MATERNITY NURSING Part 11.

When assessing the adequacy of spermfor conception to occur, which of thefollowing is the most useful criterion?a.Sperm countb.Sperm m otilityc.Sperm maturityd.Semen volume2.A couple who wants to conceive but hasbee n unsuccessful during the last 2 yearshas undergone many diagnosticprocedures. W hen discussing the situationwith the nurse, one partner states, Weknow several fr iends in our age group andall of them have their own child already,Why cant we ha ve one?. Which of thefollowing would be the most pertinentnursing diagnosis for t his couple?a.Fear related to the unknownb.Pain related to numerousprocedures.c.I neffective family coping related toinfertility.d.Self-esteem disturbance related toinfertility.3.Which of the following urinary symptomsdoes the pregnant woman most frequentlyexperience during the first trimester?a.Dysuriab.Frequencyc.Incon tinenced.Burning4.Heartburn and flatulence, common in thesecond trimester, are m ost likely theresult of which of the following?a.Increased plasma HCG levelsb.De creased intestinal motilityc.Decreased gastric acidityd.Elevated estrogen levels 5.On which of the following areas would thenurse expect to observe chloasma?a.Br east, areola, and nipplesb.Chest, neck, arms, and legsc.Abdomen, breast, and thi ghsd.Cheeks, forehead, and nose6.A pregnant client states that shewaddles when she walks. The nursesexplanation is based on which of thefollowing as the cause?a.Th e large size of the newbornb.Pressure on the pelvic musclesc.Relaxation of the p elvic jointsd.Excessive weight gain7.Which of the following represents theaverag e amount of weight gained duringpregnancy?a.12 to 22 lbb.15 to 25 lbc.24 to 30 l bd.25 to 40 lb8.When talking with a pregnant client who isexperiencing aching sw ollen, leg veins,the nurse would explain that this is mostprobably the result of which of thefollowing?a.Thrombophlebitis b.Pregnancy-inducedhypertensionc.Press ure on blood vessels from theenlarging uterusd.The force of gravity pulling down on the uterus9.Cervical softening and uterine souffle areclassified as which of the following?a.Diagnostic signsb.Presumptive signsc.Probable signsd.Positive si gns10.Which of the following would the nurseidentify as a presumptive sign of pr egnancy?a.Hegar signb.Nausea and vomitingc.Skin pigmentation changesd.Positive s erum pregnancy test11.Which of the following common emotionalreactions to pregna ncy would the nurseexpect to occur during the first trimester?a.Introversion, eg ocentrism,narcissismb.Awkwardness, clumsiness, andunattractivenessc.Anxiety, pas sivity, extroversiond.Ambivalence, fear, fantasies12.During which of the followi ng would thefocus of classes be mainly on physiologicchanges, fetal development, sexuality,during pregnancy, andnutrition?a.Prepregnant periodb.First trimesterc .Second trimesterd.Third trimester13.Which of the following would bedisadvantage of breast feeding?a.Involution occurs more rapidlyb.The incidence of allergies increasesdue to maternal antibodiesc.The father may resent the infantsdemands on the mothers bodyd.There is a greater chance for errorduring preparation14.Which o f the following would cause afalse-positive result on a pregnancy test?a.The tes t was performed less than10 days after an abortionb.The test was performed too e arlyor too late in the pregnancyc.The urine sample was stored toolong at room te mperature This is a collapser for Adult d.A spontaneous abortion or amissed abortion is impending15.FHR can be auscultat ed with a fetoscopeas early as which of the following?a.5 weeks gestationb.10 we eks gestationc.15 weeks gestationd.20 weeks gestation16.A client LMP began July 5. Her EDD shouldbe which of the following?a.January 2b.March 28c.April 12d.Octo ber 1217.Which of the following fundal heightsindicates less than 12 weeks gestat ionwhen the date of the LMP is unknown?a.Uterus in the pelvisb.Uterus at the xip hoidc.Uterus in the abdomend.Uterus at the umbilicus18.Which of the following da nger signs shouldbe reported promptly during theantepartum period?a.Constipation b.Breast tendernessc.Nasal stuffinessd.Leaking amniotic fluid19.Which of the fol lowing prenatal laboratorytest values would the nurse consider assignificant?a.H ematocrit 33.5%b.Rubella titer less than 1:8c.White blood cells 8,000/mm3d.One h our glucose challenge test110 g/dL20.Which of the following characteristics of c ontractions would the nurse expect tofind in a client experiencing true labor?a. Occurring at irregular intervalsb.Starting mainly in the abdomenc.Gradually incr easing intervalsd.Increasing intensity with walking21.During which of the follow ing stages of labor would the nurse assess crowning?a.First stageb.Second stagec.T

hird staged.Fourth stage22.Barbiturates are usually not given for painrelief dur ing active labor for which of thefollowing reasons?a.The neonatal effects includ ehypotonia, hypothermia,generalized drowsiness, andreluctance to feed for the fi rst fewdays. b. These drugs readily cross theplacental barrier, causingdepressiv e effects in the newborn 2to 3 hours after intramuscularinjection.c.They rapidly transfer across theplacenta, and lack of an antagonistmake them generally inapp ropriateduring labor.d.Adverse reactions may includematernal hypotension, allerg ic ortoxic reaction or partial or totalrespiratory failure23.Which of the follow ing nursinginterventions would the nurse performduring the third stage of labor? a.Obtain a urine specimen and otherlaboratory tests.b.Assess uterine contraction s every30 minutes.c.Coach for effective client pushingd.Promote parent-newbornin teraction.24.Which of the following actionsdemonstrates the nurses understandinga bout the newborns thermoregulatoryability?a.Placing the newborn under aradiant wa rmer.b.Suctioning with a bulb syringec.Obtaining an Apgar scored.Inspecting the newborns umbilicalcord25.Immediately before expulsion, which of the following car dinal movements occur?a.Descentb.Flexionc.Extensiond.External rotation26.Before birth, which of the followingstructures connects the right and leftauricles of t he heart?a.Umbilical veinb.Foramen ovalec.Ductus arteriosusd.Ductus venosus27.Wh ich of the following when present in theurine may cause a reddish stain on thedi aper of a newborn?a.Mucusb.Uric acid crystalsc.Bilirubind.Excess iron28.When ass essing the newborns heart rate,which of the following ranges would beconsidered n ormal if the newborn weresleeping?a.80 beats per minuteb.100 beats per minutec.1 20 beats per minuted.140 beats per minute29.Which of the following is true regar dingthe fontanels of the newborn? a.The anterior is triangular shaped;the posterior is diamond shaped.b.The poster ior closes at 18 months;the anterior closes at 8 to 12weeks.c.The anterior is la rge in size whencompared to the posterior fontanel.d.The anterior is bulging; th eposterior appears sunken.30.Which of the following groups of newbornreflexes be low are present at birth andremain unchanged through adulthood?a.Blink, cough, r ooting, and gagb.Blink, cough, sneeze, gagc.Rooting, sneeze, swallowing, andcoug hd.Stepping, blink, cough, and sneeze31.Which of the following describes theBabi nski reflex?a.The newborns toes willhyperextend and fan apart fromdorsiflexion of the big toe whenone side of foot is stroked upwardfrom the ball of the heel and acrossthe ball of the foot.b.The newborn abducts and flexes allextremities and may begin to crywhen exposed to suddenmovement or loud noise.c.The newborn turns the head in thedirection of stimulus, opens themouth, and begins to suck whench eek, lip, or corner of mouth istouched.d.The newborn will attempt to crawlforwar d with both arms and legswhen he is placed on his abdomenon a flat surface32.Whi ch of the following statements bestdescribes hyperemesis gravidarum?a.Severe ane mia leading toelectrolyte, metabolic, andnutritional imbalances in theabsence of other medicalproblems.b.Severe nausea and vomitingleading to electrolyte, metab olic,and nutritional imbalances in theabsence of other medicalproblems.c.Loss of appetite and continuousvomiting that commonly results indehydration and ultimat elydecreasing maternal nutrientsd.Severe nausea and diarrhea thatcan cause gastr ointestinal irritationand possibly internal bleeding33.Which of the following wo uld the nurseidentify as a classic sign of PIH?a.Edema of the feet and anklesb.E dema of the hands and facec.Weight gain of 1 lb/weekd.Early morning headache34.I n which of the following types of spontaneous abortions would the nurseassess da rk brown vaginal discharge and anegative pregnancy tests?a.Threatenedb.Imminentc .Missedd.Incomplete35.Which of the following factors would thenurse suspect as p redisposing a client toplacenta previa?a.Multiple gestationb.Uterine anomaliesc. Abdominal traumad.Renal or vascular disease36.Which of the following would the n urseassess in a client experiencing abruptioplacenta?a.Bright red, painless vagi nalbleedingb.Concealed or external dark redbleedingc.Palpable fetal outlined.Sof t and nontender abdomen37.Which of the following is described aspremature separa tion of a normallyimplanted placenta during the second half of pregnancy, usuall y with severehemorrhage?a.Placenta previab.Ectopic pregnancyc.Incompetent cervix d.Abruptio placentae38.Which of the following may happen if theuterus becomes ov erstimulated byoxytocin during the induction of labor?a.Weak contraction prolong ed tomore than 70 secondsb.Tetanic contractions prolonged tomore than 90 seconds

c.Increased pain with bright redvaginal bleedingd.Increased restlessness and anx iety39.When preparing a client for cesareandelivery, which of the following keyc oncepts should be considered whenimplementing nursing care?a.Instruct the mothers supportperson to remain in the familylounge until after the deliveryb.Arrange f or a staff member of theanesthesia department to explainwhat to expect postopera tivelyc.Modify preoperative teaching tomeet the needs of either a plannedor emer gency cesarean birthd.Explain the surgery, expectedoutcome, and kind of anesthet icsThis is a collapser for 728x90 40.Which of the following best describespreterm labor?a.Labor that begins after 20 weeksgestation and before 37 weeksgestationb.Labor that begins after 15 weeks gestation and before 37 weeksgestationc.Labor that begins after 24 weeksgestatio n and before 28 weeksgestationd.Labor that begins after 28 weeksgestation and be fore 40 weeksgestation41.When PROM occurs, which of the followingprovides eviden ce of the nursesunderstanding of the clients immediateneeds?a.The chorion and amni on rupture 4hours before the onset of labor.b.PROM removes the fetus mosteffecti ve defense against infectionc.Nursing care is based on fetalviability and gestat ional age.d.PROM is associated withmalpresentation and possiblyincompetent cervi x42.Which of the following factors is theunderlying cause of dystocia?a.Nurtiona lb.Mechanicalc.Environmentald.Medical43.When uterine rupture occurs, which of th efollowing would be the priority?a.Limiting hypovolemic shockb.Obtaining blood s pecimensc.Instituting complete bed restd.Inserting a urinary catheter44.Which of the following is the nurses initialaction when umbilical cord prolapseoccurs?a.B egin monitoring maternal vitalsigns and FHRb.Place the client in a knee-chestpos ition in bedc.Notify the physician and preparethe client for deliveryd.Apply a s terile warm salinedressing to the exposed cord45.Which of the following amounts of bloodloss following birth marks the criterion fordescribing postpartum hemorr hage?a.More than 200 mlb.More than 300 mlc.More than 400 mld.More than 500 ml46. Which of the following is the primarypredisposing factor related to mastitis?a.E pidemic infection from nosocomialsources localizing in the lactiferousglands and ductsb.Endemic infection occurringrandomly and localizing in theperiglandular c onnective tissuec.Temporary urinary retention due todecreased perception of the urgeto avoidd.Breast injury caused byoverdistention, stasis, and crackingof the nipples47.Which of the following best describesthrombophlebitis?a.Inflammation a nd clot formationthat result when blood componentscombine to form an aggregatebo dyb.Inflammation and blood clots thateventually become lodged withinthe pulmonar y blood vesselsc.Inflammation and blood clots thateventually become lodged withi nthe femoral veind.Inflammation of the vascularendothelium with clot formation o nthe vessel wall48.Which of the following assessmentfindings would the nurse exp ect if theclient develops DVT?a.Midcalf pain, tenderness andredness along the ve inb.Chills, fever, malaise, occurring 2weeks after deliveryc.Muscle pain the pre sence of Homans sign, and swelling in theaffected limbd.Chills, fever, stiffness , and painoccurring 10 to 14 days afterdelivery49.Which of the following are the mostcommonly assessed findings in cystitis?a.Frequency, urgency, dehydration,na usea, chills, and flank painb.Nocturia, frequency, urgencydysuria, hematuria, fe ver andsuprapubic painc.Dehydration, hypertension,dysuria, suprapubic pain, chil ls,and feverd.High fever, chills, flank painnausea, vomiting, dysuria, andfreque ncy50.Which of the following best reflects thefrequency of reported postpartumblu es?a.Between 10% and 40% of all newmothers report some form of postpartum blues