MCN EXAM GESTATIONAL CONDITIONS 1. The nursing intervention to relieve morning sickness in a pregnant woman is by giving A.

Dry carbohydrate food like crackers B. Low sodium diet C. Intravenous infusion D. Antacid 2. The common normal site of nidation/implantation in the uterus is A. Upper uterine portion B. Mid-uterine area C. Lower uterine segment D. Lower cervical segment 3. Which of the following is the most likely effect on the fetus if the woman is severely anemic during pregnancy? A. Large for gestational age (LGA) fetus B. Hemorrhage C. Small for gestational age (SGA) baby D. Erythroblastosis fetalis 4. Which of the following signs and symptoms will most likely make the nurse suspect that the patient is having hydatidiform mole? A. Slight bleeding B. Passage of clear vesicular mass per vagina C. Absence of fetal heart beat D. Enlargement of the uterus 5. Upon assessment the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP) 5 months ago, fetal heart beat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition? A. Hydatidiform mole B. Missed abortion C. Pelvic inflammatory disease D. Ectopic pregnancy

6. When a pregnant woman goes into a convulsive seizure, the MOST immediate action of the nurse to ensure safety of the patient is: A. Apply restraint so that the patient will not fall out of bed B. Put a mouth gag so that the patient will not bite her tongue and the tongue will not fall back C. Position the mother on her side to allow the secretions to drain from her mouth and prevent aspiration D. Check if the woman is also having a precipitate labor 7. Which of the following signs will distinguish threatened abortion from imminent abortion? A. Severity of bleeding B. Dilation of the cervix Page 1 of 9

C. Nature and location of pain D. Presence of uterine contraction 8. The nursing measure to relieve fetal distress due to maternal supine hypotension is: A. Place the mother on semi-fowlers position B. Put the mother on left side lying position C. Place mother on a knee chest position D. Any of the above 9. In placenta previa marginalis, the placenta is found at the: A. Internal cervical os partly covering the opening B. External cervical os slightly covering the opening C. Lower segment of the uterus with the edges near the internal cervical os D. Lower portion of the uterus completely covering the cervix 10. Before giving a repeat dose of magnesium sulfate to a pre-eclamptic patient, the nurse should assess the patients condition. Which of the following conditions will require the nurse to temporarily suspend a repeat dose of magnesium sulfate? A. 100 cc. urine output in 4 hours B. Knee jerk reflex is (+)2 C. Serum magnesium level is 10mEg/L. D. Respiratory rate of 16/min 11. In the Philippines, if a nurse performs abortion on the mother who wants it done and she gets paid for doing it, she will be held liable because A. Abortion is immoral and is prohibited by the church B. Abortion is both immoral and illegal in our country C. Abortion is considered illegal because you got paid for doing it D. Abortion is illegal because majority in our country are catholics and it is prohibited by the church 12. The fetal heart rate is checked following rupture of the bag of waters in order to: A. Check if the fetus is suffering from head compression B. Determine if cord compression followed the rupture C. Determine if there is utero-placental insufficiency D. Check if fetal presenting part has adequately descended following the rupture

13. The peak point of a uterine contraction is called the A. Acceleration B. Acme C. Deceleration D. Axiom Situation: A 16 year old client visits the prenatal clinic at 32 weeks gestation. She has been receiving care at the clinic and has early signs of pregnancy induced hypertension.

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14. The nurse assesses the client for possible risk factors for pregnancy -induced hypertension. Which of the following would be most important for the nurse to assess? A. primigravid status B. unmarried status C. ABO incompatibility D. Upper socio economic level 15. The nurse assesses the client for symptoms typical of mild pregnancy induced hypertension. Which of the following data indicate mild pregnancy-induced hypertension? A. BP of 160/110mmHg on two separate occasions B. Proteinuria, >5 grams/24 hours C. Urine output <400 ml/24 hours D. Swelling of fingers, hands, face and ankles 16. The nurse assesses the clients BP. Which of the following data would confirm the clients diagnosis of mild pregnancy-induced hypertension? A. systolic BP of at least 140 mmHg B. diastolic BP above 90 mmHg C. an increase in systolic and diastolic pressures of at least 20 mmHg above baseline pressures D. an increase above baseline pressures of at least 30 mmHg systolic and 15 mmHg diastolic 17. The nurse plans to instruct the client in care while the client is at home. Which of the following is an appropriate goal for the client? The client will A. return to the prenatal clinic in 1 month B. exhibit decreased edema following 1 week of a low CHON, low salt diet C. rest on the left side, with bathroom privileges D. immediately report adverse reactions from oral magnesium sulphate medications. 18. The nurse teaches the client about how pregnancy-induced hypertension affects the growing fetus. The nurse realizes that the client needs further instructions when she says that PIH can lead to A. stillbirth B. prematurity C. congenital anomalies D. intrauterine growth retardation

19. The nurse plans to instruct the client about nutrition during pregnancy. The teaching plan includes instructing the client to avoid overcooking vegetables, because this practice destroys vitamin A. A B. C C. E D. K 20. The client reports that she has been taking supplemental mineral and vitamin preparation daily. In addition to the mineral and vitamin supplement, the nurse instructs the client to increase her dietary intake of A. iron B. vitamin D Page 3 of 9

C. magnesium D. riboflavin 21. In reviewing the clients prenatal records, which of the following data would be most indicative of the clients diagnosis of severe PIH? A. polyuria B. urine specific gravity of 1.04 C. proteinuria below 3 grams in 24 hours D. weight gain less than 1 pound per week 22. In planning for the clients admission, the nurse selects the most appropriate room for the client from the following available choices. A. a brightly lit room close to the nurses station B. a room in the ICU where the client can be monitored C. a quiet room where the staff can observe the client frequently D. a room on a surgical unit where the client can be transferred quickly to the OR if necessary 23. When preparing the room before the clients admission, the nurse should make sure that which of the following equipments is readily available in the room? A. UTZ machine B. Padded side rails C. Catheterization kit D. Flashlights 24. The physician orders D5LRS solution and magnesium sulphate IV. Before administering the magnesium sullfate, the nurse should first assess A. fetal heart rate B. maternal PR C. maternal temperature D. maternal RR 25. The nurse monitors the client during MgSO4 administration. If the client develops MgSO4 toxicity , the nurse obtains the antidote drug A. calcium gluconate B. diazepam C. lorfan D. naloxone

26. The clients BP increase to 160/110 mmHg. Which of the following symptoms would suggest to the nurse that the client may be about to convulse? A. fetal movements B. severe headache C. feeling of warmth D. inability to void 27. If the client begins to convulse due to eclampsia, the nurses first action is to A. pad the side rails B. apply wrist and ankle restraints C. increase the flow rate of IV infusion Page 4 of 9

D. suction the mouth to keep the airway open 28. The nurse should suggest that the client assume which position while on bed rest? A. supine B. semi fowlers C. left lateral D. trendelenburg 29. When counselling the client about diet during pregnancy, the nurse realizes that the client needs further instruction when she says A. I should eliminate all salts from my diet B. A high protein diet is recommended C. Moderate salt intake is ok D. I need to eat more meat and beans each day Situation : A 29 year old gravida 2, para 1 at 32 weeks gestation is admitted to the hospital because of vaginal bleeding 30. In planning the clients care, one of the first actions the nurse list in the nursing care plan is to A. perform a vaginal examination B. provide a cleansing enema C. shave the abdomen and perineal area D. check the fetal heart rate and maternal BP 31. The nurse assesses the client for symptoms of abruption placenta, noting especially A. uterine contractions B. abdominal rigidity C. lack of pain D. early membrane rupture 32. While collecting data about the clients lifestyle, which of the following factors might lead the nurse to suspect a amedical diagnosis of abruption placenta? A. cigarette smoking B. history of placenta accrete C. previous low transverse cesarian delivery D. malnutrition

33. The nurse assesses the client for symptoms of placenta previa, noting especially A. painless vaginal bleeding B. a boardlike fundus C. intermittent pain with spotting D. dull lower abdominal pain 34. The client asks, What is the difference between abruption placenta and placenta previa? the nurses best response is to explain that implantation of abruption placenta is A. normal B. abnormal C. outside the uterus Page 5 of 9

D. in the lower uterine segment Situation: A 35 year old multi gravida at 36 weeks gestation is admitted to the hospital with a diagnosis of partaial placenta previa 35. in explaining the diagnosis, the nurse tells the client that the partial placenta previa implantation site A. is near the internal cervical OS B. covers the entire internal cervical os C. covers a portion of the internal cervical os D. lies within 5 cm of the internal cervical os 36. The client begins to have excessive vaginal bleeding soon after admission, and an emergency cesarian section is planned. In planning care for the client, the first nursing measure should be to A. shave the abdomen and perineal area B. ask the family to wait in the waiting room C. check fetal status D. start IV fluid infusion 37. A client is suspected having an ectopic pregnancy, on admission it is particularly important for the nurse to assess whether or not she A. has recently had intercourse B. has been pregnant before C. is currently taking birth control pills D. knows when her last menstrual period began 38. UTZ confirms that the client has an ectopic pregnancy. The nurse explains that in ectopic pregnancy, implantation of the fertilized ovum most commonly occurs in the A. ovary B. cervix C. fallopian tube D. peritoneal cavity 39. The nurse formulates a nursing diagnosis for the client soon after admission. The most appropriate diagnosis for the client is A. Anticipatory grieving related to the loss of pregnancy B. Fear related to the outcome of pregnancy C. In effective family coping related to hospitalization D. High risk for infection related to probable urinary stasis 40. The nurse assesses the client for symptoms of a tubal rupture, noting especially A. uncontrollable vomiting B. sharp abdominal pain C. excessive vaginal bleeding D. marked abdominal distention 41. The client is scheduled for emergency surgery. Before surgery, the nurse assesses the clients blood pressure and A. uterine cramping B. papillary reflexes C. vaginal discharge D. pulse rate

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42. For which of the following procedures should the nurse plans to prepare the client with possible ruptured ectopic pregnancy soon after admission? A. dilatation and curettage B. culdocentesis C. evacuation of the uteru D. shirodkar cerclage 43. After admission, it is most important or the nurse to assess the clients health history for A. infectious hepatitis B. incompetent cervix C. late onset of menarche D. pelvic inflammatory disease 44. Following surgery, the nurse instructs the client about potential complications. The nurse determines that the client needs further instructions when she states that a potential complication is A. pain B. edema C. fever D. bleeding 45. A client with H- Mole visits the clinic. Due to the clients excessive vomiting the nurse assesses her urine for A. protein B. albumin C. glucose D. acetone 46. The nurse should recommend a pregnant client who is experiencing severe morning sickness to A. take sips of carbonated beverages B. come to the prenatal clinic after 1 week C. consider obtaining psychological counselling D. eat dry crackers before arising in the morning

47. If the client excessive vomiting continues, the nurse should assess for symptoms of A. hypocalcemia B. hyponatremia C. hypokalemia D. hypoglycaemia 48. After explaining the need for follow up care after the evacuation of mole in molar pregnancy, the nurse determines that the client understand the instructions when she states that she is at risk for developing A. severe anemia B. choriocarcinoma C. invasion of the mole into the ovaries D. polyps in the fallopian tube

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49. Following admission of a client with premature rupture of membranes, it is particularly important for the nurse to assess for symptoms of A. urinary tract infection B. uterine rupture C. small for gestational age fetus D. anemia 50. The physician orders IV Magnesium Sulfate. The nurse explains to the client that the primary purpose of Magnesium Sulfate is to A. provide sedation B. combat hypomagnesia C. improve fetal pulmonary function D. inhibit uterine contractions IDENTIFICATION: 1. The antihypertensive drug of choice during pregnancy 2. Type of abortion wherein the uterus passes all the products of conception 3. It is characterized by early fetal intrauterine death without expulsion of the products of conception 4. Spontaneous abortion of three or more consecutive pregnancies 5. Spontaneous abortion in which infection accompanies abortion. 6. Fetus that is aborted weighing less than 500 grams 7. Non convulsive form of pregnancy induced hypertension 8. Drug of choice for eclampsia 9. Antidote of Magnesium Sulfate 10. Hypertension that develops after 20th week of gestation to a previously normotensive woman 11. It is also known as pernicious vomiting 12. Implantation of fertilized ovum in a site other than the endometrial lining of the uterus 13. Bluish discoloration around the umbilicus due to internal bleeding 14. Most common site of implantation of ectopic pregnancy in the fallopian tube 15. Expected level of HCG in ectopic pregnancy 16. Abnormal proliferation and degeneration of the trophoblastic villi 17. A type of gestational trophoblastic disease which usually leads to carcinoma 18. A fast growing highly invasive malignant tumor that develops in the uterus 19. Anticancer drug given to client with H mole to prevent development of malignancy 20. Abnormal implantation of the placenta in the lower uterine segment 21. It occurs when the placental border reaches the border of the internal os 22. Characteristics of vaginal bleeding in placenta previa 23. Drug to speed up lung maturity 24. Spontaneous break or tear in the amniotic sac before the onset of regular contractions 25. Cervical effacement and dilatation in early second trimester resulting in expulsion of the products of conception 26. Suturing of the cervix at around 14 weeks AOG to prevent dilatation 27. Premature separation of a normally implanted placenta after 20th week of pregnancy 28. Example of a tocolytic drug 29. Type of abruptio placenta which begins with small areas of separation and internal bleeding between the placenta and uterine wall Page 8 of 9

30. The characteristics of vaginal bleeding in abruption placenta ENUMERATION 13 Signs of Magnesium toxicity 46 Symptoms of pre eclampsia 7 10 Sites at which ectopic pregnancy may occur 11 13 Types of placenta previa 14 17 Neonatal risk of PROM 18 20 Management for incompetent cervix

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