pregnancy?
A. Alpha thalassemia C. Iron
deficiency anemia
B. Beta thalassemia D. Sickle
cell anemia
14. A pregnant client is suspected of
having iron deficiency anemia. Which of the
following would the nurse expect to note
regarding the client’s status?
A. A low hemoglobin and hematocrit level
B. A high hemoglobin and hematocrit level
C. Fluid volume excess
D. Fluid volume deficit
23. A pregnant client is admitted to the
hospital with a diagnosis of sickle cell crisis.
The nurse contacts the physician to question
which order documented in the child’s
record?
A. Intravenous fluids C. Bedrest
B. Supplemental oxygen D.
Meperidine hydrochloride
24. A pregnant client is admitted to the
hospital with a suspected diagnosis of
immune thrombocytopenic purpura.
Diagnostic studies are performed. Which of
the following diagnostic results is indicative
of this disorder?
A. Bone marrow examination indicating an
increased number of immature white blood
cells
B. Bone marrow examination showing an
increased number of megakaryocytes.
C. Elevated platelet count
D. Elevated hemoglobin and hematocrit
levels
Renal and Urinary
25. The most common microorganism
responsible for urinary tract infection is
A. Escherichia coli C. group
B streptococcus
B. Staphylococcus aureus D.
Pneumocystis carinii
26. A primigravid client in her 12th week of
gestation asks the nurse ways on how to
prevent urinary tract infection. Which of the
following responses of the nurse is correct?
A. “Do vaginal douching after intercourse.”
B. “ Void frequently at least every two
hours.”
C. “Wear loose, comfortable synthetic
underwear.”
D. “Wipe from the back to the front after
bowel movement.”
27. A nurse has provided instructions to a
pregnant client with urinary tract infection
regarding food and fluids to consume that
checks that which of the following will acidify the urine. Which of the following
medications is available for use if needed as fluids, if identified by the mother, indicates a
an antidote to the iron? need for further education regarding fluids
A. Deferoxamine C. Ferrous that will acidify the urine?
fumarate A. Apricot juice C. Prune
B. Dirithromycin D. juice
Ferrous sulfate B. Carbonated drinks D.
Cranberry juice
20. A pregnant client with sickle cell
anemia is at an increased risk for having a 28. Which of the following medications is
sickle cell crisis during pregnancy. not to be used in managing urinary tract
Aggressive management of a sickle cell crisis infection during the third trimester?
includes which of the following measures? A. Ampicillin C.
A. Antihypertensive agents C. I.V. Sulfonamides
Fluids B. Amoxicillin D.
B. Diuretic agents D. Cephalosporin
Acetaminophen for pain
29. A pregnant client with chronic renal
21. A client in labor has a concurrent failure has been treated with sodium
diagnosis of sickle cell anemia. Because the polysterene sulfonate (Kayexalate) by
client is at high risk for sickling crisis, which mouth. The nurse would evaluate this
nursing action is the priority to assist in therapy as effective if which of the following
preventing a crisis from occurring during values was noted on follow-up laboratory
labor? testing?
A. Reassure the client A. Potassium 4.9mEq/L C. Phosphorus 3.9
B. Administer oxygen as ordered throughout mEq/L
labor B. Sodium 142mEq/L D. Calcium 9.8
C. Maintain strict asepsis mEq/L
D. Prevent bearing down
30. Pregnant women with renal disease
22. A pregnant client is admitted to the and taking corticosteroids at a maintenance
hospital with sickle cell crisis. The nurse level is highly likely to have newborns
monitors this client for which of the following experiencing which of the following
most frequent symptoms of this disorder? conditions?
A. Bradycardia C. Diarrhea A. Hyperglycemia C.
C. Pain D. Blurred Hypoglycemia
vision B. Respiratory depression D.
Increased irritability

31. A client at 16 weeks’ gestation is

receiving antibiotic therapy for
pyelonephritis. The nurse is aware that the
safest antibiotic for administration during
pregnancy is
A. Gantrisin C.
Ampicillin
B. Tetracycline D.
Nitrofurantoin

Respiratory 39. A nurse is conducting a clinic visit with

32. A pregnant client is screened for
tuberculosis during her first prenatal visit.
An intradermal injection of purified protein
derivative of the tuberculin bacilli is given.
The client is considered to have a positive
test for which of the following results?
A. An indurated wheal under 10mm in
diameter appears in 6-12 hours
B. An indurated wheal over 10mm in
diameter appears in 48-72 hours
C. A flat circumscribed area under 10mm in
diameter appears in 6-12 hours
D. A flat circumscribed area over 10mm in
diameter appears in 48-72 hours
a prenatal client with heart disease. The
nurse carefully assesses the client’s vital
signs, weight, and fluid and nutritional status
to detect complications caused by
A. Hypertrophy and increased contractility of
the heart
B. The increase in circulating blood volume
C. Fetal cardiomegaly
D. Rh incompatibility
40. A prenatal client is admitted to an
obstetric unit during an exacerbation of a
heart condition. When planning for the
nutritional requirements of the client, a nurse

33. A pregnant client who had asthma
claims that her asthma attacks became
infrequent since she got pregnant. Which of
the following conditions during pregnancy
could have contributed to the decreased
frequency of attacks?
A. High circulating levels of corticosteroid
B. Increased histamine release
C. Increased lung capacity
D. High circulating levels of progesterone
34. A nurse is reviewing the results of a
sweat test performed on a pregnant client
with cystic fibrosis. The nurse would expect
to note which finding?
A. A sweat sodium concentration less than
40mEq/L
B. A sweat potassium concentration less
than 40mEq/L
C. A sweat potassium concentration greater
than 40mEq/L
D. A sweat chloride concentration greater
than 60mEq/L
Rheumatoid
35. A nurse is assigned to care for a
prenatal client with juvenile rheumatoid
arthritis. The nurse reviews the plan of care,
knowing that which of the following is the
priority nursing diagnosis?
A. Body Image Disturbance related to
activity intolerance
B. Potential for Self Care Deficit related to
immobility
C. High Risk for Injury related to impaired
physical mobility
D. Pain related to the inflammatory process
GI
36. A pregnant client with hiatal hernia is
asking the nurse for something to drink. The
nurse offers the client which of the following
items?
A. Tomato juice C. Grapefruit
juice
B. Orange juice D. Apple
juice
Cardiovascular
37. A nurse is performing a cardiovascular
assessment on a pregnant client. Which of
the following items would the nurse assess
to gain the best information about the
client’s left-sided heart function?
A. Breath sounds C. Jugular vein
distention
B. Peripheral edema D.
Hepatojugular reflux
38. A nurse is performing a cardiovascular
assessment on a pregnant client. Which of
the following items would the nurse assess
to gain the best information about the
client’s right-sided heart function?
A. Breath sounds C. Presence of
dyspnea
would consult with a dietitian to ensure
which of the following?
A. A low-calorie diet to ensure absence of
weight gain
B. A diet low in fluids and fiber to decrease
blood volume
C. A diet high in fluids and fiber to decrease
constipation
D. Unlimited sodium intake to increase
circulating blood volume
41. After instruction of a primigravid client
at 8 weeks’ gestation diagnosed with heart
disease about self-care during pregnancy,
which of the following client statements
would indicate the need for additional
teaching?
A. “I should avoid being near people who
have a cold.”
B. “I may be given antibiotics during my
pregnancy.”
C. “I should reduce my intake of protein in
my diet.”
D. “I should limit my salt intake at meals.”
42. While caring for a primigravid client
with congestive heart disease at 28 weeks’
gestation, the nurse would instruct the client
to contact her physician immediately if the
client experiences which of the following?
A. Mild ankle edema
B. Emotional stress on the job
C. Weight gain of 1 pound in 1 week
D. Increased dyspnea at rest
43. A nurse is providing diet teaching to a
pregnant client with congestive heart failure.
The nurse tells the client to avoid
A. Leafy green vegetables C. Cooked
cereal
B. Catsup D. Sherbet
44. A nurse is assessing a pregnant client
with left sided heart failure. The client states
that it is necessary to use three pillows
under the head and chest at night to be able
to breathe comfortably while sleeping. The
nurse documents that the client is
experiencing
A. Dyspnea on exertion
B. Dyspnea at rest
C. Orthopnea
D. Paroxysmal nocturnal dyspnea
45. A primigravid client with heart disease
who is visiting the clinic at 8 weeks’
gestation tells the nurse that she has been
maintaining a low-sodium, 1,800-calorie diet.
Which of the following instructions should
the nurse give the client?
A. Avoid folic acid supplements to prevent
megaloblastic anemia
B. Severely restrict sodium intake
throughout the pregnancy
C. Take iron supplements with milk to
enhance absorption
D. Increase calorie intake to 2,200 calories
B. Peripheral edema D. Respiratory
rate
47. A pregnant client with mitral valve
prolapse is receiving anticoagulant therapy
during pregnancy. A nurse performs an
assessment on the client and expects that
the client will indicate that which of the
following medications is prescribed?
A. Oral intake of 15mg of warfarin
(Coumadin) daily
B. Intravenous infusion of heparin sodium,
5000 units daily
C. Subcutaneous administration of heparin
sodium 5000 units daily
D. Subcutaneous administration of
terbutaline (Brethine) daily
Endo
48. A primigravid client with diabetes at 39
weeks’ age of gestation is seen in the high-
risk clinic. The physician estimates that the
fetus weighs at least 4,500g. The client
asks, ”What causes the baby to be so large?”
The nurses’ response is based on the
understanding that fetal macrosomia is
usually related to which of the following?
A. Family history of large infants
B. Fetal anomalies
C. Maternal hyperglycemia
D. Maternal hypertension
49. Clients with gestational diabetes are
usually managed by which of the following
therapies?
A. Diet
B. Long-acting insulin
C. Oral hypoglycemic drugs
D. Oral Hypoglycemic drugs and insulin
50. Which of the following problems
typically result from uncontrolled gestational
diabetes?
A. Maternal hyperglycemia C. Insufficient
amniotic fluid
B. Fetal demise D. Maternal
hypertension
51. A 27-year old primigravid client with
insulin-dependent diabetes at 34 weeks’
gestation undergoes a nonstress test, the
results of which are documented as reactive.
The nurse tells the client that the test results
indicate which of the following?
A. A contraction stress test is necessary
B. The nonstress test should be repeated
C. Chorionic villus sampling is necessary
D. There is evidence of fetal well-being.
52. A primigravid client with insulin-
daily to promote fetal growth
46. A pregnant client is diagnosed with
thrombophlebitis of the left leg. A nurse
documents in the nursing care plan that the
client should be placed on bed rest with
A. The left leg kept flat D.
Bathroom privileges
B. Elevation of the left leg
C. The left leg in a dependent position
55. A woman who has had diabetes mellitus
for 3 years becomes pregnant. On her initial
prenatal visit, she asks the nurse how this
pregnancy will affect her insulin
requirements. Which of the following is true
regarding insulin needs during pregnancy?
A. Insulin needs during pregnancy will be
essentially the same as before pregnancy, as
long as the client maintains a well-balanced
diet.
B. Insulin needs will vary throughout the
pregnancy and will need to be watched
closely. It is not possible to predict when
insulin needs will be greatest.
C. With a proper balance of nutrition and
exercise, the client may not need insulin
during pregnancy. This is because the baby
will be producing insulin, which will be
available for the mother’s body to use.
D. Insulin needs will vary throughout the
pregnancy. Need is likely to decrease during
the first trimester and then continue to
increase throughout the remainder of the
pregnancy
56. At 38 weeks’ gestation, a primigravid
client with poorly controlled diabetes and
severe preeclampsia is admitted for a
cesarean delivery. The nurse explains to the
client that delivery helps to prevent which of
the following?
A. Neonatal hyperbilirubinemia
B. Congenital anomalies
C. Perinatal asphyxia
D. Stillbirth
Bleeding
57. Which of the following rationales best
explains why a pregnant client should lie on
her left side when resting or sleeping in the
later stages of pregnancy?
A. To facilitate digestion
B. To facilitate bladder emptying
C. To prevent compression of the vena cava
D. To avoid the development of fetal
anomalies
58. A 21-year-old client arrives at the
emergency department with complaints of
cramping lower abdominal pain that radiates
to the shoulders and mild vaginal bleeding.
Pelvic examination shows a left adnexal
mass that is tender when palpated.
Culdocentesis shows blood in the cul-de-sac.
This client probably has which of the
following conditions?
A. Abruptio placentae C.
dependent diabetes tells the nurse that the
contraction stress test performed earlier in
the day was suspicious. The nurse interprets
this test result as indicating that the fetal
heart rate pattern showed which of the
following?
A. Frequent late decelerations
B. Decreased fetal movement
C. Inconsistent late decelerations
D. Lack of fetal movement
53. When teaching a primigravid client with
diabetes about common causes of
hyperglycemia during pregnancy, which of
the following would the nurse include?
A. Fetal macrosomia
B. Obesity before conception
C. Maternal infection
D. Pregnancy-induced hypertension
54. After teaching a diabetic primigravida
about symptoms of hyperglycemia and
hypoglycemia, the nurse determines that the
client understands the instruction when she
says that hyperglycemia may be manifested
by which of the following?
A. Dehydration C. Sweating
B. Pallor D.
Nervousness
62. A woman who is 8 weeks pregnant
comes to the emergency department with
moderate bright red vaginal bleeding. On
examination, the physician finds the client’s
cervix 2cm dilated. Which term best
describes the client’s condition?
A. Incomplete abortion C.
Threatened Abortion
B. Inevitable abortion D. Missed
abortion
63. A multigravida is admitted to the
hospital with a diagnosis of threatened
abortion. Her initial nursing management
would include which of the following?
A. Examining all perineal pads for tissues
and clots
B. Placing the patient in Trendelenburg
position
C. Preparing her for a Shirodkar procedure.
D. Restricting all physical activity and fluid
intake
64. The physician tells a woman who
experienced bleeding in the first trimester
that she has had “a missed abortion.” The
woman asks the nurse to explain what this
means. Which response is most
appropriate?
A. “It’s another name for a miscarriage.”
Hydatidiform mole
B. Ectopic pregnancy D. Pelvic
inflammatory disease
59. Before surgery to remove an ectopic
pregnancy and the fallopian tube, which of
the following would alert the nurse to the
possibility of tubal rupture?
A. Amount of vaginal bleeding and discharge
B. Falling hematocrit and hemoglobin levels
C. Slow, bounding pulse rate of 80 beats per
minute
D. Marked abdominal edema
60. A 36-year old multigravid client is
admitted to the hospital with possible
ruptured ectopic pregnancy. When obtaining
the client’s history, which of the following
would be most important to identify as a
predisposing factor?
A. Urinary tract infection
B. Cocaine use during pregnancy
C. Episodes of pelvic inflammatory disease
D. Use of estrogen-progestin contraceptives
61. A multigravid client is admitted to the
hospital with a diagnosis of ectopic
pregnancy. The nurse anticipates that,
because the client’s fallopian tube has not
yet ruptured, which of the following may be
ordered?
A. Progestin contraceptives C.
Methotrexate
B. Medroxyprogesterone D.
Betamethasone
70. Which of the following findings would
indicate that a woman might be developing
complications from an abruptio placentae
A. The woman’s temperature is 100 degrees
F
(38.3 degrees C)
B. Fluid-filled vesicles appear in the vaginal
discharge
C. A venipuncture site continuous to bleed
for 15 minutes
D. Urinary output is approximately 50ml/hr
71. In assessing the client with vaginal
bleeding in the third trimester of pregnancy.
Abruptio placenta is suspected. Which of
the following procedures would the nurse
perform?
A. Monitor urine output by inserting a Foley
catheter
B. Perform a vaginal examination to
evaluate progression of labor
C. Check the client’s vital signs every 30
minutes.
D. Conduct an abdominal examination for
signs of tenderness and rigidity
72. In providing nursing care for the woman
with abruptio placenta, which of the
following measures would be appropriate
and provide the most benefit to the fetus?
B. “The baby is deformed, resulting in an
abortion.”
C. “The baby is no longer alive and growing,
but your body hasn’t expelled it yet.”
D. “There was no pregnancy; your body just
responded as if there was one.”
65. A client with painless vaginal bleeding
has just been diagnosed as having placenta
previa. Which of the following procedures is
usually performed to diagnosed placenta
previa?
A. Amniocentesis
B. Digital or speculum examination
C. External or fetal monitoring
D. Ultrasound
66. A pregnant client who reports painless
vaginal bleeding at 28 weeks’ gestation is
diagnosed with placenta previa. The
placental edge reaches the internal os. This
type of placenta previa is known as which of
the following types?
A. Low-lying placenta previa C. Partial
placenta previa
B. Marginal placenta previa D. Total
placenta previa
67. After giving instruction about the cause
of the vaginal bleeding to a multigravid
client at 36 weeks’ gestation diagnosed with
placenta previa, the nurse determines that
the teaching has been effective when the
client says that the bleeding results from
which of the following?
A. Diminished clotting factors
B. Exposure of maternal blood sinuses
C. Increased platelet levels
D. A large-for-gestational age fetus
68. A woman in the eighth month of
pregnancy has mild vaginal bleeding
associated with a diagnosis of placenta
previa. In caring for this client, the nurse
would
A. Prepare for a vaginal examination
B. Expect an emergency cesarean birth
C. Keep the woman on bedrest
D. Place the woman in Trendelenburg
position
69. A woman is hospitalized with placenta
previa. Which of the following is most
important for the nurse to teach this client
regarding her condition?
A. Reduce external stimuli in the room
B. Decrease fluid intake
C. Limit physical activity
D. Avoid emotional upset
78. In complete hydatidiform mole, which of
the following karyotypes is typically found?
A. 46XX C. 69XXX
B. 69XXY D. 69XYY
79. When caring for a multigravid client
admitted to the hospital with vaginal
A. Turn the client every 30 minutes
B. Administer oxygen
C. Estimate amount of blood loss
D. Observe for changes in the pattern of
uterine contractions
73. The nurse is caring for a woman with a
diagnosis of abruptio placentae. What
complication of this condition is of most
concern to the nurse?
A. Disseminated intravascular coagulation
syndrome
B. Pulmonary embolus
C. Hypocalcemia
D. Urinary tract infection
74. Which of the following symptoms occurs
with a hydatidiform mole?
A. Heavy, bright red bleeding every 21 days
B. Fetal cardiac motion after 6 weeks’
gestation
C. Benign tumors found in the smooth
muscle of the uterus
D. “Snowstorm” pattern on ultrasound with
no fetus or gestational sac
75. A client is being admitted to the
emergency room for hypovolemia secondary
to hyperemesis gravidarum. Which of the
following factors predisposes a client to the
development of this condition?
A. Trophoblastic disease
B. Maternal age older than 35 years
C. Malnourished or underweight clients
D. Low levels of human chorionic
gonadotropin
76. A 21-year old client has just been
diagnosed with having a hydatidiform mole.
Which of the following factors is considered a
risk factor for developing a hydatidiform
mole?
A. Age in 20s or 30s C.
Primigravida
B. High socioeconomic status D. Prior
molar gestation
77. After suction and evacuation of a
complete hydatidiform mole,
The 28 year-old primigravid client asks the
nurse when she can become pregnant again.
The nurse would advise the client not to
become pregnant again for at least which of
the following time spans?
A. 6 months C. 18
months
B. 12 months D. 24
months
86. The physician orders betamethasone
(Celestone) for a 34-year old multigravid
client at 32 weeks’ gestation who is
experiencing preterm labor. The nurse
explains that this drug is given for which of
the following reasons?
A. Enhance fetal lung maturity
bleeding at 38 weeks’ gestation, which of the
following would the nurse anticipate
administering intravenously if the client
develops disseminated intravascular
coagulation (DIC)?
A. Ringer’s lactate solution C. 5%
dextrose solution
B. Fresh frozen platelets D. Warfarin
sodium
80. Which of the following drugs is the
antidote for Heparin toxicity?
A. Calcium gluconate C.
Hydralazine
B. Phytomenadione D.
Protamine sulfate
Preterm Labor
81. A client is diagnosed with preterm labor
at 28 weeks’ gestation. Later she comes to
the emergency department saying,”I think
I’m in labor.” The nurse would expect her
physical examination to show which of the
following conditions?
A. Painful contractions with no cervical
dilation
B. Regular uterine contractions with cervical
dilation
C. Irregular uterine contraction with no
cervical dilation
D. Irregular uterine contractions with
cervical effacement
82. A client hospitalized for premature labor
tells the nurse she’s having occasional
contractions. Which of the following nursing
interventions would be most appropriate?
A. Teach the client the possible
complications of premature birth
B. Tell the client to walk to see if she can get
rid of the contractions
C. Encourage her to empty her urinary
bladder and drink plenty of fluids, and give
I.V. fluids
D. Notify anesthesia dept. for immediate
epidural placement to relieve the pain
associated with contractions
83. A 31-year old client at 32 weeks’
gestation, is admitted to the hospital with
contractions of moderate intensity occurring
every 3-4 minutes. The client, who has
previously delivered two nonviable fetuses at
30 weeks’ gestation, is crying on admission.
The client asks, “What causes preterm
labor?” After giving instruction about various
risks for preterm labor, the nurse determines
that additional explanation is needed when
the client says that preterm labor is often
associated with which of the following?
A. Age older than 30 years C. Chronic
hypertension
B. Polyhydramnios D. Multifetal
gestation
84. A multigravid client at 34 weeks’
gestation is being treated with
indomethazine to halt preterm labor. If the
B. To counter the effects of tocolytic therapy
C. To treat chorioamnionitis
D. To decrease neonatal production of
surfactant
87. When preparing a multigravid client at
34 weeks’ gestation experiencing preterm
labor for the shake test performed on
amniotic fluid, the nurse would instruct the
client that this test is done to evaluate the
maturity of which of the following fetal
systems?
A. Urinary C.
Cardiovascular
B. Gastrointestinal D.
Pulmonary
PROM
88. A multigravid client at 34 weeks’
gestation visits the hospital because because
she suspects that her water has broken.
After testing the leaking fluid with nitrazine
paper, the nurse confirms that the client’s
membranes have ruptured when the paper
turns which of the following colors?
A. Yellow C. Blue
B. Green D. Red
89. When premature rupture of the
membranes (PROM) occurs, which of the
following provides evidence of the nurse’s
understanding of the client’s immediate
needs?
A. The chorion and the amnion rupture 4
hours before the onset of labor.
B. PROM removes the fetus’ most effective
defense against infection
C. Nursing care is based on fetal viability
and gestational age
D. PROM is associated with malpresentation
and possibly incompetent cervix
90. A primigravid client at 30 weeks’
gestation has been admitted to the hospital
with premature rupture of the membranes
without contractions. Her cervix is 2cm
dilated and 50% effaced. Which of the
following would be a priority assessment for
this client?
A. Red blood cell count C. Urinary
output
B. Degree of discomfort D.
Temperature
91. A primigravid client at 34 weeks’
gestation is experiencing contractions every
3 to 4 minutes lasting for 35 seconds. Her
cervix is 2cm dilated and 50% effaced.
While the nurse is assessing the client’s vital
signs, the client says, “I think my bag of
water just broke.” Which of the following
would the nurse do first?
A. Check the status of the fetal heart rate.
B. Turn the client to her right side
C. Test the leaking fluid with nitrazine paper
D. Perform a sterile vaginal examination
Trauma
93. A primigravid client comes to the clinic
for her initial prenatal visit. She is at 32
weeks’ gestation. The client says that she
has had periodic headaches during her
pregnancy, and that she is continually
bumping into things. The nurse notes
numerous bruises in various stages of
healing around the client’s breasts and
abdomen. Vital signs are: BP=120/80, pulse
72, respirations 18, and FHT 142. Which of
the following responses by the nurse is best?
A. “Are you battered by your partner?”
B. “How do you feel about being pregnant?”
C. “Tell me about your headaches.”
D. “You may be more clumsy due to your
size.”
94. A pregnant woman who is at 32 weeks’
gestation is admitted to the obstetric unit for
observation after an automobile accident.
The client is experiencing slight vaginal
bleeding and mild cramps. The nurse does
which of the following to determine the
viability of the fetus?
A. Inserts an intravenous line and begins an
infusion at 125ml/hr
B. Administers oxygen to the woman via
face mask at 7-10L/min
C. Positions and connects the ultrasound
transducer and the tocotransducer to the
external fetal monitor
D. Positions and connects a spiral electrode
to the fetal monitor for internal fetal
monitoring
PIH
95. Which of the following maternal
complications is associated with obesity in
pregnancy?
A. Anemia C.
Preeclampsia
B. Placenta previa D. Rh
isoimmunization
96. At 32 weeks’ gestation, a 15-year old
primigravid client who is 5 feet, 2 inches tall
has gained a total of 20 pounds, with a 1-
pound gain in the last two weeks. Urinalysis
reveals negative glucose and a trace of
protein. The nurse determines that which of
the following factors increases this client risk
for preeclampsia?
A. Total weight gain C.
Adolescent age group
B. Short stature D.
Proteinuria
97. A primigravid client’s baseline blood
pressure at her initial visit at 12 weeks’
gestation was 110/70mmHg. During an
assessment at 38 weeks’ gestation, which of
the following data would indicate mild
preeclampsia?
A. Blood pressure of 160/100mmHg on two
separate occasions
B. Proteinuria, more than 5 grams in 24
hours
100. Magnesium sulfate is given to clients
with pregnancy-induced hypertension to
prevent seizure activity. Which of the
following magnesium levels is therapeutic for
clients with preeclampsia?
A. 4 to 7 mEq/L C. 10 to 12
mEq/L
B. 8 to 10 mEq/L D. greater
than 15 mEq/L
101. A client is receiving magnesium
sulfate for severe preeclampsia. Which of
the following adverse effects is associated
with magnesium sulfate?
A. Anemia C.
Hyperreflexia
B. Decreased urine output D. Increased
respiratory rate
102. Which of the following drugs is the
antidote for magnesium toxicity?
A. Calcium gluconate C.
Hydralazine
B. Naloxone D.
Protamine sulfate
103. A client is receiving magnesium
sulfate and asks the nurse if the drug will
affect her baby. What would be the best
response?
A. “No, the placenta acts as a barrier to the
medication.”
B. “The doctor wouldn’t order it if it would
hurt the baby.”
C. “It has a minor effect; however, the
effects of a convulsion are much more
severe.”
D. “We don’t know if this drug crosses the
placental barrier.”
104. When developing the teaching plan for
a primigravid client at 30 weeks’ gestation
diagnosed with mild preeclampsia who is
being treated at home, which of the following
would the nurse identify as the most
appropriate client-centered goal?
A. Return visit to the prenatal clinic in
approximately 4 weeks
B. Decreased edema after 1 week of a low-
protein, low-fiber diet
C. Bed rest on the left side during the day,
with bathroom privileges
D. Immediate reporting of adverse reactions
to magnesium sulfate therapy
105. After instructing a primigravid client at
38 weeks’ gestation about how preeclampsia
can affect both the client and the growing
fetus, the nurse realizes that the client needs
additional instruction when she says that
preeclampsia can lead to which of the
following?
A. Hydrocephalic infant C. Intrauterine
growth retardation
B. Abruptio placentae D. Poor
placental perfusion
C. Serum creatinine concentration of
1.4mg/dl
D. Weight gain of 2 pounds in the last week
98. Magnesium sulfate is given to pregnant
clients to prevent which of the following
conditions?
A. Hemorrhage C.
Hypomagnesemia
B. Hypertension D. Seizures
99. Which of the following would the nurse
identify as the priority to achieve when
developing the plan of care for a primigravid
client at 38 weeks’ gestation who is
hospitalized with severe preeclampsia and
receiving intravenous magnesium sulfate?
A. Decreased generalized edema within 8
hours
B. Decreased urinary output during the first
24 hours
C. Sedation and decreased reflex excitability
within 48 hours
D. Absence of any seizure activity during the
first 48 hours
109. A 28-year old multigravid client at 37
weeks’ gestation arrives at the emergency
department with a blood pressure of
160/104mmHg and 3+ reflexes without
clonus. The client, who is diagnosed with
severe preeclampsia, asks the nurse, “What
is the cure for my high blood pressure?”
Which of the following would the nurse
identify as the primary cure?
A. Administration of glucocorticoids
B. Vaginal or cesarean delivery of the fetus
C. Sedation with phenytoin (Dilantin)
D. Reduction of fluid retention with thiazide
diuretics
110. A 16-year old primigravid client at 37
weeks’ gestation with severe preeclampsia is
in early active labor. The client’s blood
pressure is 164/110mmHg. Which of the
following would alert the nurse that the
client may be about to experience a seizure?
A. Decreased contraction intensity
B. Decreased temperature
C. Epigastric pain
D. Hyporeflexia
111. As the nurse enters the room of a
newly admitted primigravid client diagnosed
with severe preeclampsia, the client begins
to experience a seizure. Which of the
following should the nurse do first?
A. Insert an airway to improve oxygenation
B. Note the time when seizure begins and
ends
C. Call for immediate assistance
D. Insert a padded tongue blade in her
mouth
106. When teaching a multigravid client
diagnosed with mild preeclampsia about
nutritional needs, which of the following
types of diet would the nurse discuss?
A. High- residue diet C. Regular diet
B. Low-sodium diet D. High-protein
diet
107. When reviewing the prenatal records
of a 16-year old primigravid client at 37
week’ gestation diagnosed with severe
preeclampsia, the nurse would interpret
which of the following as most indicative of
the client’s diagnosis?
A. Blood pressure of 138/94mmHg
B. Severe blurring of vision
C. Less than 2 gram protein in a 24-hour
urine sample
D. Weight gain of 0.5 pound in 1 week
108. A primigravid client with severe
preeclampsia exhibits hyperactive, very brisk
patellar reflexes with ankle clonus present
and two movements after the reflex. The
nurse documents these findings as which of
the following?
A. 1+ C. 3+
B. 2+ D. 4+
117. Which of the following doses of Rho (D)
immune globulin (RhoGAM) is appropriate for
a pregnant client at 28 weeks’ gestation?
A. 50mcg in a sensitized client
B. 50mcg in an unsensitized client
C. 300mcg in a sensitized client
D. 300mcg in an unsensitized client
118. Rh isoimmunization in a pregnant
client develops during which of the following
conditions?
A. Rh-positive maternal blood crosses into
fetal blood, stimulating fetal antibodies
B. Rh-positive fetal blood crosses into
maternal blood, stimulating maternal
antibodies
C. Rh-negative fetal blood crosses into
maternal blood, stimulating maternal
antibodies
D. Rh-negative maternal blood crosses into
fetal blood, stimulating fetal antibodies
Multiple Pregnancy
119. One of the most common causes of
hypotonic uterine dystocia is
A. Twin gestation C. Maternal
anemia
B. Pelvic contracture D. PIH
120. Usually, individual twins will grow
appropriately and at the same rate as
singletons until how many weeks’ gestation?
A. 16-18 wks C. 30-32
wks
B. 18-22 wks D. 38-40
wks
121. In twin-to-twin transfusion syndrome,
112. If a client at 36 weeks’ gestation with the arterial circulation of one twin is in
eclampsia begins to exhibit signs of labor communication with the venous circulation
after an eclamptic seizure, for which of the of the other twin. One fetus is considered
following would the nurse assess? the “donor” twin and one becomes the
A. Abruptio placentae C. Placenta “recipient” twin. Assessment of the recipient
accreta twin would most likely show which of the
B. Transverse lie D. Uterine following conditions?
atony A. Anemia C.
Polycythemia
113. The nurse evaluates that the danger of B. Oligohydramnios D. Small
a seizure in a client with eclampsia ends fetus
A. After labor begins C. 24 hours
postpartum 122. A nurse in the prenatal clinic is
B. After delivery occurs D. 48 hours monitoring a client who is pregnant with
postpartum twins. The nurse monitors the client most
closely for which complication that is most
114. For a multigravid client at 39 weeks’ likely associated with a twin pregnancy?
gestation with suspected HELLP syndrome, A. Maternal anemia C.
the nurse would immediately notify the Hemorrhoids
physician for which of the following B. Postterm labor D.
laboratory test results? Gestational diabetes
A. Hyperfibrogenemia C. Decreased
liver enzymes 123. The presence of multiple gestation
B. Thrombocytopenia D. should be detected as early as possible and
Hypernatremia the pregnancy managed with high risk in
mind because
115. For a multigravid client at 39 weeks’ A. Postpartum hemorrhage is an expected
gestation with suspected HELLP syndrome, complication
the nurse would immediately notify the B. Perinatal mortality is two to three times
physician for which of the following greater than single births
laboratory test results? C. Maternal mortality is much higher during
A. Hyperfibrogenemia C. Decreased the prenatal period in multiple gestation
liver enzymes D. The mother needs time to adjust
B. Decreased RBC count D. psychologically and physiologically after
Hypernatremia delivery

Isoimmunization Fetal Death

116. Which of the following answers best
describes the stage of pregnancy in which
maternal and fetal blood are exchanged?
A. Conception
B. 9 weeks’ gestation when the fetal heart is
well developed
C. 32 to 34 weeks’ gestation (third
trimester)
D. Maternal and fetal blood are never
exchanged
124. A nurse receives report at the
beginning of the shift regarding a client with
an intrauterine fetal demise. On assessment
of the client, the nurse expects to note which
of the following?
A. Elevated blood pressure, proteinuria, and
edema
B. Regression of pregnancy symptoms and
absence of fetal heart tones
C. Uterine size greater than expected for
gestational age
D. Intractable vomiting and dehydration