CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela

Prepared by:

EARL OMAR A. TUMANGUIL, RN, MSN

GENERAL INSTRUCTIONS:

1. This test questionnaire contains 100 questions. 2. This exam is for 2 hours only. You must pass your answer sheet when the time allotted has
elapsed. Answer sheets that will be passed after the allotted time will NOT BE ACCEPTED.

3. Shade only (1) box for each question on your answer sheets. Two or more boxes shaded will
invalidate your answer. 4. Do not put any unnecessary markings on the answer sheet. Doing so will invalidate your answers. 5. Keep the answer sheets neat and clean. DO NOT MUTILATE. START HERE! 1. Elvira asks you which fetal position and presentation are ideal. Your best answer would be: a. Right Occipitoanterior full flexion b. Left transverse anterior in moderate flexion c. Right Occipitoposterior with no flexion d. Left Occipitoposterior with no flexion 2. Elvira is having long and hard uterine contractions. What length of contractions would you report as abnormal? a. Any length over 30 seconds b. A contraction over 90 seconds in length c. A contraction that peaks at 20 seconds d. A contraction shorter than 60 seconds 3. The assessment findings revealed that a patient is having cord compression. Which decelerations correlate to this finding? a. Early Decelerations b. Late Decelerations c. Middle Decelerations d. Variable Decelerations 4. On which of the following areas would the nurse expect to observe chloasma? a. Breast, areola, and nipples b. Chest, neck, arms, and legs c. Abdomen, breast, and thighs d. Cheeks, forehead, and nose 5. A pregnant client states that she waddles when she walks. The nurses explanation is based on which of the following as the cause? a. The large size of the newborn b. Pressure on the pelvic muscles c. Relaxation of the pelvic joints d. Excessive weight gain 6. Which of the following represents the average amount of weight gained during pregnancy? a. 12 to 22 lb b. 15 to 25 lb c. 24 to 30 lb d. 25 to 40 lb 7. When talking with a pregnant client who is experiencing aching swollen, leg veins, the nurse would explain that this is most probably the result of which of the following? Thrombophlebitis Pregnancy-induced hypertension Pressure on blood vessels from the enlarging uterus The force of gravity pulling down on the uterus 8. Cervical softening and uterine souffle are classified as which of the following? Diagnostic signs Presumptive signs

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
Probable signs Positive signs 9. Which of the following would the nurse identify as a presumptive sign of pregnancy? a. Hegar sign b. Nausea and vomiting c. Skin pigmentation changes d. Positive serum pregnancy test 10. Which of the following common emotional reactions to pregnancy would the nurse expect to occur during the first trimester? a. Introversion, egocentrism, narcissism b. Awkwardness, clumsiness, and unattractiveness c. Anxiety, passivity, extroversion d. Ambivalence, fear, fantasies 11. During which of the following would the focus of classes be mainly on physiologic changes, fetal development, sexuality, during pregnancy, and nutrition? a. Prepregnant period b. First trimester c. Second trimester d. Third trimester 12. A client LMP began July 5. Her EDD should be which of the following? a. January 2 b. March 28 c. April 12 d. October 12 13. Which of the following fundal heights indicates less than 12 weeks gestation when the date of the LMP is unknown? a. Uterus in the pelvis b. Uterus at the xiphoid c. Uterus in the abdomen d. Uterus at the umbilicus 14. Which of the following characteristics of contractions would the nurse expect to find in a client experiencing true labor? a. Occurring at irregular intervals b. Starting mainly in the abdomen c. Gradually increasing intervals d. Increasing intensity with walking 15. During which of the following stages of labor would the nurse assess crowning? a. First stage b. Second stage c. Third stage d. Fourth stage 16. Immediately before expulsion, which of the following cardinal movements occur? a. Descent b. Flexion c. Extension d. External rotation 17. Which of the following is true regarding the fontanels of the newborn? a. The anterior is triangular shaped; the posterior is diamond shaped. b. The posterior closes at 18 months; the anterior closes at 8 to 12 weeks. c. The anterior is large in size when compared to the posterior fontanel. d. The anterior is bulging; the posterior appears sunken. 18. Which of the following would the nurse identify as a classic sign of PIH? a. Edema of the feet and ankles b. Edema of the hands and face c. Weight gain of 1 lb/week d. Early morning headache 19. Which of the following would the nurse assess in a client experiencing abruptio placenta? a. Bright red, painless vaginal bleeding

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
b. Concealed or external dark red bleeding c. Palpable fetal outline d. Soft and nontender abdomen 20. Which of the following best describes preterm labor? a. Labor that begins after 20 weeks gestation and before 37 weeks gestation b. Labor that begins after 15 weeks gestation and before 37 weeks gestation c. Labor that begins after 24 weeks gestation and before 28 weeks gestation d. Labor that begins after 28 weeks gestation and before 40 weeks gestation 21. Which of the following amounts of blood loss following birth marks the criterion for describing postpartum hemorrhage? a. More than 200 ml b. More than 300 ml c. More than 400 ml d. More than 500 ml 22. Which of the following is the primary predisposing factor related to mastitis? a. Epidemic infection from nosocomial sources localizing in the lactiferous glands and ducts b. Endemic infection occurring randomly and localizing in the periglandular connective tissue c. Temporary urinary retention due to decreased perception of the urge to avoid d. Breast injury caused by overdistention, stasis, and cracking of the nipples 23. Which of the following assessment findings would the nurse expect if the client develops DVT? a. Midcalf pain, tenderness and redness along the vein b. Chills, fever, malaise, occurring 2 weeks after delivery c. Muscle pain the presence of Homans sign, and swelling in the affected limb d. Chills, fever, stiffness, and pain occurring 10 to 14 days after delivery 24. When teaching a client about contraception. Which of the following would the nurse include as the most effective method for preventing sexually transmitted infections? a. Spermicides b. Diaphragm c. Condoms d. Vasectomy 25. A client in her third trimester tells the nurse, Im constipated all the time! Which of the following should the nurse recommend? a. Daily enemas b. Laxatives c. Increased fiber intake d. Decreased fluid intake 26. The client tells the nurse that her last menstrual period started on January 14 and ended on January 20. Using Nageles rule, the nurse determines her EDD to be which of the following? a. September 27 b. October 21 c. November 7 d. December 27 27. A client 12 weeks pregnant come to the emergency department with abdominal cramping and moderate vaginal bleeding. Speculum examination reveals 2 to 3 cms cervical dilation. The nurse would document these findings as which of the following? a. Threatened abortion b. Imminent abortion c. Complete abortion d. Missed abortion 28. The nurse assesses the postpartum vaginal discharge (lochia) on four clients. Which of the following assessments would warrant notification of the physician? a. A dark red discharge on a 2-day postpartum client b. A pink to brownish discharge on a client who is 5 days postpartum c. Almost colorless to creamy discharge on a client 2 weeks after delivery d. A bright red discharge 5 days after delivery 29. Which of the following should the nurse do when a primipara who is lactating tells the nurse that she has sore nipples? a. Tell her to breast feed more frequently b. Administer a narcotic before breast feeding

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
c. Encourage her to wear a nursing brassiere d. Use soap and water to clean the nipples 30. A client with severe preeclampsia is admitted with of BP 160/110, proteinuria, and severe pitting edema. Which of the following would be most important to include in the clients plan of care? a. Daily weights b. Seizure precautions c. Right lateral positioning d. Stress reduction 31. A postpartum primipara asks the nurse, When can we have sexual intercourse again? Which of the following would be the nurses best response? a. Anytime you both want to. b. As soon as choose a contraceptive method. c. When the discharge has stopped and the incision is healed. d. After your 6 weeks examination. 32. A client at 8 weeks gestation calls complaining of slight nausea in the morning hours. Which of the following client interventions should the nurse question? a. Taking 1 teaspoon of bicarbonate of soda in an 8-ounce glass of water b. Eating a few low-sodium crackers before getting out of bed c. Avoiding the intake of liquids in the morning hours d. Eating six small meals a day instead of thee large meals 33. The nurse documents positive ballottement in the clients prenatal record. The nurse understands that this indicates which of the following? a. Palpable contractions on the abdomen b. Passive movement of the unengaged fetus c. Fetal kicking felt by the client d. Enlargement and softening of the uterus 34. During a pelvic exam the nurse notes a purple-blue tinge of the cervix. The nurse documents this as which of the following? a. Braxton-Hicks sign b. Chadwicks sign c. Goodells sign d. McDonalds sign 35. Which of the following would be the nurses most appropriate response to a client who asks why she must have a cesarean delivery if she has a complete placenta previa? a. You will have to ask your physician when he returns. b. You need a cesarean to prevent hemorrhage. c. The placenta is covering most of your cervix. d. The placenta is covering the opening of the uterus and blocking your baby. 36. The nurse understands that the fetal head is in which of the following positions with a face presentation? a. Completely flexed b. Completely extended c. Partially extended d. Partially flexed 37. The amniotic fluid of a client has a greenish tint. The nurse interprets this to be the result of which of the following? a. Lanugo b. Hydramnio c. Meconium d. Vernix 38. A patient is in labor and has just been told she has a breech presentation. The nurse should be particularly alert for which of the following? a. Quickening b. Ophthalmia neonatorum c. Pica d. Prolapsed umbilical cord 39. The Atienzas are a couple undergoing testing for infertility. Infertility is said to exist when: a. A couple has been trying to conceive for 1 year b. A woman has no children c. A woman has no uterus

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
d. A couple has wanted a child for 6 months 40. Rizalyn is scheduled to have an amniocentesis to test for fetal maturity. What instruction would you give her before this procedure? a. Void immediately before the procedure to reduce your bladder size b. The x-ray used to reveal your fetus position has no long-term effects c. The intravenous fluid infused to dilate your uterus does not hurt the fetus d. No more amniotic fluid forms afterward, which is why only a small amount is removed 41. The nurse assigned in the area is aware that at 20 weeks gestation, the fundus is normally located at: a. 28 cm, and fetal heart can be heard with a Doppler b. At the level of the umbilicus, and the fetal heart can be heard with a fetoscope c. 18 cm and the baby is just about to move d. is over the symphysis, and fetal heart cannot be heard 42. In doing the Leopolds maneuver palpation, which among the following is not considered a good preparation? a. Be certain the hands of the nurse are warm b. The woman empties her bladder before palpation c. The woman should lie in a supine position with knees flexed slightly d. The hands of the nurse should be cold before performing the procedure 43. At 20 weeks of gestation, it is expected that Reigne would report to Nurse Josie which among the following: a. feeling of relief from dyspnea b. Nausea and vomiting related to HCG production c. feeling of ambivalence d. Feeling fetal kicks 44. What would you expect during assessment 9 days before EDC? a. Cervix close, uneffaced, FH-midway between the umbilicus and symphysis pubis b. Fundic height- 2 fingers below xyphoid process, engaged c. Cervix open, fundic height 2 fingers below xyphoid, floating d. Fundic height at least at the level of the xyphoid process, engaged 45. The nurse caring for a client receiving intravenous magnesium sulfate must closely observe for side effects associated with drug therapy. An expected side effect of magnesium sulfate is: a. Decreased urinary output b. Hypersomnolence c. Absence of knee jerk reflex d. Decreased respiratory rate 46. The nurse is caring for a neonate whose mother is diabetic. The nurse will expect the neonate to be: a. Hypoglycemic, small for gestational age b. Hyperglycemic, large for gestational age c. Hypoglycemic, large for gestational age d. Hyperglycemic, small for gestational age 47. As the client reaches 8cm dilation, the nurse notes late decelerations on the fetal monitor. The FHR baseline is 165175bpm with variability of 02bpm. What is the most likely explanation of this pattern? a. The baby is asleep. b. The umbilical cord is compressed. c. There is a vagal response. d. There is uteroplacental insufficiency. 48. A client is admitted to the labor and delivery unit. The nurse performs a vaginal exam and determines that the client's cervix is 5cm dilated with 75% effacement. Based on the nurse's assessment the client is in which phase of labor? a. Active b. Latent c. Transition d. Early 49. An important skill that a primigravida has to acquire is the ability to bathe her newborn and to clean her breast is she decides to breastfeed her baby. To which of the learning domains will the above goals be classified into? a. Psychomotor b. Cognitive c. Affective d. Attitudinal

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
50. The first step that the nurse must first remember in implementing a health education program for clients is which of the following? a. Assess the clients readiness to learn b. Assist the client to define goals and objectives c. Prioritize clients needs d. Evaluate the health education program 51. Accompanied by her husband, a patient seeks admission to the labor and delivery area. The client states that she is in labor, and says she attended the hospital clinic for prenatal care. Which question should the nurse ask her first? a. Do you have any chronic illness? b. Do you have any allergies? c. What is your expected due date? d. Who will be with you during labor? 52. A patient is in the second stage of labor. During this stage, how frequently should the nurse in charge assess her uterine contractions? a. Every 5 minutes b. Every 15 minutes c. Every 30 minutes d. Every 60 minutes 53. A patient is in last trimester of pregnancy. Nurse Jane should instruct her to notify her primary health care provider immediately if she notices: a. Blurred vision b. Hemorrhoids c. Increased vaginal mucus d. Shortness of breath on exertion 54. The nurse in charge is reviewing a patients prenatal history. Which finding indicates a genetic risk factor? a. The patient is 25 years old b. The patient has a child with cystic fibrosis c. The patient was exposed to rubella at 36 weeks gestation d. The patient has a history of preterm labor at 32 weeks gestation 55. A adult female patient is using the rhythm (calendar-basal body temperature) method of family planning. In this method, the unsafe period for sexual intercourse is indicated by; a. Return preovulatory basal body temperature b. Basal body temperature increase of 0.1 degrees to 0.2 degrees on the 2ndor 3rd day of cycle c. 3 full days of elevated basal body temperature and clear, thin cervical mucus d. Breast tenderness and mittelschmerz 56. During a nonstress test (NST), the electronic tracing displays a relatively flat line for fetal movement, making it difficult to evaluate the fetal heart rate (FHR). To mark the strip, the nurse in charge should instruct the client to push the control button at which time? a. At the beginning of each fetal movement b. At the beginning of each contraction c. After every three fetal movements d. At the end of fetal movement 57. When evaluating a clients knowledge of symptoms to report during her pregnancy, which statement would indicate to the nurse in charge that the client understands the information given to her? a. Ill report increased frequency of urination.

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
b. If I have blurred or double vision, I should call the clinic immediately. c. If I feel tired after resting, I should report it immediately. d. Nausea should be reported immediately. 58. When assessing a client during her first prenatal visit, the nurse discovers that the client had a reduction mammoplasty. The mother indicates she wants to breast-feed. What information should the nurse give to this mother regarding breast-feeding success? a. Its contraindicated for you to breast-feed following this type of surgery. b. I support your commitment; however, you may have to supplement each feeding with formula. c. You should check with your surgeon to determine whether breast-feeding would be possible. d. You should be able to breast-feed without difficulty. 59. Following a precipitous delivery, examination of the clients vagina reveals a fourth-degree laceration. Which of the following would be contraindicated when caring for this client? a. Applying cold to limit edema during the first 12 to 24 hours b. Instructing the client to use two or more peripads to cushion the area c. Instructing the client on the use of sitz baths if ordered d. Instructing the client about the importance of perineal (Kegel) exercises 60. A client makes a routine visit to the prenatal clinic. Although shes 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Diaz diagnoses gestational trophoblastic disease and orders ultrasonography. The nurse expects ultrasonography to reveal: a. an empty gestational sac. b. grapelike clusters. c. a severely malformed fetus. d. an extrauterine pregnancy. 61. After completing a second vaginal examination of a client in labor, the nurse-midwife determines that the fetus is in the right occiput anterior position and at 1 station. Based on these findings, the nurse-midwife knows that the fetal presenting part is: a. 1 cm below the ischial spines. b. directly in line with the ischial spines. c. 1 cm above the ischial spines. d. in no relationship to the ischial spines. 62. Which of the following would be inappropriate to assess in a mother whos breast-feeding? a. The attachment of the baby to the breast. b. The mothers comfort level with positioning the baby. c. Audible swallowing. d. The babys lips smacking 63. During a prenatal visit at 4 months gestation, a pregnant client asks whether tests can be done to identify fetal abnormalities. Between 18 and 40 weeks gestation, which procedure is used to detect fetal anomalies? a. Amniocentesis. b. Chorionic villi sampling. c. Fetoscopy. d. Ultrasound 64. A client, 30 weeks pregnant, is scheduled for a biophysical profile (BPP) to evaluate the health of her fetus. Her BPP score is 8. What does this score indicate? a. The fetus should be delivered within 24 hours. b. The client should repeat the test in 24 hours.

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
c. The fetus isnt in distress at this time. d. The client should repeat the test in 1 week. 65. A client whos 36 weeks pregnant comes to the clinic for a prenatal checkup. To assess the clients preparation for parenting, the nurse might ask which question? a. Are you planning to have epidural anesthesia? b. Have you begun prenatal classes? c. What changes have you made at home to get ready for the baby? d. Can you tell me about the meals you typically eat each day? 66. A postpartum patient was in labor for 30 hours and had ruptured membranes for 24 hours. For which of the following would the nurse be alert? a. Endometritis b. Endometriosis c. Salpingitis d. Pelvic thrombophlebitis 67. A client at 36 weeks gestation is schedule for a routine ultrasound prior to an amniocentesis. After teaching the client about the purpose for the ultrasound, which of the following client statements would indicate to the nurse in charge that the client needs further instruction? a. The ultrasound will help to locate the placenta b. The ultrasound identifies blood flow through the umbilical cord c. The test will determine where to insert the needle d. The ultrasound locates a pool of amniotic fluid 68. While the postpartum client is receiving herapin for thrombophlebitis, which of the following drugs would the nurse Mica expect to administer if the client develops complications related to heparin therapy? a. Calcium gluconate b. Protamine sulfate c. Methylegonovine (Methergine) d. Nitrofurantoin (macrodantin) 69. When caring for a 3-day-old neonate who is receiving phototherapy to treat jaundice, the nurse in charge would expect to do which of the following? a. Turn the neonate every 6 hours b. Encourage the mother to discontinue breast-feeding c. Notify the physician if the skin becomes bronze in color d. Check the vital signs every 2 to 4 hours 70. A primigravida in active labor is about 9 days post-term. The client desires a bilateral pudendal block anesthesia before delivery. After the nurse explains this type of anesthesia to the client, which of the following locations identified by the client as the area of relief would indicate to the nurse that the teaching was effective? a. Back b. Abdomen c. Fundus d. Perineum 71. The nurse is caring for a primigravida at about 2 months and 1 week gestation. After explaining self-care measures for common discomforts of pregnancy, the nurse determines that the client understands the instructions when she says: a. Nausea and vomiting can be decreased if I eat a few crackers before arising b. If I start to leak colostrum, I should cleanse my nipples with soap and water

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
c. If I have a vaginal discharge, I should wear nylon underwear d. Leg cramps can be alleviated if I put an ice pack on the area 72. Thirty hours after delivery, the nurse in charge plans discharge teaching for the client about infant care. By this time, the nurse expects that the phase of postpartal psychological adaptation that the client would be in would be termed which of the following? a. Taking in b. Letting go c. Taking hold d. Resolution 73. A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following? a. Activity limited to bed rest b. Platelet infusion c. Immediate cesarean delivery d. Labor induction with oxytocin 74. Nurse Julia plans to instruct the postpartum client about methods to prevent breast engorgement. Which of the following measures would the nurse include in the teaching plan? a. Feeding the neonate a maximum of 5 minutes per side on the first day b. Wearing a supportive brassiere with nipple shields c. Breast-feeding the neonate at frequent intervals d. Decreasing fluid intake for the first 24 to 48 hours 75. When the nurse on duty accidentally bumps the bassinet, the neonate throws out its arms, hands opened, and begins to cry. The nurse interprets this reaction as indicative of which of the following reflexes? a. Startle reflex b. Babinski reflex c. Grasping reflex d. Tonic neck reflex 76. A primigravida client at 25 weeks gestation visits the clinic and tells the nurse that her lower back aches when she arrives home from work. The nurse should suggest that the client perform: a. Tailor sitting b. Leg lifting c. Shoulder circling d. Squatting exercises 77. Which of the following would the nurse in charge do first after observing a 2-cm circle of bright red bleeding on the diaper of a neonate who just had a circumcision? a. Notify the neonates pediatrician immediately b. Check the diaper and circumcision again in 30 minutes c. Secure the diaper tightly to apply pressure on the site d. Apply gently pressure to the site with a sterile gauze pad 78. Which of the following would the nurse Sandra most likely expect to find when assessing a pregnant client with abruption placenta? a. Excessive vaginal bleeding b. Rigid, boardlike abdomen c. Titanic uterine contractions d. Premature rupture of membranes

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
79. While the client is in active labor with twins and the cervix is 5 cm dilates, the nurse observes contractions occurring at a rate of every 7 to 8 minutes in a 30-minute period. Which of the following would be the nurses most appropriate action? a. Note the fetal heart rate patterns b. Notify the physician immediately c. Administer oxygen at 6 liters by mask d. Have the client pant-blow during the contractions 80. A client tells the nurse, I think my baby likes to hear me talk to him. When discussing neonates and stimulation with sound, which of the following would the nurse include as a means to elicit the best response? a. High-pitched speech with tonal variations b. Low-pitched speech with a sameness of tone c. Cooing sounds rather than words d. Repeated stimulation with loud sounds 81. A 31-year-old multipara is admitted to the birthing room after initial examination reveals her cervix to be at 8 cm, completely effaced (100 %), and at 0 station. What phase of labor is she in? a. Active phase b. Latent phase c. Expulsive phase d. Transitional phase 82. A pregnant patient asks the nurse Kate if she can take castor oil for her constipation. How should the nurse respond? a. Yes, it produces no adverse effect. b. No, it can initiate premature uterine contractions. c. No, it can promote sodium retention. d. No, it can lead to increased absorption of fat-soluble vitamins. 83. A patient in her 14th week of pregnancy has presented with abdominal cramping and vaginal bleeding for the past 8 hours. She has passed several cloth. What is the primary nursing diagnosis for this patient? a. Knowledge deficit b. Fluid volume deficit c. Anticipatory grieving d. Pain 84. Immediately after a delivery, the nurse-midwife assesses the neonates head for signs of molding. Which factors determine the type of molding? a. Fetal body flexion or extension b. Maternal age, body frame, and weight c. Maternal and paternal ethnic backgrounds d. Maternal parity and gravidity 85. For a patient in active labor, the nurse-midwife plans to use an internal electronic fetal monitoring (EFM) device. What must occur before the internal EFM can be applied? a. The membranes must rupture b. The fetus must be at 0 station c. The cervix must be dilated fully d. The patient must receive anesthesia 86. A primigravida patient is admitted to the labor delivery area. Assessment reveals that she is in early part of the first stage of labor. Her pain is likely to be most intense:

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
a. Around the pelvic girdle b. Around the pelvic girdle and in the upper arms c. Around the pelvic girdle and at the perineum d. At the perineum 87. A female adult patient is taking a progestin-only oral contraceptive, or minipill. Progestin use may increase the patients risk for: a. Endometriosis b. Female hypogonadism c. Premenstrual syndrome d. Tubal or ectopic pregnancy 88. A patient with pregnancy-induced hypertension probably exhibits which of the following symptoms? a. Proteinuria, headaches, vaginal bleeding b. Headaches, double vision, vaginal bleeding c. Proteinuria, headaches, double vision d. Proteinuria, double vision, uterine contractions 89. Because cervical effacement and dilation are not progressing in a patient in labor, Dr. Smith orders I.V. administration of oxytocin (Pitocin). Why must the nurse monitor the patients fluid intake and output closely during oxytocin administration? a. Oxytoxin causes water intoxication b. Oxytocin causes excessive thirst c. Oxytoxin is toxic to the kidneys d. Oxytoxin has a diuretic effect 90. Five hours after birth, a neonate is transferred to the nursery, where the nurse intervenes to prevent hypothermia. What is a common source of radiant heat loss? a. Low room humidity b. Cold weight scale c. Cools incubator walls d. Cool room temperature 91. After administering bethanechol to a patient with urine retention, the nurse in charge monitors the patient for adverse effects. Which is most likely to occur? a. Decreased peristalsis b. Increase heart rate c. Dry mucous membranes d. Nausea and Vomiting 92. The nurse in charge is caring for a patient who is in the first stage of labor. What is the shortest but most difficult part of this stage? a. Active phase b. Complete phase c. Latent phase d. Transitional phase 93. After 3 days of breast-feeding, a postpartal patient reports nipple soreness. To relieve her discomfort, the nurse should suggest that she: a. Apply warm compresses to her nipples just before feedings b. Lubricate her nipples with expressed milk before feeding c. Dry her nipples with a soft towel after feedings d. Apply soap directly to her nipples, and then rinse

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CENTER FOR ALLIED MEDICAL PROFESSIONS Maharlika Highway, Santiago City, Isabela
94. The nurse is developing a teaching plan for a patient who is 8 weeks pregnant. The nurse should tell the patient that she can expect to feel the fetus move at which time? a. Between 10 and 12 weeks gestation b. Between 16 and 20 weeks gestation c. Between 21 and 23 weeks gestation d. Between 24 and 26 weeks gestation 95. Normal lochial findings in the first 24 hours post-delivery include: a. Bright red blood b. Large clots or tissue fragments c. A foul odor d. The complete absence of lochia 96. When preparing a teaching plan for a client who is to receive a rubella vaccine during the postpartum period, the nurse in charge should include which of the following? a. The vaccine prevents a future fetus from developing congenital anomalies b. Pregnancy should be avoided for 3 months after the immunization c. The client should avoid contact with children diagnosed with rubella d. The injection will provide immunity against the 7-day measles. 97. A client with eclampsia begins to experience a seizure. Which of the following would the nurse in charge do first? a. Pad the side rails b. Place a pillow under the left buttock c. Insert a padded tongue blade into the mouth d. Maintain a patent airway 98. While caring for a multigravida client in early labor in a birthing center, which of the following foods would be best if the client requests a snack? a. Yogurt b. Cereal with milk c. Vegetable soup d. Peanut butter cookies 99. The multigravida mother with a history of rapid labor who us in active labor calls out to the nurse, The baby is coming! which of the following would be the nurses first action? a. Inspect the perineum b. Time the contractions c. Auscultate the fetal heart rate d. Contact the birth attendant 100. While assessing a primipara during the immediate postpartum period, the nurse in charge plans to use both hands to assess the clients fundus to: a. Prevent uterine inversion b. Promote uterine involution c. Hasten the puerperium period d. Determine the size of the fundus

END OF THE EXAM God Bless! Ask and you shall Receive, Seek and you shall Find, Knock and it shall be Opened to you - omie -

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