MATERNAL AND CHILD NURSING

INSTRUCTIONS: Select the correct answer for each of the following questions. Mark only one answer for each item by making the
box corresponding to the letter of your choice on the answer sheet provided.
1.

The normal position of the uterus is:

A. Anteroflexion
B. Retroversion
C. Anteversion
D. Anteversoflexion

2.

Which organ is responsible for ovulation?

A. Uterus
B. Fallopian tube
C. Ovary
D. Vagina

3.

Which among the following is TRUE of progesterone?

A. Stimulation of follicles for ovulation to occur
B. Development of female reproductive organs
C. Preparation of the uterus to receive a fertilized ovum
D. Establishment of the secondary male sex characteristics

4.

Complete organogenesis takes place by the end of ______ gestation?

A. 1 month
B. 2 months
C. 3months
D. First trimester

5.

Which of the following best describes the basal body temperature during the ovulation?
A. during ovulation & slightly drops during the luteal phase
B. during proliferative phase then increase following ovulation and remains high
C. Decrease during the pre-menstrual phase and increase following ovulation and remains high
D. Decrease during ovulation, then increase following ovulation and decrease during the luteal phase

6.

Once the sperm is deposited in the vagina, the sperm is capable of fertizing the ovum for a period of _____ hours?
A. 12 24 hours
B. 24 36 hours
C. 48 72 hours
D. 72 90 hours

7.

A pregnant client asked you about autosomes, which she has read about. You will tell her that autosomes:
A. Are sex chromosomes
B. Carry the X and Y chromosomes
C. Carry the babys hereditary traits
D. Contain the enzyme hyaluronidase

8.

The most common site of implantation of the fertilized ovum is in the ________ portion of the uterus:
A. Anterior upper
B. Posterior upper
C. Anterior lower
D. Posterior lower

9.

The outer fetal membrane that provides nourishment to the embryo is the:
A. Langhans layer
B. Amnion
C. Chorion
D. Yolk sac

10. Oxygen moves from maternal to fetal blood by moving from an area of greater concentration to an area of lesser concentration.
This movement is referred to as:
A. Facilitates Transport
B. Diffusion
C. Active transport
D. Pinocytosis
11. The best advice a nurse can give to a pregnant client on the first trimester of pregnancy is:
A. Cut down on drugs, alcohol and cigarettes
B. Administer all drugs and refrain from smoking and ingesting alcohol
C. Avoid smoking, alcohol consumption and dont take any drugs without doctors order.
D. Take only prescription drugs especially in the 2nd and 3rd trimester
12. After 12wks of pregnancy, the chief source of estrogen and progesterone is the:
A. Placenta
B. Adrenal Cortex

C. Corpus luteum
D. Anterior hypophysis
13. In fetal circulation, the fetal structure that directs the blood from the placenta to the IVC is:
A. Umbilical artery
B. Umbilical vein
C. Ductus venosus
D. Ductus arteriosus
14. The fetal heart begins to beat by the end of ______ lunar month:
A. First
B. Second
C. Third
D. Fourth
15. On her first clinic visit, a pregnant client tells the nurse that she is nauseated in the morning and sometimes vomits her breakfast.
The nurse should suggest that 30 minutes before arising, she should:
A. Eat some crackers and jam
B. Nibble on some potato chips or corn chips
C. Drink a glass of warm milk
D. Chew a stick of gum
Situation: A newly wed couple is expecting their first baby. They are attending prepared childbirth classes. Several exercises were
taught in preparation for the child birth.
16. The nurse explained to the couple that the most important expected outcome of childbirth preparation is to:
A. Make labor painless by eliminating fear of the unknown
B. Help husband feel useful during birth
C. Prevent woman from taking analgesics that may harm the fetus during labor
D. Provide possible tools to help the woman cope with the labor process.
17. Another exercise that pregnant client was taught to practice is the pelvic rock. This will be helpful at any time in her life if she
develops:
A. Leg cramps
B. Urinary incontinence
C. Low back pain
D. Hemorrhoids
Situation: A pregnant client sought consultation for the first time, Nov.25.Her chief complaints were body malaise, nausea and
vomiting. Based on the nursing history, her last menstrual period was July 25-28. Her OB history is as follows:
Delivered NSD, live baby boy, AOG 38wks
Ectopic pregnancy
Delivered NSD, live baby boy, died after 3 days, AOG 3132 wks
Delivered NSD, live baby boy, AOG 39 wks
Miscarriage D&C was done
Presently pregnancy
18. From her OB history, she is considered a :
A. Multipara
B. Grand multipara
C. Multigravida
D. Grand Multigravida
19. Her gravity and parity is:
A. G6P6
B. G6P3
C. G6P4
D. G6P5
20. Her AOG is:
A. 8-9 wks
B. 10-11 wks
C. 16 17 wks
D. 17 18 wks
21. Her nausea and vomiting is considered as:
A. Normal
B. Abnormal
22. Which of the following data given by the client is most indicative of pregnancy?
A. Body Malaise
B. Amenorrhea
C. Nausea & Vomiting
D. Quickening

23. If pap smear is to be done, the nurse should prepare the ff articles except:
A. Goose neck lamp
B. Slides
C. microscope
D. Speculum
24. The clients next clinic visit will be on:
A. Dec.3
B. Dec.10
C. Dec.25
D. Anytime
Situation: Another client, Mrs. Q, came to the ante-partal clinic. She is 16 years old, pregnant for the first time and is on her 24 th to 25th
week of pregnancy.
25. She further told the nurse that she has gained 4lbs in one month and plans to diet by skipping meals. Which response would be
most appropriate?
A. Have you noticed that your hands and feet have become swollen?
B. You should cut down on high calorie foods like candies, cakes and ice cream but you should not skip meals
C. Your weight gain is just right for this period of pregnancy, you are doing fine
D. You are supposed to gain a lot of weight. Its good for the baby. Youll lose it all after the baby is born
26. Leopolds maneuver was done. The purpose of which is to determine:
1. Fetal back
2. Fetal presentation
3. Fetal lie
4. Fetal descent
A.
B.
C.
D.

1, 2, 3
1, 3, 4
2, 3, 4
All

27. Mrs. Q complained that she has a hemorrhoid and asked how her anal discomfort can be relieved. The nurse best response would
be:
A. To use an ice bag
B. To avoid knee chest position
C. To purchase a hemorrhoid suppository
D. Not to attempt to reinsert the hemorrhoid herself
28. She also asked the nurse if she needs to take her iron supplement. The Nurse response should be:
A. Let us plan a menu that will provide extra iron you need during this semester
B. Iron is a mineral and is not to be considered a medication
C. Let us check the results of your blood test because if you are not anemic, you will not need extra iron
D. Iron is prescribed because it is very difficult to obtain enough palatable distribution
29. Mrs. Q has stopped drinking orange juice because she believes that it gives her heartburn. Which of the ff statement of the nurse
would be most appropriate?
A. If you take your multivitamins everyday, you can skip the orange juice
B. Try drinking your orange juice after eating and not when you are hungry
C. Ill give you a list of other foods that you can eat instead
D. Although a lot of pregnant women get heartburn from orange juice, you really do need it. The heartburn will only last for a
short time.
30. When discussing nutrition, Mrs. Q asks the nurse if she must continue to drink 5 cups of milk a day. Which response would be
most appropriate?
A. 4 cups are enough, but if you need to nurse the baby, you will need 5 cups/day
B. 3 cups and add 5tbsp of powdered milk to soup and eat a slice of cheese
C. 8 cups a day, because you are still a teenager
D. 4 cups plus meat, fruits and yellow vegetables
31. An ultrasound has been ordered for Mrs. Q. Before she leaves the unit, what instructions should the nurse give her?
A. Void before the procedure
B. Not to eat from midnight until after the procedure is done
C. Ingest an adequate amount of water
D. Avoid perineal flushing 2 hrs before the procedure
Situation: A client had been admitted to the labor and delivery suite. Her uterine contractions are 5 minutes apart lasting 60 sec. The
fetal monitor has been applied. The client was practicing the breathing techniques she has learned.
32. Vaginal examination reveals 5cm dilatation. Which breathing technique should the nurse instruct her to use?
A. Shallow,light
B. Slow,Chest
C. Rythmic,, abdominal
D. Rapid, panting

33. The nurse recognizes that the patient is having a problem using the breathing technique effectively when she states:
A. My fingers are tingling
B. I have to vomit
C. My lips feel dry
D. I have to push
34. 10 hours have passed since the client was admitted at the labor room and her contractions continued to be mild and irregular.
Oxytocin 10 U in 1000 CC of Normal Saline was administered via piggyback and infused at the rate of 8 drops / minute. The
nurse observed 2 contractions, 70 seconds apart lasting 1 minutes. The nurse should:
A. Lower the rate to 3 drops / min
B. Maintain the same flow rate
C. Stop the infusion & call the physician
D. Lower the rate of flow to 2 gtts/min
35. About 30 minutes, the client tells the nurse that she has the urge to push. After a vaginal exam that indicates that her cervix is
fully dilated, the nurse should instruct her to:
A. Breathe more repeatedly with her thoracic muscles and bear down
B. Lie on her side and concentrate on total relaxation while breathing deeply
C. Take a deep breath; hold it for a count of 10 and push. Repeat until contraction ends.
D. Just try to urinate and then continue with the panting and blowing type of breathing.
36. The clients EDC was supposed to be 2 weeks ago. The doctor ordered an Oxytocin Challenge Test
ordered to help determine:
A. Fetal Age
B. Maternal pelvic adequacy
C. Fetal well being
D. Natural uterine irritability

( OCT ). The OCT was

37. Several hours later, the clients cervix is 5 cm dilated. She tells the nurse that she has severe back pain. The nurse assesses that the
presentation of the fetus is:
A. Breech
B. Occipito anterior
C. Face
D. Occipito posterior
38. Bio Physical Scoring reveals equivocal findings,This means that the obstetrician gave a score of:
A. 8/8
B. 6/8
C. 4/8
D. 2/8
39. The widest anterior/ posterior diameter of the birth canal is known as the:
A. Bi-ischial diameter
B. Diagonal conjugate
C. Transverse diameter
D. Transverse conjugate
40. During labor, station +1 indicates that the presenting part is:
A. On the perineum
B. High in the false pelvis
C. Slightly below the ischial spine
D. Slightly above the ischial spine
41. One hour after the delivery, the client informs the nurse that her episiotomy is very painful. The nurse observes that it is
edematosis and the sutures are intact. The nurse should then:
A. Encourage her to lie on her side
B. Provide her with a sitzbath as ordered
C. Notify her obstetrician
D. Offer her a rubber ring (doughnut) for sitting
42. The client asks the nurse how she can best relieve breast engorgement. After assessing, her breast feels firm and warm, the nurse
should suggest that she:
A. Give the baby formula for a day or two until her breast soften
B. Apply warm compress about 10 minutes before each feeding
C. Practice previously learned inhalation techniques and exercises
D. Apply ice packs immediately after each feeding
43. During discharge planning, the client asks the nurse which weight loss diet may she utilize to return to her pre-pregnant weight.
The nurse should counsel that she:
A. Return to her pre-pregnant calorie intake after lactation has been fully established
B. Eat the same amount as during pregnancy but eliminate cakes and sweets
C. Not consider dieting until after she has stopped breast feeding
D. Plan a weight watchers type of diet after 6 post partum weeks

44. To a client seeking advice about the use of IUD, the nurse explains that the IUD provides contraception by:
A. Blocking the cervix
B. Increase the mobility of the uterus
C. Preventing the sperm from reaching the uterus
D. Setting a non-specific inflammatory reaction in the endometrium
45. The nurse should explain that a very common problem that has been associated with the use of IUD is:
A. Uterine perforation
B. Discomforts associated with coitus
C. Developments of vaginal infections
D. Spontaneous expulsion of the device
Situation: Mrs. Q is having her first baby and is at term. She is having uterine contractions when admitted to the hospital.
46. Which of the following questions that the nurse asks Mrs. Q upon admission is least pertinent?
A. When did you last eat?
B. Have you ever had an enema?
C. Have your membrane ruptured already?
D. When did your contraction start?
47. She is to have a vaginal examination. The nurse should help prepare for Mrs. Qs vaginal examination by:
A. Having sterile gloves ready
B. Empty her bladder
C. Placing the patient in lithotomy position
D. Cleaning the patients vulva
48. During which of the following stages of labor should the nurse anticipate that Mrs. Q will ordinarily need the most
encouragement and support?
A. During the early part of stage 1
B. During the transition part of stage 1
C. During stage 2
D. During stage 3
49. Mrs. Q begins ambulation about 6 hours after delivery. This type of activity is especially beneficial to help prevent problems
associated with the patients:
A. Circulatory system
B. Process of involution
C. Milk producing ability
D. Musculo-skeletal system
50. Five days after delivery, the nurse notes that Mrs. Q is having reddish vaginal discharge with clots, This assessment finding is
indicative of:
A. Bleeding compication
B. Infection
C. Normal findings
D. Laceration
51. What is the earliest sign of puberty that may be observed in a 10 year old?
A. Fat deposition
B. Appearance of pubic hair
C. Menarche
D. Breast budding
52. Hormones influence a womans sexual maturation. Of importance is progesterone, which is normally secreted in relatively large
quantities by the:
A. Edometrium
B. Pituitary Gland
C. Adrenal cortex
D. Corpus luteum
53. If a woman has a 25 day cycle, ovulation occurs on what day?
A. 11th
B. 12th
C. 13th
D. 14th
54. Which of the following describes menstrual blood?
A. It contains clots and mucus
B. It is odorless and dark red in color
C. It is non-foul emitting, saturating a pad in less than an hour
D. It bears a fleshy odor and contains endometrial cells
55. Which is not true regarding the human sexual response?
A. In general, males have one basic pattern, whereas females may have variable responses
B. Because of the homologous male and female structures, male and female responses are more alike than different

C. Sympathetic stimulation causes erection, whereas para-sympathetic causes ejaculation.

D. Males have a refractory period which makes them incapable of multiple orgasms
56. During the process of gametogenesis, the male and female sex cells devide and each mature sex cell contain:
A. 22 pairs of autosomes nuclei
B. 46 pairs of autosomes nuclei
C. Diploid number of chromosomes
D. Haploid number of chromosomes
57. A client asks what determines her babys sex. You will explain that:
A. Zygote contains 22 pairs of autosomes that determine the sex
B. Union of X and Y chromosomes determines the sex
C. Zygote formed within 24 hours of ovulation will probably be female
D. The sex of the baby is determined by the sperm
58. A client sought consultation because of missed periods. She underwent a urine test for pregnancy. You know that this is based on
the presence of which hormone?
A. Progesterone
B. Lactogen
C. HCG
D. HPL
59. The placenta does not produce:
A. Somatotropin
B. Chorionic gonadotropin
C. FSH
D. Progesterone
60. You will caution a pregnant client against exposure of teratogens. The greatest hazard to the baby is during the period of the:
A. Ovum
B. Embryo
C. Fetus
D. Zygote
61. A pregnant client expresses her concern about her dark nipples. The nurse explains that this adaptation is due to the hyperactivity
of the:
A. Ovaries
B. Thyroid gland
C. Adrenal gland
D. Pituitary gland
62. In fetal development, growth is most rapid in the:
A. 1st trimester
B. 2nd trimester
C. 3rd trimester
D. Implantation period
63. Fetal movement will first be felt by the pregnant women
A. 2 weeks before delivery
B. 4 wks before delivery
C. At about 8 12 wks AOG
D. At about 16 20 wks AOG
64. Which are true of fetal development?
1. The fetus is able to respond to sound
2. The fetus acquires maternal antibodies by placental transfer
3. The presence of surfactants in the amniotic fluid can be used to determine lung maturity
4. The last three months of pregnancy allows the fetus to put on weight.
A.
B.
C.
D.

1, 2, 3
1, 3, 4
2, 3, 4
all

65. A client complains of constipation and occasional leg cramps. Which of the ff measures would be most appropriate to minimize
constipation?
1. Drink adequate amount of milk
2. Avoid intake of caffeine containing beverage
3. Take 10 20 cc of mineral oil to soften stools
4. Eat fruits like papaya, prunes, pineapple
A.
B.
C.
D.

4 only
1&2
374
All

Situation: A newly-wed couple is expecting their first baby. They are attending prepared childbirth classes. Several exercises were
taught in preparation for the child birth.
66. The nurse told the pregnant client to practice Kegel exercise after she had the baby to:
A. Limit lochial flow
B. Relieve episiotomy pain
C. Reduce upper leg varicose veins
D. Alleviate after pains
67. In preparation for child birth, which exercises will strengthen and stretch her perineal muscles?
1. Squatting
2. walking
3. Kegels exercise
4. Tailor sitting
A.
B.
C.
D.

1, 4
1, 3, 4
2, 3, 4
All

Situation: A pregnant client sought consultation for the first time. Her chief complaints were body malaise, nausea and vomiting.
Based on the nursing history, her last menstrual period was Oct. 25-28. Her OB history are as follows:
Delivered NSD, live baby boy, AOG 36 wks
Miscarriage D & C was done
Delivered NSD, live baby boy, died after 3 days, AOG 43 wks
Delivered NSD, live baby boy, AOG 39 wks
Miscarriage D&C was done
Present pregnancy
68. Her numerical OB history is ( T-P-A-L )?
A. 2-1-2-3
B. 2-1-2-2
C. 1-2-2-3
D. 1-2-2-2
69. Using the Naegels Rule, her EDC will be on:
A. August 1
B. July 3
C. July 30
D. August 4
70. Using the Bartholonews rule. Her fundic height is expected to be:
A. At the level of symphysis pubis
B. above the symphysis pubis
C. above the symphysis pubis
D. below the umbilicus
71. The best way to relieve her nausea and vomiting is to:
A. Take ice chips
B. Have adequate rest
C. Limit fluid intake
D. eat in small amount, but frequently
72. Which of the following procedures would the client undergo during her visit?
1. Vaginal speculum exam
2. Bimanual exam
3. Anthropometric measurements
4. FHT Auscultation
A.
B.
C.
D.

3, 4
1, 2, 3
1, 2, 4
All

73. The client refuses to return to the clinic for her scheduled visit. The nurse tells the client that each visit is important:
A. Even though problems rarely occur during the second trimester
B. Because toxemia usually occurs at this and can be controlled if recognized early
C. Even though she had no problems and her nausea and vomiting disappeared
D. Because at her age complications that could affect her and the baby are more likely to occur
Situation: Another client, Mrs. K, came to the ante-partal clinic. She is 18 years old, pregnant for the first time and is on her 34 th to 35th
week of pregnancy.

74. Mrs. K asked the nurse how much weight gain she can expect to gain during her pregnancy. The nurse most appropriate response
would be:
A. The average weight gain during pregnancy should be 25 30 lbs.
B. Depending on the height and pre-pregnant weight, the average weight gain should be between 10 12 kgs.
C. Nutrition is very important to the fetus that maternal weight gain need not be restricted
D. The caloric intake will be restricted to limit weight gain thus conserving cardiac load
75. The average weight gain for Mrs K is:
A. 1 kg / wk
B. 1 lb / wk
C. 0.5 kg / month
D. 2 lbs / month
76. During leopolds maneuver, a hard rounded mass was palpated at the fundus and a nodular uneven surface at the left abdominal
wall. With these findings, the FHR can be heard at what part of the mothers abdomen?
A. LUQ
B. LLQ
C. RUQ
D. RLQ
77. She further verbalizes that when her mother was pregnant, she had varicose veins that eventually necessitated surgery. She asked
how that condition can be prevented. The nurse can tell her:
A. Sit with the legs together and with the knees higher than the pelvis
B. Wear support stockings day and night
C. Walk slowly on level grounds only
D. Elevate the legs above the hips whenever possible
78. Iron pills are best absorbed in the GIT if taken with a glass of juice rich in:
A. Vit. A
B. Vit. C
C. Vit. B complex
D. Calcium
79. Mrs. K and the nurse plan menu that would increase the clients iron consumption. Which snack food has high iron content?
A. Banana, cheddar cheese, wheat wafers
B. Carrot, hard-boiled egg, milk with rye toast
C. Prunes, mixes peanuts and raisins, liver spread on wheat roast
D. Celery stalk, apple, cottage cheese, orange marmalade on rye toast
80. If Mrs. Ks fundic height is 25 cm, what could be her AOG in weeks?
A. 25 26 wks
B. 28 29 wks
C. 21 22 wks
D. 30 31 wks
81. Urinalysis was also ordered. Which of the following is not true about urine collection?
A. An early midterm urine is collected
B. Receptacle for collection should be sterile
C. Avoid coitus 12 24 hrs before the collection
D. Perineal flushing is done prior to collection
Situation: A client had been admitted to the labor and delivery suite. Her uterine contractions are 5 minutes apart lasting 35 sec. The
fetal monitor has been applied. The client was practicing the breathing techniques she has learned.
82. After a contraction, what is the first instruction the nurse should give the client?
A. Turn on your left side
B. Close your eyes and relax
C. Take a cleansing breath
D. Take some ice chips
83. 3 hours later, the nurse offers the client a bedpan. The client tells the nurse that she does not have the urge to void. The nurse
should:
A. Ask her to call for help when she has the need to urinate
B. Encourage her to void by turning on the tap water and ensuring privacy
C. Tell her that if she cannot void she will have to be catheterized
D. Increase the rate of IV flow to 150 cc/ hr
84. When her cervix has dilated to 8 cm. the client tells her husband and the nurse that the breathing technique she has been using no
longer controls the pain. The nurse should tell her that she has entered the transition phase of labor and that she should:
A. Assume a sitting position while focusing on her concentration point
B. Begin the shallow panting and blowing breathing pattern
C. Use the abdominal muscles while breathing more rapidly
D. Continue the same breathing pattern and that a small amount of analgesic will be administered

85. During the transitional phase of labor, the clients membrane ruptured. The color of the amniotic fluid is green. The FHR on the
electronic monitor drops to 110 beats/min during the next contraction and returns to 140 beats / min. 1 minute after the
contraction was over. The nurse should:
A. Inform the client that labor is progressing as expected
B. Notify the doctor & record the findings
C. Check the amniotic fluid for meconium with nitrazine paper
D. Observe the fetal heart rate during the next 2 contractions
86. When admitted to the labor room, she asks the nurse what can be done to ease her pain and help labor progress more rapidly. How
should the nurse respond?
A. Every womans labor is different & the doctor will have to decide if you need any medicine
B. First labor is usually long and difficult. Well try to make you as comfortable as possible
C. The doctor will prescribe a medicine to help you rest. When you awaken your contraction should become more regular.
D. Oxytocin is usually administered. It will make your contraction more effective and allow labor to progress more rapidly.
87. Which comfort measure is most effective for relieving the clients pain during contraction:
A. Effleurage
B. Sitting upright
C. Sacral pressure
D. Rapid Breathing
88. The ischial spine is designated as an important landmark in labor & delivery because the distance between the spine is:
A. The narrowest diameter of the pelvis
B. The widest measurement of the pelvis
C. A measurement of the floor of the pelvis
D. A measurement of the inlet of the birth canal
89. The client in active labor begins to tremble, becomes very tense with contractions and is quite irritable. She frequently states, I
cannot stand this minute any longer . This kind of behavior maybe indicative of the fact that the client:
A. Is entering the transition phase of labor
B. Needs immediate administration of an analgesic or aesthetic.
C. Has been very poorly prepared for labor in the parents class
D. Is developing some abnormality in terms of uterine contractions.
90. During the period of induction of labor with oxytocin, a client should be observed carefully for signs of:
A. Severe pain
B. Uterine atony
C. Hypoglycemia
D. Prolapse of the umbilical cord
91. She also tells the nurse that she finds it difficult to sit. The nurse should then:
A. Discourage her to ambulate
B. Provide her a cushion when sitting
C. Encourage her to squeeze the buttocks together
D. Encourage her turn to sides every 1- 2 hours
92. The nurse evaluates that the client understands the basic principle involved in breast care, especially during engorgement, when
she is observed:
A. Wearing a tight, supportive brassiere between feedings
B. Using a breast pump to collect milk for bottle feedings
C. Exercising by rotating her extended arms in wide swings
D. Using a nipple should force the baby to feed just 5 minutes at each breast
93. The family planning nurse, when asked about the BBT, explains that its efficiency as a form of birth control rests on some factors.
Among these is the:
A. Presence of stress
B. Length of abstinence
C. Age of those involved
D. Frequency of intercourse
94. The nurse teaches further that the most frequent side effect associated with the use of IUD is:
A. Ectopic pregnancy
B. Expulsion of IUD
C. Uterine rupture
D. Excessive menstrual flow
95. A biphasic anti-ovulatory medicine of combined progestin & lactogen is prescribed for a female client. The nurse instructing the
client about the medicine should include the need to:
A. Report any vaginal bleeding
B. Have bimonthly pap smear
C. Increase her intake of calcium
D. Temporarily restrict sexual activities

Situation: Mrs. Q is having her first baby and is at term. She is having uterine contractions when admitted to the hospital.
96. Mrs. Q thinks her membranes have ruptured but she is not sure. The nurse in charge performs a Nitrazine test. The primary
purpose of this test is to:
A. Difference between urine and amniotic fluid
B. Differentiate between amniotic fluid and vaginal mucus
C. Determine whether there is blood in the amniotic fluid
D. Determine whether there is meconium in the amniotic fluid
97. The nurse who performs the vaginal exam on Mrs. Q recorded that the cervix is 4 cm dilated. In terms of cervical dilatation, it can
be interpreted that Mrs. Q is:
A. At a very early stage of dilatation
B. Approaching half of the total amount of dilatation
C. Nearing total dilatation
D. In labor but an interpretation of dilatation cannot be made with available information
98. Shortly after delivery, Mrs. Q complains of chilliness and says she is hungry. This could be due which of the following reasons:
A. Patient is reacting unfavorably to an analgesic used during labor
B. Patients hormonal system is in a period of adjustment after delivery
C. Patient has experienced a rapid cooling of her body immediately after delivery
D. Patients temperature control center is temporarily very sensitive to environmental coolness after delivery
99. Mrs. Q. has a temperature of 37.8 centigrade on her first postpartum day. The most likely reason for this elevated temperature is
that Mrs. Q is:
A. Experiencing dehydration
B. Experiencing subinvolution
C. Developing a breast infection
D. Developing a urinary infection
100. The nurse uses measures to help Mrs. Q to void after delivery. If Mrs. Q is allowed to have an over-distended bladder, she is at
risk for developing:
A. A hematoma
B. Thrombophlebitis
C. Bladder herniation
D. Bladder infection