2. Study effectively:
1. Use memory aids, pictures, pathogenesis,
schematic diagrams and mnemonics. They will
assist in drawing associations from other ideas
with the use of visual aids.
2. Review class notes the next day . Very effective
study habit to develop during school is to review
the class notes the day after the class.
Correlate the notes and the visual the instructor
presented with the information in the textbook.
3. 3. Plan your study time when you are most
receptive to learning. Don’t study the night
before the exam, only 40% will retain the next
day. Your favorite study mode: toxic cramming.
4. Set a schedule of your daily activities. For
example, when you set aside 2 hours for review
after the class everyday then 2 hours of
facebook after. Have a time schedule to deal
with personal activities, family activities and
then your school activities. Please feel guilty if
you did not study for 2 hours that evening.
4. 5. Set a study goal:
a. Decide on a study method
b. Divide the review materials into segments
c. Prioritize the segments; review first the areas in
which you feel you are deficient or weak. Leave
those areas you are the most comfortable with
& most knowledgeable about for last.
d. Identify areas that will require additional review
in your Nursing textbook. Read your books!
5. e. Establish a realistic schedule and follow it.
Example:
8-5 classroom discussion.
5- 7 facebook/ friendster/ multiply/youtube
or any internet gaming.
regular study mode: 8-10 pm daily.
f. Plan on achieving your study goal several
days before the examinations.
6. Group study:
1. Limit the group to four to five people.
2. Group members should be mature & serious
about studying. Don’t end up laughing and
impersonating your funny lecturers.
3. The group should agree on the planned study
schedule.
4. If the group makes you anxious or you do not
feel it meets your study needs, do not continue
to participate.
7. 5. Group study is very effective with the right mix of
participants
Decrease some anxiety-provoking situations before
examinations:
a) Be early
b) Don’t cram your classmates in the room.
c) Do something pleasant the evening before the
examination.
d) Anxiety is contagious. If those around are
extremely anxious, avoid contact with them.
8. e) Settle your accounts a few days before so you
will not worry about it the day of examination.
f) If the other person finishes before you do, will it
put increased pressure on you to hurry up and
finish? Don’t mind the people around you.
g) Make your meal before the test a light, healthy
one. Avoid eating highly spiced or different
foods. This is not the time for gastrointestinal
upset.
9. h) Do not take study material to the examination
site. Its too late to study.
i) Don’t panic when you encounter very hard
questions that increases your anxiety. Take a
deep breath and close your eyes at the moment
then return to the question.
j) Bring your past success to bring positive energy
and “vibes” to your exam. YOU WILL PASS! I
KNOW YOU CAN DO IT.
11. Situation: Jent, a 32 year old primigravida at 39-
40 weeks AOG is admitted to the Labor Room
due to hypo gastric and lumbo-sacral pains. IE
reveals a fully dilated, fully effaced cervix, BOW,
Station O.
1. The nurse inspects the amniotic fluid of Jent.
Which of the following characteristics of the
amniotic fluid confirm the diagnosis of fetal
distress?
A. Mucus-tinged c. Greenish
B. Colorless d. Pinkish
12. 2. The nurse knows that Jent needs NO further
instruction on monitoring fetal movement.
Which of the following remarks of Jent
influence the nurse to think so?
a. “My baby is in good status, I felt her move twice
for an hour.”
b. “The last time my baby move was an hour ago.”
c. “Maybe my baby is asleep. I have not felt her
movement since an hour ago.”
d. “My baby is very active, she move about 5 times
per hour.”
13. Situation: Celine is pregnant for the second
time. Since she is breastfeeding her first baby,
she has menstruated. She reports having
noticed tingling breast tenderness and feels
nauseated in the morning.
3. If Celine is not menstruating after her first
child, what sign will help her estimate her
gestational age?
A. Quickening c. Abdominal girth
B. First time heart
sound was using Doppler d. Lightening
14. 4. Celine is given instruction to notify the nurse
if she notices any of the following signals,
Except:
A.Tight finger rings, puffy eyelids
B. Severe, persistent headache
C. Vaginal bleeding
D. Nausea and vomiting in the first
15. 5. The first action of the nurse upon admission
is to:
a. Take the fetal heart tone
b. Notify the obstetrician
c. Determine cervical dilatation
d. Inspect the color, amount and odor of the
amniotic fluid
16. 6. A woman is having a prenatal visit at 18 weeks
gestation. Why is it important to ask her about
fetal movement?
a. Absence of fetal movement at this time suggests that
the pregnancy is more advanced than her dates
indicated.
b. Denial of fetal movement at this stage in pregnancy
may indicate that the woman is not accepting her
pregnancy.
c. If she has started feeling the movement, the fetal
heartbeat will be checked with the use of a fetoscope
to confirm that the fetus is living.
d. Fetal movement is the first felt by the mother about
this time and provides a marker for a approximate
gestational age.
17. Situation: Annabelle, an 18-year-old primigravida
at 39-40 weeks gestation is admitted to the
hospital in active labor. Her cervical dilatation is
7cms. 90% effaced station 0 and positive for bag
of water(BOW).
7. Soon after, Annabelle is admitted; she had a
bloody mucoid vaginal discharge. Which of the
following is the BEST action of the nurse?
a. Call the obstetrician
b. Perform IE to determine the cervical dilatation
c. Prepare for a double set-up procedure
d. Check if there is a rupture of the bag of water
18. 8. She starts to have intolerable pain
during contractions. Which of the
following breathing techniques will be
MOST effective during this phase?
A. Pursed lip breathing
B. Deep chest breathing
c. Pant, pant, blow
d. Slow chest breathing
19. 9. Her cervical dilatation is now 10cm. 100%
effaced and station + 1. Her BOW ruptured
spontaneously to clear amniotic fluids. Which
of the following actions of the nurse is
PRIORITY?
A. Check the FHT
B. Start an intravenous fluid line
c. Notify the obstetrician
d. Transfer Annabelle to the delivery table.
20. 10. The obstetrician is still scrubbing when
Annabelle shouts. “The baby is coming!”
Which of the following actions should
the nurse perform?
A. Tell her to push when she has the urge
B. Urge her to do shallow breathing
C. Instruct her to pant-blow
D. Administer oxygen per mask
21. 11. Annabelle delivered a live baby girl. She
remarks, “She looks just like me when I was a
baby!” Which of the following is an
interpretation of this statement?
A. Potential post-partum depression
B. Maternal-infant boding
c. Disappointment of the gender of the babY
d. Rejection of her baby
22. Situation: Rachel Osorio, 24 years old, full term
primigravida, is admitted to the Labor Room. IE
findings 3-4cms. Dilated; 70% effaced; station-2;
breech presentation.
12. Which of the following statements BEST
describes what a station-2 means? The
presenting part of the fetus is;
a. Two cms. above the ischial spines
b. Two cms. below the sacral prominence
c. At the level of the ischial spines
d. Two cms. above the symphysis pubis
23. 13. What type of breech presentation does
the fetus assume when the legs are
extended and lie against the abdomen
and chest?
a. Single footing c. Frank
b. Complete d. Double footing
24. 14. In breech presentation, where can the
fetal heart sounds be usually heard at its
loudest?
a. Above the symphysis pubis
b. Slightly above the umbilicus
c. At the level of the symphysis
d. Below the umbilicus
25. 15. What method of delivery will the nurse
anticipate to prepare considering the
status of Mrs. Osorio?
a. Low mid forceps delivery
b. Breech extraction
c. Normal spontaneous delivery
d. Cesarean section
26. 16. Artificial rupture of the membrane is done.
Which of the following nursing diagnosis is
PRIORITY?
a. High risk for infection related to rupture of
membranes
b. Potential for injury related to prolapse of cord
c. Alteration if comfort related to increasing strength
of uterine contractions
d. Anxiety related to unfamiliar procedure
27. 17. Upon admission, FHT is noted to be 110
beats per minute over RLQ. Which of the
following actions should be immediately done
by the nurse?
a. Place her on left lateral position
b. Monitor FHT every 15 minutes
c. Call the obstetrician
d. Administer oxygen inhalation
28. 18. Which of the following BEST describes a
threatened abortion?
a. A likely expulsion of the fetus and placenta before
the 10th week of gestation
b. Prolonged retention of a fetus who died during the
first half of pregnancy
c. A sudden gush of fluid accompanied by bleeding
and pain during early pregnancy
d. Any vaginal discharge or bleeding which appears
during the first half of pregnancy
29. 19. What will be the immediate nursing action
be done?
a. Start an IVF infusion
b. Notify her obstetrician
c. Request for CBC, blood typing and cross
matching
d. Place her in a complete bed rest
20. After D and C is done, Melissa should be
observed for:
a. Hemorrhage and infection
b. Depression
c. Dehydration and hemorrhage
d. Dehydration
30. 21. The client asked how she would recognize a
true labor. What are the characteristics of the
uterine contractions in a true labor?
a. Regular with increasing frequency of duration
b. Regular and remain constant in frequency
c. Occasional and irregular in duration
d. Regular with diminishing frequency and duration
31. 22. A woman is hospitalized for the treatment of
severe preeclampsia. Which of the following
represents an unusual finding for this
condition?
a. Convulsions
b. blood pressure 160/100 mmHg
c. protenuria
d. generalized edema
32. 23. A woman is admitted with severe
preeclampsia. What type of room should the
nurse select for this woman?
a. a room next to the elevator
b. the room farthest from the nursing station
c. the quietest room on the floor
d. the labor suite
33. 24. A woman is discharged after treatment for
hydatidiform mole. The nurse should include
which of the following in the discharge
teaching plan?
a. Do not become pregnant for at least one year
b. Have blood pressure checked weekly for six
months
c. Avoid smoking for one year
d. An amniocentesis can detect a recurrence of this
disorder in the future
34. 25. A woman 30 weeks gestation is being
discharge to home care with a diagnosis of
placenta previa. The nurse knows that the
client understands her home care when the
client states:
a. “As I get closer to my due date I will have to
remain in bed”
b. “I can continue with my office job because its
mostly sitting”
c. “My husband won’t be too happy with this “no sex”
order”
d. “I’m disappointed that I will need a cesarean
section”
35. 26. After a prenatal check up and class on health
behaviors during pregnancy, the nurse can
evaluate that learning has occurred when a client
states.
a. “Alcohol in the first trimester of pregnancy is very
dangerous, later its OK.”
b. “Drinking alcohol during pregnancy is the most
preventable cause of mental retardation”
c. “Alcohol is bad during pregnancy, but a little with
breastfeeding helps with breastfeeding”
d. “Problems for the baby usually only occur with heavy
drinking of alcohol”
36. 27. The nurse is caring for a 20 year old
primigravida who has been in the first stage of
labor for about 8 hours. What assessment
findings would indicate the client is
progressing to the 2nd stage of labor?
a. uterine contraction about 10 minutes apart,
cervical dilatation at 6cm.
b. cervical effacement at 100% dilatation at 10cm.
c. scant to moderate blood mucus showing, station
+2
d. fetal station at -2 and fetal hearth rate noted at
level of the umbilicus
37. 28. The nurse is assessing a client 12 hours
after a prolonged labor and delivery. What
assessment data would cause the nurse the
most concern?
a. oral temperature of 98 degree Fahrenheit.
b. Moderate amount of dark red vaginal
discharge
c. Episiotomy area bruised with small
amount of dark bloody drainage
d. Uterine fundus palpated to the right of
the umbilicus
38. 29. The nurse is caring for a client in labor. How
are frequency of contractions timed?
a. End of one to the beginning of the next
b. Beginning of one to the end of the next
c. End of one to the end of the next
d. Beginning of one to the beginning of the next
39. 30. A client is 38 weeks pregnant and is
admitted with bright red vaginal bleeding. She
complains of abdominal discomfort, but she is
not having contractions. After assessing the
client’s vital signs and the FHR. What is the
most important information to obtain?
a. The amount of cervical dilatation that is present.
b. The exact location of her abdominal discomfort.
c. The station of the presenting part.
d. At what time the client last ate.
40. 31. The pelvic examination reveals the fetus to
be at -1 station. What information does this
indicate to the nurse about the presenting part
of the fetus?
a. Is visible on the perineum.
b. Has not yet entered the inlet of pelvis.
c. Is above large to fit through the opening into the
true pelvis.
d. Is too large to fit through the opening into the true
pelvis.
41. 32. During the first stage of labor, the cervix
becomes thin and distinct from the body of the
uterus. What is the term the nurse would use to
describe this observation?
a. Dilation b. Attitude
c. Effacement d. Transition
42. 33. The nurse is checking a laboring client. Her
assessment reveals the head at +3 station.
What will the nurse do?
a. Prepare for the delivery of the infant.
b. Begin administration of oxygen at 6L/min.
c. Determine if contractions are increasing
d. Determine the FHR
43. 34. A multigravida client comes to the emergency
room complaining of abdominal pain. She is at 30
weeks gestation. On assessment, the nurse
observes complete dilatation and effacement of
the cervix with the perineal area bulging. What is
your nursing action?
a. prepare the client for an emergency cesarean delivery.
b. Place even gentle pressure on infant’s head and
support it through the birth canal.
c. Have the client hold her legs together and take her to
the labor and delivery unit.
d. Have the client take two deep breaths and push hard
with next contraction.
44. 35. A woman who is gravida 1 is in the active
phase of stage 1 labor. The fetal position is
LOA. When her membranes rupture the nurse
should expect to see?
a. a large amount of bloody fluid.
b. a moderate amount of clear to straw-colored fluid.
c. a small amount of greenish fluid.
d. A small amount of the umbilical cord.
45. 36. The nurse is caring for a woman in stage 1
labor. The fetal position is LOA. When her
membranes rupture the nurse’s first action
should be to:
a. notify the physician
b. measure the amount of fluid
c. count the fetal heart rate
d. perform a vaginal examination
46. 37. A woman had a mediolateral episiotomy
performed at delivery. The primary purpose of
the episiotomy is to?
a. allow forceps to be applied
b. enlarge the vaginal opening
c. eliminate the possibility of lacerations
d. eliminate the need for cesarean birth
47. 38. A woman is admitted to the hospital in
labor. Vaginal examination reveals that she is
8cm. dilated. At this point in her labor, which
of the following statements would the nurse
expect her to make?
a. “I can’t decide what to name my baby”
b. “It feels good to push with each contraction”
c. “Take your hand off my stomach when I have a
contraction!”
d. “This isn’t as bad as I expected”
48. 39. The nurse is talking with a woman who is
36 weeks gestation during a prenatal visit.
Which statement indicates that the woman
understands the onset of labor?
a. “I need to go to the hospital as soon as the
contractions become painful.”
b. “If I experience bright red vaginal bleeding I know
that I am about to deliver.”
c. I need to go to the hospital when I am having
regular contractions and bloody show.”
d. “My labor will not start until my membranes
rupture and gush fluid.”
49. 40. Using Leopold’s maneuvers to determine
fetal position, the nurse finds that the fetus is
in a vertex position with the back on the left
side. Where is the best place for the nurse to
listen for fetal heart tones?
a. in the right upper quadrant of the mother’s
abdomen.
b. In the left upper quadrant of the mother’s
abdomen.
c. In the right lower upper quadrant of the mother’s
abdomen.
d. In the left lower upper quadrant of the mother’s
abdomen.
50. 41. A woman arrives at the CEH ER in active labor.
On examination, the cervix is 5 cm. dilated
membranes intact and bulging and the presenting part
at -1 station. The woman asks if she can go for a
walk. What is the best response for the nurse to give?
a. “I think it would be best for you to remain in bed at this time
because of the risk of cord prolapsed.”
b. “It’s time for you to walk, but please stay nearby. If you feel a
gush of fluid, I will need to check you and your baby.”
c. “It will be best time for you to walk because that will assist
the natural body to bring the baby down the birth canal”
d. “I would be glad to get you a bean bag chair or rocker
instead
51. 42. A woman who is in active labor at 4 cm.
dilated, 100% effaced and 0 station is ambulating
and experienced a gush of fluid. What is the most
appropriate initial action for the nurse to take?
a. Send a specimen of the amniotic fluid to the laboratory
for analysis.
b. Have the woman return to her room and place her in
Trendelenburg position to prevent cord prolapsed.
c. Have the woman return to her room so that you can
assess fetal status including auscultation of fetal heart
for one full minute.
d. Call the woman’s physician because a cesarean
delivery will require.
52. 43. A woman is completely dilated and at +2
station. Her contractions are strong and last
50-60 seconds. Based on this information, the
nurse should know that the client is in which
stage of labor.
a. First stage b. Second stage
b. c. Third stage d. Fourth stage
53. 44. A woman’s cervix is completely dilated
with the head at -2 station. The head has not
descended in the past hour. What is the most
appropriate initial assessment for the nurse to
make?
a. Asses to determine of the client’s bladder are
distended.
b. Send the client for X-rays to determine fetal size.
c. Notify the surgical team so that an operative
procedure should be done.
d. Assess fetal status, including fetal heart tones.
54. 45. A woman who has been in labor for 6 hours is
now 9 cm. dilated and has intense contractions
every 1 to 2 minutes. She is anxious and feels the
need to bear down with her contractions. What is
the best action for the nurse to take?
a. Allow her to push so that delivery can be expedited.
b. Encourage panting breathing through contractions to
prevent pushing.
c. Reposition her in a squatting position to make her
more comfortable.
d. Provide back rubs during contractions to distract her.
a.
55. 46. A woman is scheduled for a cesarean
section delivery due to a transverse fetal lie.
What is the best way for the nurse to evaluate
that she understands the procedure?
a. Ask her about the help she will have at home after
delivery.
b. Give her a diagram of the body and ask the
scheduled surgery.
c. Ask her to tell you what she knows about the
scheduled surgery.
d. Provide her with a booklet explaining cesarean
deliveries when she arrives at the hospital.
56. 47. A client is being admitted to the OBW unit
for Hypovolemia secondary to hyperemesis
gravidarum. Which of the following factors
predisposes to the development of this
condition?
a. trophoblastic disease
b. low levels of human chorionic gonadotropin
c. malnourished or underweight
d. maternal age older than 35 years
57. 48. A client at 14 weeks gestation is
scheduled for an intentional abortion. The
nurse should explain to the client that the
method used for the abortion will most likely
be a:
a. vacuum extraction
b. partial birth abortion
c. saline induction
d. menstrual extraction
58. 49. The nurse in a family clinic is assessing a
client who is at 30 weeks gestation. The nurse
hears a fetal heart rate (FHR) of 88 beats per
minute. What should the nurse do next?
a. notify the physician immediately
b. assess the client’s radial pulse
c. recognize that the rate is within the normal units
and document the rate
d. permit the mother to hear the heartbeat
59. 50. A pregnant client is scheduled to have an
ultrasound to determine the growth of the
fetus. To prepare the client for this diagnostic
test, the nurse should instruct the client to:
a. drink large volume of water before the test
b. void before the procedure
c. lie on her right side during the test
d. remain NPO for 8 hours before the test
60. 51. The nurse is caring for a client after
suction curettage for gestational trophoblastic
disease. When planning discharge
instructions, the nurse should instruct the
client to:
a. consider having hysterectomy in the next year
b. avoid pregnancy for at least 1 year
c. have her blood tested for HCG every 2 hours
d. try to become pregnant as soon as possible
61. 52. A multipara client who is pregnant with her
fourth child visits the prenatal clinic at 35
weeks gestation and tells the nurse that her
“hands and face are swollen”. The nurse
should assess:
a. marked hyporeflexia
b. gestational diabetes
c. pregnancy-induced hypertension
d. chronic hypertension
62. 53. A pregnant client at 36 weeks gestation is
admitted to the emergency room of CEH after
an automobile accident. The client is
conscious. The nurse should assess the client
for which of the following complications?
a. incompetent cervix
b. placenta previa
c. still birth
d. placenta separation
63. 54. During the initial history assessment of a
pregnant client, the nurse determines that the
client has a history of abruptio placenta with
her last pregnancy. Based on this information
the nurse should expect to find which of the
following in her evaluation of this client?
a. anemia
b. Stillbirth
c. hypertension
d. multiparity
64. 55. A pregnant client’s ultrasound evaluation
has determined that she is pregnant with
twins. The nurse explains to the client that she
will need more frequent prenatal visits to
assess for:
a. pregnancy-induced hypertension
b. gestational diabetes
c. fetal anomalies
d. hemolytic disease
65. 56. A client is receiving an intravenous
infusion of magnesium sulfate for severe
pregnancy-induced hypertension. Which of
the following should the nurse anticipate
giving for magnesium sulfate toxicity?
a. RhoGAM
b. Hydralazine (Apresoline)
c. calcium lactate
d. calcium gluconate
66. 57. A pregnant client at 6 weeks gestation visits
the clinic and tells the nurse that she has mild
spotting and a few “cramps”. Vaginal examination
reveals no cervical dilation. The client is most
likely experiencing a type of abortion termed.
a. inevitable b. threatened c.
therapeutic d. missed
67. 58. At 36 weeks gestation, a client visits the
emergency room and complains of a sudden
gush of bright red, painless, vaginal bleeding.
Based on this information, the nurse assess
that the client might be experiencing which of
the following complications?
a. abruption placenta
b. incompetent cervix
c. placenta previa
d. placenta accreta
68. 59. A pregnant client is diagnosed with
hydramnios at 35 weeks gestation. The nurse
should be aware that the presence of
hydramnios might be indicating that the fetus
has the potential for?
a. renal dysfunction
b. gastrointestinal malformation
c. fetal growth retardation
d. cardiac anomalies
69. 60. A client is admitted to the hospital with a
diagnosis of ruptured ectopic pregnancy.
Which of the following actions should the
nurse perform first?
a. ask the client to sign a surgery consent
b. prepare to administer antibiotic
c. assess the amount of vaginal bleeding
d. draw blood for typing and cross matching
70. 61. A 40 year old client visits the clinic and a
pregnancy of 8 weeks is confirmed. The nurse
should instruct the client that more frequent
prenatal visits will be necessary because
pregnant women of her age are at greater risk
for?
a. pregnancy-induced hypertension
b. multiple pregnancies
c. uterine rupture
d. birth defects
71. 62. A pregnant client at term and in labor tells
that she used amphetamines during her
pregnancy. After the birth, the nurse should
assess the newborn for:
a. hyperbilirubinemia
b. intrauterine growth retardation
c. meconium aspiration syndrome
d. cardiac anomalies
72. 63. A pregnant client tests, positive for cocaine
use. The nurse should instruct the client that
one of the long-term neonatal effects of this
drug is
a. tremulousness
b. continual crying
c. muscle rigidity
d. learning defects
73. 64. a pregnant client at term and in labor tells
the nurse that she used cocaine during her
pregnancy. After birth, the nurse should
assess the newborn for complication except:
a. low birth weight
b. fetal alcohol syndrome
c. microcephally
d. decrease fetal oxygenation
74. 65. The nurse is caring a nullipara in active
labor cervical dilation is 4 cm. The nurse
should explain to the client that she is in which
of the following stages of labor?
a. latent stage of labor
b. first stage of the active phase of labor
c. second stage of the active phase of labor
d. third stage of labor
75. 66. After birth of a healthy newborn, the nurse
knows that one of the signs that the placenta
is ready to deliver is:
a. shortening of the umbilical cord
b. a sudden gush of vaginal blood
c. a change in the shape of the uterus to an
oval shape
d. an increase in the amount of amniotic fluid
76. 67. During labor a client’s amniotic
membranes rupture. Meconium is present in
the amniotic fluid, which is a normal finding in
which of the following situations?
a. breech presentation
b. preterm labor
c. prolonged latent phase
d. cephalopelvic disproportion
77. 68.The degree of flexion that the fetus assumes
or the relationship of the fetal parts to one
another is termed fetal:
a. lie b. presentation
c. attitude d. position
69.The nurse is caring for a client at term who is
in active labor. The nurse should explain to
the client that the setting of the presenting
part of the fetus into the pelvis at the level of
the maternal ischial spines is termed:
a. engagement b. descent
c. lightening d. station
78. 70. The nurse is caring for a multipara client in
active labor at 39 weeks gestation. To assess
the frequency of the contractions, the nurse
should assess the length of time from the
a. end of one contraction to the end of the next
contraction
b. beginning of one contraction to the end of the
same contraction
c. beginning of one contraction to the beginning of
the next contraction
d. peak of one contraction to the peak of the next
contraction
79. 71. Passage of the fetus through the birth canal
involves various position changes by the fetus-
termed cardinal movements of labor. The first
cardinal movements is:
a. descent b. internal rotation
c. engagement d. extension
72. The nurse is caring for a primigravida client in
active labor. The nurse should encourage the
client to void every 2 hours because full bladder
can result in:
a. uterine rupture
b. delayed fetal descent
c. prolonged contractions
d. urinary tract infections
80. 73. A pregnant client visits the emergency
room at CEH because she thinks she is in
labor. The nurse should explain to the client
that true labor can be differentiated from false
labor by contractions that:
a. are often irregular
b. are felt abdominally
c. achieve cervical dilation
d. may disappear with ambulation
81. 74. The nurse is caring for a primigravida in
active labor whose cervix is 10cm. dilated and
who has been pushing for 45 minutes. The
nurse should explain to the client that one
advantage of an episiotomy is:
a. greater diameter for the fetal head
b. increased perineal tearing
c. decreased blood loss
d. advanced to 3rd labor
82. 75. The nurse is caring for a client in active
labor who will have a forceps birth.
Immediately after the forceps are applied, the
nurse should assess the:
a. client’s ability to push
b. fetal presenting part
c. client’s blood pressure
d. fetal heart rate
83. 76. A multipara has been diagnosed with
gestational diabetes. The nurse would expect
that the client would be managed initially by
which of the following therapies?
a. oral hypoglycemic drugs
b. oral hypoglycemic and insulin
c. diet
d. insulin
84. 77. What drug that is similar to natural hormone that
is being given to pregnant client for induction of
labor?
a. oxytocin
b. progesterone
c. magnesium sulfate
d. estriol
78. On fetal circulation, blood that enters the
pulmonary artery will go to lungs to supply
oxygen but will shunt to descending aorta passing
a special structure called:
a. foramen ovale
b. ductus venosus
c. ductus arteriosus
d. umbilical arteries
85. 79. Pathogenesis of RH incompatibility include
the following except:
a. accidental break in placental villi results in fetal
blood entering the maternal blood stream
b. occurs when the mother is RH positive and the
fetus is RH negative
c. maternal and fetal blood are mixed up, causing
the mother to produced antibodies that will attack
the fetus
d. maternal bloodstream will destroy the fetal red
blood cells and can result to fetal anemia
86. 80. Heart structure that connects that
right and left atrium before and closes
(at times open) after birth.
a. inferior vena cava
b. aorta, descending
c. pulmonary arteries
d. foramen ovale
87. 81. TORCH syndrome, to include Rubella is
one of the teratogenic infections that cause
fetal complication. Health teachings for
mothers planning to get pregnant include the
following except:
a. Rubella immunization 3 month before pregnancy
b. Avoid contact with children with rashes while
pregnant
c. Have intravenous Zovirax IV to women during
pregnancy
d. Infants born with rubella must be isolates from
other newborn
88. 82. Teratogenic drugs that includes alcohol,
coffee, tea and cola which of this has a non-
stimulant effect to mother and fetus?
a. cola b. tea
c. coffee d. alcohol
83. A type of presentation that the hips are
flexed but the knees are extended to rest on
chest making the buttocks alone as the
presenting part.
a. Compound
b. Frank breech
c. incomplete breech
d. transverse lie
89. 84. A type of presentation that the presenting
part is usually iliac crest, hand or an elbow.
a. Shoulder presentation
c. compound presentation
b. Vertex presentation
d. single footling
85. Identify the most common fetal position in
most pregnancies (Left occiput anterior)
90. 86. Monitoring for true labor would include:
I – cervical dilation
II – regular intervals
III – intensity remains unchanged
IV – pain starts at the lumbar area to abdomen
a. I, III & IV b. I, II only c. II, IV & I
d. I & III only
91. 87. A woman is on active labor for 2 hours and
she is on 6-7 cm dilatation. She ask for candy
during relaxation. What is your best
response?
a. Mother should maintain on NPO for possible
operation.
b. Candies are contraindicated during labor since
this will impede breathing techniques
c. Candies and lollipops are recommended for
carbohydrates fluid intake during labor
d. Inform mother of the possibility of choking as the
labor progresses
92. Identify the following presentations on the
illustrations presented:
88. Right occiput posterior
89. Left sacrum posterior
90. Right occiput posterior
91. Left occiput transverse
92. Mechanism by which fetus nestles into the
pelvis.
a. Engagement c. Descent
b. Expulsion d. Flexion
93. 93. Rotation of the fetus into the pelvis, to the
occiput anterior position while continuously
descending.
Internal rotation c. Descent
External rotation d. Flexion
94. process of the fetal head's nodding
forward toward the fetal chest.
a. Internal rotation c. Descent
b. External rotation d. Flexion
94. 95. process that the fetal head undergoes as it
begins its journey through the pelvis
a. Internal rotation c. Descent
b. External rotation d. Flexion
96. birth of the entire body
a. Engagement c. Descent
b. Expulsion d. Flexion
95. 97. The shoulders externally rotate after the
head emerges and restitution occurs, so that
the shoulders are in the anteroposterior
diameter of the pelvis.
a. Internal rotation c. Descent
b. External rotation d. Flexion
98. Stage of labor & delivery from the complete
dilatation of the cervix to the birth of the baby.
a. 1st Stage c. 2nd stage
b. 3rd stage d. 4th stage
96. 99. stage of cervical dilatation
a.1st Stage c. 2nd stage
b. 3rd stage d. 4th stage
100. from the delivery of the placenta up to
1st 4 hours after delivery.
a. 1st Stage c. 2nd stage
b. 3rd stage d. 4th stage
97. “…..the last few miles of a journey
are always tough, but if you keep
going you’ll see that the last few
steps are the most fulfilling…..”
98. Next topic: pre final sept.11,2009
Fetal distress
Prolapsed umbilical cord
causes
contributing factors
sign/symptoms
nursing care
Problems with the passageway
Abnormal size or shape of the pelvis
Cephalopelvic disproportion
Shoulder dystocia
99. Problems with the powers
Dystocia or difficult labor
hypertonic uterine dysfunction
hypotonic uterine dysfunction
abnormal progress in labor
retraction rings
premature labor
precipitate labor and birth
uterine prolapsed
uterine rupture
100. Nursing Care of the Postpartal client
assessment (
Important guidelines:
a. Breast (engorgement)
b. Uterus (contraction, position,size)
c. Bladder (distention)
d. Bowel (positive for bowel sounds or elimination)
e. Lochia (color, amount, consistency, number of pads
consumed)
f. Episiotomy (condition of wound healing, signs of infection)
g. Homan’s sign (presence or absence)
h. Emotions (presence or absence of depression, coping
mechanism)
- vital signs
- signs of complications such as hemorrhage, infections)
102. Immediate Care of the Newborn
Assessment
APGAR Scoring
Vital signs
Physical assessment
assessment for deformities
anthropometric measurements (head, chest, and
abdominal circumferences, weight and length)
management of establishing respiration
maintaining optimum temperature
identification of newborn
prevention of infection and injury
103. Immunization
Newborn screening
Promotion of adequate nutrition
Observation of passage meconium
Newborn reflexes
104. Nursing care of clients with
specific Health problems related
to Reproduction and Sexuality
