Immaculate Conception College-Albay B.

2nd trimester
Daraga, Albay C. 3rd trimester
D. 4th trimester
MIDTERM EXAMINATION
Subject: NCM 101 (Maternal & Newborn Nursing) 10. At20 weeks age of gestation, the fundus is:
Instructor: Paul Jhon A. Vergara, RN A. Just above the symphysis pubis
B. At the level of the umbilicus
C. Midway between the symphysis pubis and the
Name: _________________________ Block: __________ umbilicus
D. At the level of the xiphoid process
INSTRUCTIONS: Read each item carefully. Choose the best
response to each question and shade the circle of the 11. When teaching a pregnant woman the position to
corresponding letter in the separate answer sheet provided. maximize uterine perfusion, the nurse instructs the
Keep your answer sheet clean. Do not make any client to lie:
unnecessary markings on your answer sheet. SRICTLY NO A. Supine
ERASURES. B. Prone
C. On her right side
1. While discussing the growth and development of the D. On her left side
fetus, you were asked by the patient, “During what time
in my pregnancy is my baby most vulnerable?” as a 12. Pregnancy tests are based on detecting the presence of
nurse your best response is: what hormone in the urine or blood serum of a pregnant
A. “As your baby is forming in the first 2 months woman?
because organ development takes place at this A. Human Placental Lactogen
time.” B. Estrogen
B. “Throughout your pregnancy.” C. Human Chorionic Gonadotropin
C. “Near the end of your pregnancy.” D. Progesterone
D. “Halfway through your pregnancy: around 20 weeks
or 5 months.” 13. What condition(s) can lead to a false-positive result on
pregnancy test?
2. Jaivin, a student nurse, is asked by a patient, “What A. Hydatidiform mole
determines if my baby’s lungs are mature?” Jaivin’s B. Psychotropic drug therapy
correct response is: C. Women taking oral contraceptives
A. Fern test D. All of the above
B. Nitrazine test
C. Phosphatidylglycerol test 14. Which of the following is NOT a positive sign of
D. Lecithin-sphingomyelin ratio pregnancy?
A. Positive pregnancy test
3. The L/S ratio that indicates fetal lung maturity is: B. Audible fetal heart tones
A. 2:1 C. Fetal movements felt by an examiner
B. 2:2 D. Fetal outline by ultrasound
C. 1:2
D. 1:1 15. In preparation for birth, the fetal head descends into the
pelvis during the late part of the pregnancy. This
4. At about 24th week of pregnancy the fetus starts phenomenon is referred to as:
producing surfactant. The function of surfactant is to: A. Quickening
A. Lubricate the fetus B. Lightening
B. Cushion the fetus C. Labor
C. Increase the surface tension in the alveoli D. Parturition
D. Prevent collapse of the alveoli
16. For a primigravida, the phenomenon described in item
5. The portion of the uterus whose significant no. 15 usually takes place during the:
characteristic is to stretch during childbirth is the: A. 34th week
A. Corpus B. 36th week
B. Fundus
C. Cervix
C. 38th week
D. Internal os D. 40th week

6. The fetal heart beat can be heard using a Doppler at: 17. The extreme softening of the lower uterine segment in
A. 6th - 8th week pregnancy is known as:
A. Chadwick’s sign
B. 8th - 10th week B. Goodell’s sign
C. 10th - 12th week C. Hegar’s sign
D. 12th – 14th week D. Ballotement

7. The fetal heart sounds are audible with an ordinary 18. The purplish hue of the vagina in pregnancy is termed
stethoscope at the end of: as:
A. 12th week A. Chadwick’s sign
B. 16th week B. Goodell’s sign
C. Hegar’s sign
C. 20th week D. Ballotement
D. 24th week
19. Softening of the cervix in pregnancy is referred to as:
8. Which of the following immunoglobulins crosses the A. Chadwick’s sign
placenta to provide the fetus a temporary passive B. Goodell’s sign
immunity against diseases for which the mother has C. Hegar’s sign
antibodies? D. Ballottement
A. IgA
B. IgG 20. Suppression of the follicle-stimulating hormone causes
C. IgM what presumptive symptom of pregnancy?
D. IgE A. Nausea and vomiting
B. Amenorrhea
9. The immunoglobulin described in item no. 8 crosses the C. Melasma
placenta during the: D. Striae gravidarum
A. 1st trimester
21. The primary purpose of the mucous plug (operculum) is 31. Because of the pressure exerted by the gravid uterus to
to: the urinary bladder, pregnant women usually
A. Prevent infection in the fetus experience urinary frequency during the:
B. Prevent entry of bacteria into the vagina A. 1st trimester
C. Prevent cervical dilation B. 2nd trimester
D. Prevent amniotic fluid seepage C. 3rd trimester
D. 4th trimester
22. During pregnancy, the vaginal pH becomes highly acidic
making the vagina resistant to bacterial invasion.
32. The return of urinary frequency near the end of
However, this change in vaginal pH favors the growth of
pregnancy is a result of:
what specific microorganism?
A. Dieresis caused by resolution of edema
A. Döderlein’s bacillus
B. Hyperfunction of the kidneys
B. Lactobacillus shirota
C. Descent of the fetal head into the pelvis which
C. Lactobacillus acidophilus
exerts pressure to the bladder
D. Candida albicans
D. Hyposecretion of ADH by the pituitary gland
23. A vaginal candidiasis is manifested by the following
EXCEPT: 33. What hormone is secreted by the corpus luteum
A. Itching functions to inhibit uterine activity, thus preventing
B. Greenish-yellow frothy vaginal secretions premature labor?
A. Estrogen
C. Burning sensation B. hCG
D. Cream cheese-like discharge C. Human placental lactogen
D. Relaxin
24. A pregnant woman asks the nurse if the reddish streaks
on her abdomen will disappear after pregnancy. The 34. The psychological task during the second trimester is:
nurse’s best response will be: A. Accepting the baby
A. “Yes. That is only transient and will completely B. Accepting the pregnancy
disappear after you give birth.” C. Preparing for parenthood
B. “Yes. That is only a result of overproduction of D. Preparing for childbirth
pigment hormones.”
C. “No. Those reddish streaks will be permanent.” 35. What is the common emotional reaction by the
D. “No. It will be permanent but it will lighten and expectant parents during the first trimester?
become barely noticeable.” A. Anticipatory role-playing
B. Impatience
25. Which of the following is NOT caused by the increased C. Ambivalence
production of melanocyte-stimulating hormone during D. Narcissism
pregnancy?
A. Striae gravidarum 36. A pregnant client tells the nurse that her husband is
B. Melasma also having morning sickness like hers. The nurse knows
C. Linea nigra that the client’s husband is experiencing:
D. Chloasma A. Vena cava syndrome
B. Supine hypotension syndrome
26. During a prenatal visit, a pregnant woman complains of C. Copy cat syndrome
nasal stuffiness. What will you advise this client for the D. Couvade syndrome
relief of nasal congestion?
A. Oral antihistamine 37. To prevent breast discomfort, what kind of bra will you
B. Oral decongestant instruct a pregnant client to wear?
C. Cold compression A. Firm, supportive bra with wide straps
D. Saline nasal drops B. Firm, supportive bra with narrow straps
C. Loose, push-up bra with wide straps
27. A pregnant woman comes to the clinic complaining of D. Loose, push-up bra with narrow straps
lightheadedness, faintness, and palpitations while lying
down. The nurse based on these data suspects: 38. What would you instruct a pregnant woman on what to
A. Supine hypotension syndrome use for washing her breasts?
B. Orthostatic hypotension A. Antibacterial soap and water
C. Shock B. Mild soap and water
D. Physiologic anemia C. Water only
D. Diluted hydrogen peroxide solution
28. To prevent the occurrence of vena cava syndrome, the
nurse must instruct a pregnant woman to: 39. Which conditions are contraindications to tub bathing?
A. Lie on her right side 1. Ruptured membranes
B. Lie on her left side 2. Increased leukorrhea
C. Elevate her legs while lying down 3. Vaginal bleeding
D. Lie on her back 4. Hemorrhoids
A. 1 and 3
29. What are the two hormones responsible for decreasing B. 1 and 4
gastric motility (peristalsis) during pregnancy? C. 2 and 3
1. Estrogen D. 2 and 4
2. Progesterone
3. Relaxin 40. A pregnant woman asks the nurse what is the best
4. hCG exercise during pregnancy. The nurse correctly responds
A. 1 and 3 by saying that it is:
B. 1 and 4 A. Swimming
C. 2 and 3 B. Jogging
D. 2 and 4 C. Boxing
D. Walking
30. What condition is chiefly attributed to cause nausea and
vomiting in pregnant women? 41. Which of the following would be a favorable sleeping
A. Hyperglycemia position for a pregnant woman?
B. Decreased serum estrogen A. Prone
C. Decreased serum progesterone B. Supine
D. Increased serum hCG C. Modified trendelenburg
D. Modified Sims’

42. A nurse teaching a primigravid client about prevention
of constipation in pregnancy. Which statement if made
by the client indicates the need for further teaching by
the nurse?
A. “I need to drink at least 8 oz of fluids in a day.”
B. “I have to move my bowel regularly.”
C. “I need to exercise regularly.”
D. “I should avoid roughage in my diet.”
43. Mineral oil should be avoided as a laxative for pregnant
women because it interfere with the absorption of:
A. Water-soluble vitamins
B. Fat-soluble vitamins
C. Iron
D. Calcium
44. The following are benefits of Kegel exercises EXCEPT:
A. Helps relieve back pain
B. Strengthens perineal muscles
C. Reduces the possibility of stress incontinence
D. Helps strengthen urinary control
45. Which of the following will be helpful in reducing the
pressure on rectal veins in a pregnant woman having
hemorrhoids?
A. Knee-chest position for 10-15 minutes daily
B. Prone position for 10-15 minutes daily
C. Semi-Fowler’s position for 10-15 minutes daily
D. High-Fowler’s position for 10-15 minutes daily
_________ 53. Stand at the foot of the client, facing her,
and place both hands flat on her abdomen.
_________ 54. Explain the procedure.
_________ 55. Place fingers on both sides of the uterus
approximately 2 inches above the inguinal
ligaments, pressing downward and inward in
the direction of the birth canal. Allow fingers
to be carried downward.
_________ 56. Palpate the sides of the uterus. Hold the left
hand stationary on the left side of the
uterus while the right hand palpates the
opposite side of the uterus from top to
bottom. Then hold the right hand steady,
and repeat palpation using the left hand on
the left side.
_________ 57. Instruct the client to empty her bladder.
_________ 58. Palpate the superior surface of the fundus.
Determine consistency, shape, and mobility.
_________ 59. Gently grasp the lower portion of the
abdomen just above the symphysis pubis
between the thumb and index finger and try
to press the thumb and index finger
together. Determine any movement and
whether the part is firm or soft.

46. A client asks the nurse about ways to prevent _________ 60. Position the woman supine with knees
varicosities. Which of the following will the nurse NOT slightly flexed. Place a small pillow or rolled
include in the teaching plan? towel under one side.
A. Avoid leg crossing
B. Avoid constrictive knee-high hose
C. Avoid use of elastic support stockings
D. Avoid bending the knees while sitting EXCELSIOR!
47. The nurse, teaching a pregnant woman about the use of
an elastic support stockings, determines that the client
understood her instructions if the client stated:
A. “I will have to wear them before going to bed at
night.”
B. “I should put them on after taking a shower.”
C. “I must wear them after having breakfast.”
D. “I need to wear them before arising in the morning.”

48. A normal physiologic change that occurs during

pregnancy is an increased vaginal discharge. Which of
these client instructions will NOT be helpful in reducing
moisture in the vulvar area?
A. Sleeping at night without underwear
B. Douching
C. Daily bath or shower
D. Wearing cotton underpants

49. Which of the following exercises helps to prevent and

relieve backache in pregnancy?
A. Pelvic rocking
B. Tailor sitting
C. Kegel exercises
D. Squatting

50. Which of the following medications is considered safe

and effective for the relief of back pain during
pregnancy? © Copyright 2009. All Rights Reserved.
A. Aspirin (Aspilets) pjvergara,rn
B. Acetaminophen (Tylenol)
C. Ketoprofen (Orudis)
D. Oxaprozin (Daypro)

For items 51 to 60, arrange the following steps in

performing the Leopold’s maneuver in chronological order.
Assign an order number for each step using numbers 1 to
10 (1 being the first step and 10 as the last). Write the
assigned order number on the corresponding item number
on the separate answer sheet provided. STRICTLY NO
ERASURES.

_________ 51. Face the client and place the palms of each
hand on either side of the abdomen.

_________ 52. Wash your hands using warm water.