Sample Questions
220. When evaluating patient behaviors, consider the medications the
patient is receiving: exhibited behaviors may be manifestations of
schizophrenia or a drug reaction. By using the Bleuler’s four “As”
method, decide which variant is not a characteristic for schizophrenia?
A. Artisanal
B. Autism
C. Affect
D. Association
Answer: A
Explanation: The 4 “As” related to schizophrenia are Autism (preoccupied
with self), Affect (flat), Association (loose) and Ambivalence
(difficulty making decisions).
175. Narcotic analgesics are prepared for pain relief because they bind
to the various opiate receptor sites in the CNS and usually morphine is
the preferred narcotic. What side effect does morphine have?
A. Respiratory depression
B. High blood pressure
C. Stroke
D. Hallucinations
Answer: A
Explanation: Morphine can cause respiratory depression.
172. A 33-year old mother of 1 teenage daughter enters the hospital to
have her gallbladder removed in a same-day surgery using a scope instead
of an incision. What nursing needs will dominate in the post-anesthesia
phase?
A. Pain management, post-anesthesia precautions
B. Education about postoperative care, NPO, assist with meeting family
needs
C. Assessment, management of the operative suite.
D. pain management, dietary restrictions, activity
Answer: A
Explanation: The nursing needs that will dominate in the post-anesthesia
phase are pain management, and post-anesthesia precautions.
156. Monitoring for fetal position is important because the mother
cannot tell you she has back pain, which is the cardinal sign of
persistent posterior fetal position. Why do the regional blocks,
especially epidural and caudal, often result in assisted (forceps or
vacuum) delivery?
A. Due to the inability to push effectively in 3rd stage.
B. Due to the inability to push effectively in 4th stage.
C. Due to the inability to push effectively in 1st stage.
D. Due to the inability to push effectively in 2nd stage
Answer: D
Explanation: Regional blocks, especially epidural and caudal, often
result in assisted (forceps or vacuum) delivery due to the inability to
push effectively in 2nd stage.
216. Early detection of rheumatoid arthritis can decrease the amount of
bone and joint destruction and often the disease will go into remission.
What activity recommendations should the nurse provide a client with
rheumatoid arthritis?
A. Exercise of painful, swollen joints to strengthen them
B. Exercise joint to the point of pain so that the pain lessens
C. Make jerky movements during the exercise so that the pain lessens
D. Perform exercises slowly and smoothly
Answer: D
Explanation: A nurse should advise the client to perform exercises
slowly and smoothly so that no extra pain occurs.
166. After a client admitted that he has severe chest pain and states
that he feels a terrible, tearing sensation in his chest, the nurse
checks vital signs q1 hour, respiratory status and peripheral pulses.
What disease has been the client diagnosed with in this case?
A. Atrial tachycardia
B. Aortic stenosis
C. Dissecting aortic aneurysm
D. Hypertrophic cardiomyopathy
Answer: C
Explanation: A client that is admitted with severe chest pain and states
that he feels a terrible, tearing sensation in his chest will most
probably diagnosed with dissecting aortic aneurysm.
167. During aortic aneurysm repair, the large arteries are clamped for a
period of time and because of the fact that kidney damage can result,
the nurse should daily monitor BUN and creatinine levels. Which are the
normal BUN and creatinine levels?
A. Normal BUN: 10 to 20 mg/dl and normal creatinine is 20:1
B. Normal BUN: 5 to 15 mg/dl and normal creatinine is 15:1
C. Normal BUN: 20 to 25 mg/dl and normal creatinine is 25:1
D. Normal BUN: 10 to 25 mg/dl and normal creatinine is 10:1
Answer: A
Explanation: Normal BUN is 10 to 20 mg/dl and normal creatinine is 20:1.
40. The symptoms of left-sided cardiac failure and right-sided cardiac
failure are slightly different. From your knowledge about these
symptoms, which is the difference between the left and right sided
cardiac failure?
A. Left sided failure results in peripheral congestion
B. Right sided failure results in pulmonary congestion
C. Right sided failure results due to back up of circulation in the
right ventricle
D. Left sided failure results due to back up of circulation in the left
atrium
Answer: C
Explanation: The right sided failure results in peripheral congestion
due to back up of circulation in the right ventricle, while the
left-sided failure results in pulmonary congestion due to back-up of
circulation in the left ventricle.
21. A 42 yr. old secretary has visited 7 different doctors in the last
year with a complaint of chest pain, heart palpitations, and shortness
of breath being sure she is having a heart attack in spite of the
physician’s reassurance that all tests are normal. What type of disorder
is the old person most probably suffering of?
A. Inversion reaction
B. Conversion reaction
C. Hypochondriacal disorder
D. Somatization
Answer: C
Explanation: Persons being sure about a certain thing (heart attack in
this case) even if the results of the physical tests are normal are most
probably suffering of Hypochondriacal disorder.
22. Few years ago, a woman was involved in a motor vehicle accident that
killed her friend who was a passenger in the car she was driving was
unable to work since that day because of sever back pain, even this pain
is unrelieved by prescribed medications. What disorder does she most
probably have?
A. Inversion reaction
B. Conversion reaction
C. Hypochondriacal disorder
D. Somatization disorder
Answer: D
Explanation: A person experiencing a pain unrelieved by prescribed
medications is most probably suffering of somatization disorder.
23. After the threat with death by a stranger, the 18 year old Samantha
is suddenly unable to recall certain events in her life. What
dissociative disorder is she most probably suffering of?
A. Psychogenic amnesia
B. psychogenic fugue
C. multiple personality disorder
D. depersonalization disorder
Answer: A
Explanation: Psychogenic amnesia is the sudden inability to recall
certain events in one’s life.
24. A person is brought to the hospital after he left home and is unable
to recall their identity or their past. What dissociative disorder is
associated with these characteristics?
A. Psychogenic amnesia
B. psychogenic fugue
C. multiple personality disorder
D. depersonalization disorder
Answer: B
Explanation: A psychogenic fugue state is characterized by the
individual leaving home and being unable to recall their identity or
their past.
25. A person with depersonalization disorder suffers of temporary loss
of one’s reality, a loss of the ability to feel and express emotions, or
a sense of “strangeness” in the surrounding environment. What type of
fear do these persons experience?
A. fear of “going crazy”
B. fear of “getting lost”
C. fear of “dying”
D. fear of “being alone”
Answer: A
Explanation: Individuals with depersonalization disorder express a fear
of “going crazy”.
26. A person is unable to make decisions for self, and allows others to
assume responsibility for his/her life. What personality disorder does
this person most probably have?
A. Histrionic Personality
B. Dependent Personality
C. Borderline Personality
D. Schizoid Personality
Answer: B
Explanation: The manifestations of people having Dependent Personality
are as follows: they are unable to make decisions for self, allows
others to assume responsibility for his/her life.
27. A 17 year old adolescent is unable to conform to social norms and
his mother is very worried about that. What personality disorder is he
experiencing at his age?
A. Obsessive-Compulsive Personality
B. Passive-Aggressive Personality
C. Antisocial Personality
D. Borderline Personality
Answer: C
Explanation: Clients with Antisocial Personality are unable to conform
to social norms.
28. An adolescent is dramatic, flamboyant, and needs to be the center of
attention. What personality disorder might he/she most probably have?
A. Histrionic Personality
B. Narcissistic Personality
C. Maladaptive Personality
D. Borderline Personality
Answer: A
Explanation: Histrionic Personality = Dramatic, flamboyant, needs to be
the center of attention.
29. A client with Narcissistic Personality has feelings of
self-importance and entitlement and exploits others to get own needs
met. What thinks a client with Maladaptive Personality about himself?
A. Does not think anything he/she does is wrong, e.g., authorities are
“out to get them.”
B. Suspicious, shows, mistrust of others, is watchful and secretive
C. Unable to make decisions for self, allows others to assume
responsibility for his/her life
D. Inability to conform to social norms
Answer: A
Explanation: Maladaptive Personality = Does not think anything he/she
does is wrong, e.g., authorities are “out to get them.”
1. A patient who is 32 weeks gestation is experiencing dark, red vaginal
bleeding and the nurse determines the FHR to be 100 bpm and her abdomen
is rigid and boardlike. What action should the nurse take first?
A. Administer O2 per face mask
B. Abdominal manipulation
C. vaginal manipulation
D. Abdominal exam
Answer: A
Explanation: The nurse should immediately notify the healthcare provider
and no abdominal or vaginal manipulation or exams should be done.
Administer O2 per face mask and monitor for bleeding at IV sites and
gums due to the increased risk of DIC.
2. A patient who is 32 weeks gestation has the following symptoms: dark,
red vaginal bleeding, 100 bpm FHR, rigid abdomen and severe pain. What
is the difference between abruptio placentae and placenta previa?
A. abruptio placentae: painless bright red bleeding occurring in the
third trimester
B. abruptio placentae: occurs in the 2nd trimester
C. placenta previa: occurs in the 2nd trimester
D. placenta previa: painless bright red bleeding occurring in the third
trimester
Answer: D
Explanation: The nurse must use knowledge base to differentiate between
abruptio placentae (dark, red vaginal bleeding, 100 bpm FHR, rigid
abdomen and severe pain) from placenta previa (painless bright red
bleeding occurring in the third trimester).
3. A nurse must use knowledge base to differentiate between abruptio
placentae (dark, red vaginal bleeding, 100 bpm FHR, rigid abdomen and
severe pain) from placenta previa (painless bright red bleeding
occurring in the third trimester). What assessments should be done in
case of a patient suspected of abruptio placentae or placenta previa?
A. abdominal or vaginal manipulation
B. Leopold’s maneuvers
C. internal monitoring
D. Monitor for bleeding at IV sites and gums due to the increased risk
of DIC
Answer: D
Explanation: Patients with abruptio placentae or placenta previa (actual
or suspected) should have NO abdominal or vaginal manipulation. NO
Leopold’s maneuvers. NO vaginal exams. NO rectal exams, enemas, or
suppositories. NO internal monitoring.
4. A patient suspected of abruptio placentae or placenta previa should
be monitorized for bleeding at IV sites and gums due to the increased
risk of DIC. What isn’t DIC related to?
A. cervical carcinoma
B. fetal demise
C. infection/sepsis
D. pregnancy-induced hypertension
Answer: A
Explanation: DIC is related to fetal demise, infection/sepsis,
pregnancy-induced hypertension (Preeclampsia) and abruptio palcentae.
Cervical carcinoma is related to Podophyllin.
5. A patient which has been diagnosed with CVA has symptoms of aphasia,
right hemiparesis, but no memory or hearing deficit. In what hemisphere
has the patient most probably suffered a lesion?
A. Left
B. Superior left side
C. Inferior right side
D. Right
Answer: D
Explanation: A patient with a diagnosis of CVA presents with symptoms of
aphasia, right hemiparesis, but no memory or hearing deficit has
suffered a lesion in the left hemisphere.
6. A patient brought to the emergency room has the following symptoms:
hypertension, , bladder and bowel distention, exaggerated autonomic
responses, headache, sweating, goose bumps, and bradycardia. What will
the patient be diagnosed with in this case?
A. spinal shock
B. increased ICP
C. cerebral vascular accident
D. autonomic dysreflexia
Answer: D
Explanation: The symptoms of autonomic dysreflexia are hypertension,
bladder and bowel distention, exaggerated autonomic responses, headache,
sweating, goose bumps, and bradycardia.
1.
If a child is on oral iron medication, the family
should be thought by the nurse how it should be administered. Out of the
following options, what oral iron administration advice is
inappropriate?
A.
Oral iron should be given on empty stomach
B.
Oral iron should be given with citrus juices
C.
Oral iron should be given with dairy products
D.
A dropper or straw should be used to avoid
discoloring teeth
Answer: C
Explanation: Iron can be fatal in severe overdose
and as a result, it should be kept away from children.
Also, do not give it with dairy products.
2.
In Autosomal recessive disease, both parents must be
heterozygous, or carriers of the recessive trait, for the disease to be
expressed in their offspring. If both parents are heterozygous, what is
the chance the baby to have the disease as well?
A.
1:2
B.
1:3
C.
1:4
D.
1:1
Answer: C
Explanation: With each pregnancy, there is a 1:4 chance of the infant
having the disease.
3.
When it comes to X-linked recessive trait, the trait
is carried on the X chromosome, therefore, usually affects male
offspring, (e.g., hemophilia). What is the chance for a pregnant woman
carrier her offspring to get the disease?
A.
Male child: 75% of having the disease
B.
Female child: 50% of having the disease
C.
Male child: 50% of having the disease
D.
Female child: 25% of caring the disease
Answer: C
Explanation: With each pregnancy of a woman who is a carrier there is a
25% chance of having a child with hemophilia.
If the child is male, he has a 50% chance of having hemophilia.
If the child is female, she has a 50% chance of being a carrier.
4.
Supplemental iron is not given to clients with
sickle cell anemia because the anemia is not caused by iron deficiency.
What aspect is very important in treatment of sickle cell disease
because it promotes hemodilution and circulation of red cells through
the blood vessels?
A.
HgbAS
B.
HGBS
C.
Hydration
D.
Hydrotherapy
Answer: C
Explanation: Hydration is very important in treatment of sickle cell
disease because it promotes hemodilution and circulation of red cells
through the blood vessels.
5.
Allopurinol, a xanthine-oxidase inhibitor, is
administered to prevent renal damage from uric acid build up during
cellular lysis. In what drugs combination is Prednisone usually used for
reducing the mitosis of lymphocytes?
A.
epinephrine
B.
antineoplastic drugs
C.
l-asparaginase
D.
oral iron
Answer: B
Explanation: Prednisone is frequently used in combination with
antineoplastic drugs to reduce the mitosis of lymphocytes.
Allopurinol, a xanthine-oxidase inhibitor, is also administered
to prevent renal damage from uric acid build up during cellular lysis.
6.
An infant with hypothyroidism is often described as
a “good, quiet baby” by the parents. What early disease detection is
essential in preventing mental retardation in infants?
A.
Hyperthyroidism
B.
Phenylhetonuria
C.
Diabetes mellitus
D.
Ketoacidosis
Answer: B
Explanation: Early detection of hypothyroidism and phenylhetonuria is
essential in preventing mental retardation in infants.
Knowledge of normal growth and development is important, since a
lack of attaintment can be used to detect the existence of these
metabolic/endocrine disorders and attainment can be used for evaluating
the treatment’s effect.
7.
Diabetes mellitus (DM) in children was typically
diagnosed as insulin dependent diabetes until recently.
What diabetes type has been discovered to occur more often in
Native-American, African-American, and Hispanic children and
adolescents?
A.
Type 1
B.
Type 2
C.
Type 3
D.
Type 4
Answer: B
Explanation: Diabetes mellitus (DM) in children was typically diagnosed
as insulin dependent diabetes (Type I) until recently.
A marked increase in Type II DM has occurred recently in the US,
particularly among Native-American, African-American, and Hispanic
children and adolescents.
8.
There has been an increase in the number of children
diagnosed with Type II diabetes with the increasing rate of obesity in
children is thought to be a contributing factor. What other factors are
thought to be contributing in the increase of Type II diabetes cases?
A.
Hypotension
B.
Hypokalaemia
C.
Lack of physical activity
D.
Hyperkalaemia
Answer: C
Explanation: There has been an increase in the number of children
diagnosed with Type II diabetes.
The increasing rate of obesity in children is thought to be a
contributing factor. Other
contributing factors include lack of physical activity and a family
history of Type II diabetes.
9.
Fractures in older children are common as they fall
during play and are involved in motor vehicle accidents. What fractures
in children are related to child abuse?
A.
Greenstick Fracture
B.
Growth Plate Fracture
C.
Torus Fracture
D.
Spiral fracture
Answer: D
Explanation: Spiral fractures (caused by twisting)
and fractures in infants may be related to child abuse.
10.
Skin traction for fracture reduction should not be
removed unless prescribed by healthcare provider. What fractures have
serious consequences in terms of growth of the affected limb?
A.
Greenstick Fracture
B.
Plate Fracture
C.
Torus Fracture
D.
Spiral fracture
Answer: B
Explanation: Fractures involving the epiphyseal
plate (growth plate) can have serious consequences in terms of growth of
the affected limb.
11.
Corticosteroids are used short term in low doses
during exacerbations. What side effect do Corticosteroids have on long
term?
A.
Adverse effects on growth
B.
Adverse effects on bone structure
C.
Hypoglycemia
D.
Hypocalcemia
Answer: A
Explanation: Corticosteroids are used short term in low doses during
exacerbations. Long-term use
is avoided due to side effects and their adverse effect on growth.
12.
Skin traction for fracture reduction should not be
removed unless prescribed by healthcare provider. What do the pin sites
can usually cause in an infant client?
A.
Hypoglycemia
B.
Hypocalcemia
C.
Infection
D.
Low vitamin K concentration
Answer: C
Explanation: Pin sites can be sources of infection.
The nurse should monitor signs of infection and cleanse and dress
pin sites as prescribed.
13.
The menstrual phase varies in length for most women.
How many days usually are from ovulation to the beginning of the next
menstrual cycle?
A.
12 days
B.
14 days
C.
16 days
D.
18 days
Answer: B
Explanation: From ovulation to the beginning of the next menstrual cycle
is usually exactly 14 days.
In other words, ovulation occurs 14 days before the next menstrual
period.
14.
Sperm lives approximately 3 days and eggs live about
24 hours. Which is the time interval a couple should avoid unprotected
intercourse after the ovulation?
A.
24 hours
B.
48 hours
C.
72 hours
D.
128 hours
Answer: C
Explanation: From ovulation to the beginning of the next menstrual cycle
is usually exactly 14 days.
In other words, ovulation occurs 14 days before the next menstrual
period.
15.
A woman who is 6 weeks pregnant has the following
maternal history: a 2 yr. old healthy daughter, a miscarriage at 10
weeks, 3 years ago and an elective abortion at 6 weeks, 5 years ago. How
can be described gravidity and parity in this case?
A.
gravida 1, para 4
B.
gravida 2, para 4
C.
gravida 4, para 1
D.
gravida 4, para 2
Answer: C
Explanation: With this pregnancy, the women is a gravida 4, para 1 (only
1 delivery after 20 weeks gestation).
16.
The first day of a women’s last normal menstrual
period was October 17. By using Nagele’s rule, what is the EDB?
A.
July 10
B.
July 24
C.
June 10
D.
June 24
Answer: B
Explanation: If the first day of a woman’s last normal menstrual period
was October 17, her EDB using Nagele’s rule is July 24. Count back 3
months and add 7 days (always give February 28 days).
17.
At approximately 28 to 32 weeks gestation, the
maximum plasma volume increase of 25 to 40% occurs, resulting in normal
hemodilution of pregnancy and Hct values of 32 to 42%.
What does Hct in reality represent, even if its values may look
“good”?
A.
pregnancy-induced Hyperglycemia
B.
pregnancy-induced Hypoglycemia
C.
pregnancy-induced Hypertension
D.
pregnancy-induced Hypotension
Answer: C
Explanation: High Hct values may look “good,” but in reality represent
pregnancy-induced hypertension and a depleted vascular space.
18.
A 22-year old primigravida at 12 weeks gestation has
a high Hgb of 9.6 g/dl and a Hct of 31% and she has gained 3 pounds
during the first trimester, even if the gain of3.5 to 5 pounds during
the first trimester is recommended. Taking into consideration that the
client is anemic, what supplements should be recommended to her?
A.
Potassium
B.
Magnesium
C.
Iron
D.
Calcium
Answer: C
Explanation: For the anemic pregnant client, supplemental iron and a diet
higher in iron are needed.
19.
As pregnancy advances, the uterus presses on
abdominal vessels (vena cava and aorta). What position is best for
increasing perfusion according to the latest research?
A.
left side-lying position
B.
knee-chest position
C.
side-lying position
D.
right side-lying position
Answer: B
Explanation: Recent research indicates that the knee-chest position is
best for increasing perfusion and that the side-lying position (either
left or right side-lying) is the second most desirable position to
increase perfusion. Prior to
this research, the left side-lying position was usually encouraged.
20.
Fetal well-being is determined by assessing fundal
height, fetal heart tones/rate, fetal movement and uterine activity
(contractions). What do the
changes in fetal heart rate indicate?
A.
leukorrhea
B.
compromised blood flow to the fetus
C.
Fluid discharge from vagina
D.
Change in fetal movement
Answer: B
Explanation: Changes in fetal heart rate are the first and most important
indicator of compromised blood flow to the fetus, and these changes
require action!
21.
Changes in fetal heart rate are the first and most
important indicator of compromised blood flow to the fetus, and these
changes require action! What
is the normal FHR in a pregnant woman?
A.
150 to 180 bpm
B.
160 to 190 bpm
C.
110 to 160 bpm
D.
120 to 150 bpm
Answer: C
Explanation: Changes in fetal heart rate are the first and most important
indicator of compromised blood flow to the fetus, and these changes
require action! Remember,
the normal FHR is 110 to 160 bpm.
22.
A 28 years old pregnant woman has the following
symptoms: visual disturbance, persistent vomiting, swelling of face,
fingers or sacrum and severe continuous headache. What do these symptoms
most probably indicate?
A.
Preeclampsia/eclampsia
B.
Dysuria
C.
Chills
D.
Fluid discharge from vagina
Answer: A
Explanation: Visual disturbance, persistent vomiting, swelling of face,
fingers or sacrum and severe continuous headache are in pregnant woman
possible indications of indications of preeclampsia/eclampsia.
23.
A nurse should teach the pregnant clients to
immediately report any of the following danger signs because early
intervention can optimize maternal and fetal outcome. Which are the
signs of infection in a pregnant woman?
A.
FHR is 110 to 160 bpm
B.
Chills
C.
Persistent vomiting
D.
Visual disturbances
Answer: B
Explanation: Signs of infection in a pregnant woman are Chills, Dysuria,
pain in abdomen, fluid discharge from vagina and increased FHR.
24.
A pregnant client has temperature over 100.4 F,
Dysuria and fluid discharge from vagina. What could these signs most
probably indicate?
A.
Preeclampsia
B.
Eclampsia
C.
Infection
D.
Change in fetal movement
Answer: C
Explanation: Temperature over 100.4 F, Dysuria and fluid discharge from
vagina are signs of infection.
25.
Most providers prescribe prenatal vitamins to ensure
that the client receives an adequate intake of vitamins.
However, only the healthcare provider can prescribe prenatal
vitamins. Which is the quantity of milk a pregnant woman should drink
per day for ensuring that the daily calcium needs are met?
A.
1/2 quart milk
B.
1/3 quart milk
C.
1/4 quart milk
D.
1 quart milk
Answer: D
Explanation: It is recommended that pregnant women drink one quart of
milk/day. This will ensure
that the daily calcium needs are met an help to alleviate the occurrence
of leg cramps.
26.
The screening for neural tube defects is highly
associated with both false positives and false negatives. Through what
does the screening for neural tube defects in some states?
A.
spina bifida
B.
maternal serum AFP levels
C.
MSAFP
D.
distribution curves of maternal serum APP
Answer: B
Explanation: In some states, the screening for neural tube defects
through either
maternal serum AFP levels or amniotic fluid AFP levels is
mandated by state law. This
screening test is highly associated with both false positives and false
negatives.
27.
In a 24 years old pregnant woman, the amniocentesis
is done in early pregnancy. How should the bladder be to help support
the uterus and to help push the uterus up in the abdomen for easy
access?
A.
Empty
B.
Full
C.
¼ Empty
D.
½ Full
Answer: B
Explanation: When an amniocentesis is done in early pregnancy, the
bladder must be full to help support the uterus and to help push the
uterus up in the abdomen for easy access.
28.
In a 24 years old pregnant woman, the amniocentesis
is done in late pregnancy. How should the bladder be to avoid puncturing
the bladder?
A.
Empty
B.
Full
C.
¼ Empty
D.
½ Full
Answer: A
Explanation: When an amniocentesis is done in late pregnancy, the bladder
must be empty to avoid puncturing the bladder.
29.
The early decelerations in fetal heart rate
monitoring are the transient decrease in heart rate which coincides with
the onset of the uterine contraction. Between what cm do the early
decelerations caused by head compression and fetal descent usually occur
in the 2nd stage?
A.
2 and 6 cm
B.
4 and 7 cm
C.
3 and 8 cm
D.
7 and 10 cm
Answer: B
Explanation: Early decelerations, caused by head compression and fetal
descent, usually occur between 4 and 7 cm and in the 2nd
stage. Check for labor
progress if early decelerations are noted.
30.
A nurse consults a mother and detects cord prolapse.
How should the examiner position the pregnant woman to relieve pressure
on the cord?
A.
side-lying position
B.
right side-lying position
C.
High Flower’s position
D.
knee-chest position
Answer: D
Explanation: If cord prolapse is detected, the examiner should position
the mother to relieve pressure on the cord (i.e., knee-chest position)
or push the presenting part off the cord until IMMEDIATE Cesarean
delivery can be accomplished.
31.
A nurse consults a pregnant mother and detects late
decelerations which indicate uteroplacental insufficiency. What
conditions are late decelerations associated with?
A.
Down Syndrome, AIDS, abruptio placentae
B.
postmaturity, preeclampsia, diabetes mellitus,
cardiac disease, and abruptio placentae
C.
Autism, renal failure, renal insufficiency and
cardiac disease
D.
Kidney failure, cardiac disease, Digitalis toxicity
Answer: B
Explanation: Late decelerations indicate uteroplacental insufficiency and
are associated with conditions such as postmaturity, preeclampsia,
diabetes mellitus, cardiac disease, and abruptio placentae.
32.
At the examination of an expecting woman, the
deceleration patterns are associated with decreased or absent
variability and tachycardia. What should be done immediately in this
case?
A.
Position the mother in High Flower’s position
B.
Position the mother in knee-chest position
C.
immediate intervention and fetal assessment
D.
Spontaneous abortion
Answer: C
Explanation: When deceleration patterns (late or variable) are associated
with decreased or absent variability and tachycardia, the situation is
OMINOUS (potentially disastrous) and requires immediate intervention and
fetal assessment.
33.
In case of a decrease in uteroplacental perfusion,
the nursing interventions should include changing maternal position,
discontinuing Pitocin infusion, administering oxygen and notifying the
healthcare provider. In what do the decreases in uteroplacental
perfusion result?
A.
variable decelerations
B.
late decelerations
C.
early decelerations
D.
ominous decelerations
Answer: B
Explanation: A decrease in uteroplacental perfusion results in late
decelerations; cord compression results in a pattern of variable
decelerations.
34.
The danger of nipple stimulation lies in controlling
the “dose” of oxytocin stimulated from the posterior pituitary and the
chance of hyper-stimulation or tetany is increased. How long do the
contractions last in case of hyper-stimulation?
A.
over 90 sec
B.
over 120 sec
C.
over 150 sec
D.
over 100 sec
Answer: A
Explanation: The contractions last in case of hyper-stimulation over 90
seconds or there are contractions with less than 30 seconds in between.
35.
Percutaneous umbilical blood sampling (PUBS) can be
done during pregnancy under ultrasound for prenatal diagnosis and
therapy. What testing
can not be done using this method?
A.
clotting disorders
B.
AIDS testing
C.
Sepsis
D.
Genetic testing
Answer: B
Explanation: Hemoglobinopathies, clotting disorders, sepsis, and some
genetic testing can be done using this method.
36.
At the monthly examination, the nurse has detected
an extra uterine pregnancy in the 29 year old woman. Which is the L/S
survival ratio for fetal maturity?
A.
1:2
B.
2:0
C.
2:1
D.
1:1
Answer: C
Explanation: The most important determinant of fetal maturity for
extra-uterine survival is the L/S ratio (2:1 or higher).
37.
A 32 year old woman comes to the monthly examination
complaining to have the following symptoms: discomfort in abdomen and
contractions decrease in intensity and/or frequency with ambulation.
What will this client be diagnosed with?
A.
True labor
B.
False labor
C.
Intrauterine labor
D.
Extra-uterine labor
Answer: B
Explanation: In case of a false labor, the discomfort is in abdomen and
contractions decrease in intensity and/or frequency with ambulation and
no lower back pain is present.
38.
A nurse is consulting a 19 years old pregnant client
which made an abortion 12 months ago due to infection. What is the
normal maternal BP that indicates a normal health situation for the
client?
A.
BP: <120/90
B.
BP: <180/90
C.
BP: <140/90
D.
BP: <150/120
Answer: C
Explanation: The normal maternal BP is <140/90.
39.
A nurse is consulting a 19 years old pregnant client
which made an abortion 12 months ago due to infection. What is the
normal maternal pulse that indicates a normal health situation for the
client?
A.
<150 bpm
B.
<100 bpm
C.
<130 bpm
D.
<120 bpm
Answer: B
Explanation: The normal maternal pulse is <100 bpm.
40.
A nurse is consulting a 29 years old pregnant client
which had prior pregnancy complications due to early decelerations. What
is the normal maternal temperature for her?
A.
<100.4 F
B.
<110.4 F
C.
<120.4 F
D.
<130.4 F
Answer: A
Explanation: The normal maternal temperature for any pregnant client is
<100.4 F.
41.
The most important determinant of fetal maturity for
extra-uterine survival is the L/S ratio (2:1 or higher). What is often
the reason for slight elevation?
A.
Low maternal temperature
B.
High maternal pulse
C.
Dehydration
D.
Hypocalcemia
Answer: C
Explanation: Slight elevation is often due to dehydration and the work of
labor. Anything higher
indicates infection and must be reported immediately.
42.
Enema may be refused by woman due to pre-labor
diarrhea or recent, large bowel movement and should not be administered
to a client in active labor. What should a person watch for if head is
floating?
A.
Infection
B.
Hypoglycemia
C.
Hypocalcemia
D.
Cord prolapse
Answer: D
Explanation: An enema should not be administered to a client in active
labor. If head is
floating, watch for cord prolapse.
43.
An enema should not be administered to a client in
active labor. What color does the meconium-strained fluid that may
indicate fetal stress?
A.
Dark red- purple
B.
Yellow-green
C.
Green-red
D.
Yellow-Red
Answer: B
Explanation: Meconium-stained fluid is yellow-green and may indicate
fetal stress.
44.
A pregnant client comes to the hospital with the
following symptoms: dizziness, tingling on fingers, and stiff mouth.
What will she most probably be diagnosed with?
A.
respiratory alkalosis
B.
digitalis toxicity
C.
hyperglycemia
D.
hypocalcemia
Answer: A
Explanation: Hyperventilation results in respiratory alkalosis due to
blowing off too much CO2. Symptoms include: dizziness, tingling on
fingers, and stiff mouth.
45.
A pregnant client with dizziness, tingling on
fingers and stiff mouth is suffering of hyperventilation resulting in
respiratory alkalosis. What is the cause of hyperventilation?
A.
Blowing too much O2
B.
Blowing too much H2O
C.
Lack of Fe
D.
Lack of CH2
Answer: A
Explanation: Hyperventilation results in respiratory alkalosis due to
blowing off too much CO2.
Have woman breathe into her cupped hands or a paper bag in order
to rebreathe CO2.
46.
If pushing starts too early, the cervix can become
edematous and never fully dilate. Which is the cervix diameter when it
is completely dilated?
A.
15 cm
B.
10 cm
C.
8 cm
D.
18 cm
Answer: B
Explanation: Cervix should be completely dilated (10 cm) before the
client begins pushing. If
pushing starts too early, the cervix can become edematous and never
fully dilate.
47.
A nurse should determine cervical dilation before
allowing client to push. What happens in the case that the client starts
pushing too early?
A.
Cervix becomes edematous
B.
Client can pass out because of the pain caused by
the not dilated cervix
C.
Fetus can suffer traumas
D.
Fetus can die
Answer: A
Explanation: Determine cervical dilation before allowing client to push.
Cervix should be completely dilated (10 cm) before the client
begins pushing. If pushing
starts too early, the cervix can become edematous and never fully
dilate.
48.
Oxytocin drug causes the uterus to contract and
because of that, the moment when it is administered is very important.
From your knowledge about this fact, when should oxytocin be
administered?
A.
After cervix is dilated
B.
Before cervix is dilated
C.
after the placenta is delivered
D.
before the placenta is delivered
Answer: C
Explanation: Give the oxytocin after the placenta is delivered because
the drug will cause the uterus to contract.
If the oxytocic drug is administered before the placenta is
delivered, it may result in a retained placenta, which predisposes the
client to hemorrhage and infection.
49.
Oxytocin should be administered after the placenta
is delivered because the drug will cause the uterus to contract. What
can happen if the drug is administered before placenta is delivered?
A.
Will predispose the client to nausea
B.
Will predispose the client to amnesia
C.
Will predispose the client to hemorrhage
D.
Will predispose the client to hypocalcemia
Answer: C
Explanation: If the oxytocic drug is administered before the placenta is
delivered, it may result in a retained placenta, which predisposes the
client to hemorrhage and infection.
50.
After the delivery, two of the perineal pads should
be placed on perineum. What application should the nurse make use of
after delivery?
A.
Apply from back to front so that the pad is dragged
across the anus
B.
Apply from front to back so that the pad is dragged
across the anus
C.
Not apply from back to front being careful not to
drag pad across the anus
D.
Apply from front to back being careful not to drag
pad across the anus
Answer: D
Explanation: The applications of perineal pads after delivery are:
placing two on perineum, not touching inside of pad and applying from
front to back, being careful not to drag pad across the anus.
51.
Pitocin should be given with caution to clients with
hypertension. What drug shouldn’t be given to clients with hypertension
due to its vasoconstrictive action?
A.
analgesics
B.
meperidine
C.
codeine
D.
methergine
Answer: D
Explanation: Methergine is NOT given to clients with hypertension due to
its vasoconstrictive action.
Pitocin is given with caution to those with hypertension.
52.
In the first 12 hours after delivery, the 22 years
old client shows signs of hemorrhage. What is one of the common reasons
for uterine atony and/or hemorrhage in the first 24 hours after
delivery?
A.
Empty bladder
B.
Full bladder
C.
Hypoglycemia
D.
Low blood pressure
Answer: B
Explanation: FULL BLADDER is one of the most common reasons for uterine
atony and/or hemorrhage in the first 24 hours after delivery.
53.
When examining a client after delivery, the nurse
finds the fundus soft, boggy, and displaced above and to the right of
the umbilicus. What action should the nurse take first in this case?
A.
have the client empty her bladder
B.
perform fundal massage
C.
administer narcotic analgesics
D.
administer codeine and meperidine
Answer: B
Explanation: First the nurse should perform fundal massage; then have the
client empty her bladder.
54.
When examining a client after delivery, the nurse
finds the fundus soft, boggy, and displaced above and to the right of
the umbilicus. After performing fundal massage and having the client
emptying her bladder when should the nurse recheck fundus?
A.
q15 minutes X 4 (1 hour)
B.
q 45 minutes X 2 (1.5 hours);
C.
q 30 minutes X 4 (2 hour);
D.
q 30 minutes X 2 (1 hour);
Answer: A
Explanation: The nurse should recheck fundus q15 minutes X 4 (1 hour);
q30 minutes X 2 hours.
55.
If narcotic analgesics (codeine, meperidine) are
given, a nurse should raise side rails and place call light within reach
and also instruct client not to get out of bed or ambulate without
assistance. What is the side effect the client should know about?
A.
Nausea
B.
Diarrhea
C.
Amnesia
D.
Drowsiness
Answer: D
Explanation: If narcotic analgesics (codeine, meperidine) are given, the
client should be cautioned about drowsiness as a side effect.
56.
Tears cause pain and swelling and because of that
rectal manipulations should be avoided. What do the 2nd
degree tear involve?
A.
epidermis
B.
dermis, muscle, and fascia
C.
anal sphincter
D.
rectal mucosa
Answer: B
Explanation: A 2nd degree tear involves dermis, muscle, and
fascia.
57.
Tears cause pain and swelling and because of that
rectal manipulations should be avoided. What tear degree extends into
the anal sphincter?
A.
1st degree tear
B.
2nd degree tear
C.
3rd degree tear
D.
4th degree tear
Answer: C
Explanation: A 3rd degree tear extends into the anal
sphincter.
58.
Rectal manipulations should be avoided because tears
cause pain and swelling. What degree tear extends up the rectal mucosa?
A.
1st degree tear
B.
2nd degree tear
C.
3rd degree tear
D.
4th degree tear
Answer: D
Explanation: A 4th degree tear extends up the rectal mucosa.
59.
Tears cause pain and swelling and because of that
rectal manipulations should be avoided. What do the first degree tear
involves?
A.
epidermis
B.
dermis, muscle, and fascia
C.
anal sphincter
D.
rectal mucosa
Answer: A
Explanation: A 1st degree tear involves only the epidermis.
60.
If it was documented that the fetus passed meconium
in utero or the nurse noted LATE passage of meconium in delivery room,
the neonate MUST be attended by a pediatrician, neonatologist, and/or
nurse practitioner to determine, through endotracheal tube observation
and suction, the presence of meconium below the cords. What can this
fact result in?
A.
Down syndrome
B.
pneumonitis/meconium aspiration syndrome
C.
Stanley syndrome
D.
Asperger syndrome
Answer: B
Explanation: It can result in pneumonitis/meconium aspiration syndrome,
which will necessitate a sepsis workup including a chest x-ray early in
the transitional newborn period.
61.
Apgar scores of 6 or < at 5 minutes require an
additional Apgar assessment at 10 minutes. When should the resuscitation
begin of the compromised neonate?
A.
Only after a 1 minute Apgar
B.
Only after 2 minute Apgar
C.
Do not wait until a 1 minute Apgar is assigned to
begin resuscitation
D.
Only after 5 minute Apgar
Answer: C
Explanation: Do not wait until a 1 minute Apgar is assigned to begin
resuscitation of the compromised neonate.
62.
A client in labor needs administration of
analgesics. What type of analgesic administration is preferred in this
case because the onset and peak occurs more quickly and duration of the
drug is shorter?
A.
IM
B.
IV
C.
Oral administration
D.
VI
Answer: B
Explanation: IV administration of analgesics is preferred to IM for the
client in labor because the onset and peak occurs more quickly and
duration of the drug is shorter.
63.
IV administration of analgesics is preferred to IM
for the client in labor because the onset and peak occurs more quickly
and duration of the drug is shorter. Which is the predictable onset with
IV administration?
A.
2 minutes
B.
5 minutes
C.
10 minutes
D.
8 minutes
Answer: B
Explanation: The predictable onset of IV administration of analgesics is
5 minutes.
64.
A 29 years old female client on delivery is
administered IV analgesics. How long can the peak be in this case?
A.
1 hour
B.
20 minutes
C.
30 minutes
D.
15 minutes
Answer: C
Explanation: The peak in this case is 30 minutes.
65.
IV administration of analgesics is preferred to IM
for the client in labor because the onset and peak occurs more quickly
and duration of the drug is shorter. Which is the peak time after
injection in this case?
A.
2 hours
B.
1-3 hours
C.
4-6 hours
D.
3-5 hours
Answer: B
Explanation: Peak duration is 1 to 3 hours after injection.
66.
During the labor, a client is prescribed Phenergan
tranquilizers that are used in this case as analgesic-potentiating
drugs. What effect do these drugs have in this case?
A.
Pain relief
B.
Decrease of maternal anxiety
C.
Decrease of nausea symptoms
D.
Stress management
Answer: B
Explanation: Tranquilizers (ataractics and/or phenothiazines) Phenergan,
Vistaril, are used in labor as analgesic-potentiating drugs to decrease
maternal anxiety.
67.
Tranquilizers (ataractics and/or phenothiazines)
Phenergan, Vistaril, are used in labor as analgesic-potentiating drugs
to decrease maternal anxiety. What narcotic drugs produce narcosis and
have a higher risk for maternal/fetal respiratory depression?
A.
Stadol
B.
Nubain
C.
Demerol
D.
Vistaril
Answer: C
Explanation: Agonist narcotic drugs (Demerol, morphine) produce narcosis
and have a higher risk for maternal/fetal respiratory depression.
68.
Antagonist drugs (Stadol, Nubain) have less
respiratory depression, but have to be used with caution by the clients.
What is the drawback of the antagonist drugs?
A.
withdrawal symptoms occur immediately
B.
produce narcosis
C.
onset and peak occurs more quickly
D.
duration of the drug is shorter
Answer: A
Explanation: Antagonist drugs (Stadol, Nubain) have less respiratory
depression but MUST be used with caution in a mother with preexisting
narcotic dependency since withdrawal symptoms occur immediately.
69.
The first sign of block effectiveness is usually
warmth and tingling of ball/big toe of foot. What block is used only for
all stages of labor?
A.
Peri/epidural
B.
Pudendal
block
C.
Subarachnoid block
D.
saddle block
Answer: A
Explanation: Pudendal block and subarachnoid (saddle block) are used only
for second stage of labor.
Peri/epidural may be used for all stages of labor.
70.
Pudendal block and subarachnoid (saddle block) are
used only for second stage of labor.
Peri/epidural may be used for all stages of labor. Which is
usually the first sign of block effectiveness?
A.
cold and tingling of ball/big toe of foot
B.
warmth and tingling of ball/big toe of foot
C.
Internal rotation
D.
Regional rotation
Answer: B
Explanation: The first sign of block effectiveness is usually warmth and
tingling of ball/big toe of foot.
71.
The first sign of block effectiveness is usually
warmth and tingling of ball/big toe of foot. When is internal rotation
harder to achieve?
A.
when the pelvic floor is relaxed by anesthesia
B.
when the pelvic floor is tensed
C.
when the uterus is relaxed by anesthesia
D.
when the uterus is tensed
Answer: A
Explanation: Internal rotation is harder to achieve when the pelvic floor
is relaxed by anesthesia resulting in persistent occiput posterior
position of fetus.
72.
Monitoring for fetal position is important because
the mother cannot tell you she has back pain, which is the cardinal sign
of persistent posterior fetal position. Why do the regional blocks,
especially epidural and caudal, often result in assisted (forceps or
vacuum) delivery?
A.
Due to the inability to push effectively in 3rd
stage.
B.
Due to the inability to push effectively in 2nd
stage.
C.
Due to the inability to push effectively in 4th
stage.
D.
Due to the inability to push effectively in 1st
stage.
Answer: B
Explanation: Regional blocks, especially epidural and caudal, often
result in assisted (forceps or vacuum) delivery due to the inability to
push effectively in 2nd stage.
73.
Internal rotation is harder to achieve when the
pelvic floor is relaxed by anesthesia resulting in persistent occiput
posterior position of fetus. What regional blocks often result in
assisted (forceps or vacuum) delivery due to the inability to push
effectively in 2nd stage?
A.
Epidermis
B.
anal sphincter
C.
rectal mucosa
D.
caudal
Answer: D
Explanation: Regional blocks, especially epidural and caudal, often
result in assisted (forceps or vacuum) delivery due to the inability to
push effectively in 2nd stage.
74.
Nerve block anesthesia (spinal or epidural) during
labor blocks motor as well as nerve fibers. What does result from
vasodilation below the level of the block?
A.
Maternal hypertension
B.
Maternal hypotension
C.
Low BP
D.
High BP
Answer: B
Explanation: Vasodilation below the level of the block results in blood
pooling in the lower extemities and maternal hypotension.
75.
Vasodilation below the level of the block results in
blood pooling in the lower extemities and maternal hypotension. Which is
the quantity of IV lactated ringers the client should 20 minutes prior
to operation be hydrated with?
A.
100-200 cc
B.
300-500 cc
C.
500-1000 cc
D.
600-800 cc
Answer: Approximately 20 minutes prior to nerve block anesthesia, the
client should be hydrated with 500 to 1000 cc of lactated ringers IV.
76.
Approximately 20 minutes prior to nerve block
anesthesia, the client should be hydrated with 500 to 1000 cc of
lactated ringers IV. What should the nurse do if hypotension occurs?
A.
Administer Stadol
B.
Administer O2 at 10 L/min by facemask
C.
Administer CO2 at 10 L/min by facemask
D.
Administer Nubain
Answer: B
Explanation: If hypotension occurs – turn the client to her side,
administer O2 at 10 L/min by facemask, and increase IV rate.
77.
Normal leukocytosis of pregnancy averages 12,000 to
15,000 mm3. What leukocytosis values are common in the first 10 to 12
post-delivery days?
A.
18,000 mm3
B.
20,000 mm3
C.
22,000 mm3
D.
25,000 mm3
Answer: D
Explanation: The first 10 to 12 days post-delivery, values of 25,000 mm3
are common.
78.
Elevated WBC and the normal elevated ESR may confuse
interpretation of acute postpartal infections. If the nurse assesses a
client’s temperature to be 101 F on the client’s second postpartum day,
what assessments should be made before notifying the physician?
A.
Check for Homan’s sign
B.
Check for postnatal bleeding
C.
Check for gastric burns
D.
Check for BP
Answer: A
Explanation: In the client’s second postpartum day, the nurse should
assess fundal height and firmness, perineal integrity, check for a
positive Homan’s sign and other symptoms, i.e., burning on urination,
pain in leg, excessive tenderness of uterus.
79.
A nurse should teach the client in the post-natal
period about the lochia changes, perineal care, breastfeeding, and sore
nipples. What is the most common cause of uterine atony in the 1st
PP day?
A.
Renal failure
B.
Kidney failure
C.
retained placental fragments
D.
blood loss
Answer: C
Explanation: After the 1st PP day, the most common cause of
uterine atony is retained placental fragments.
The nurse must check for presence of fragments in lochial tissue.
80.
Women can tolerate blood loss, even slightly
excessive blood loss, in the postpartal period due to the 40% increase
in plasma volume during pregnancy.
What is the max cc amount per day that a woman can void after the
delivery to reduce this volume increase that occurred during the
pregnancy?
A.
up to 1,000 cc/day
B.
up to 3,000 cc/day
C.
up to 2,000 cc/day
D.
up to 4,000 cc/day
Answer: B
Explanation: In postpartal period can void up to 3,000 cc/day to reduce
this volume increase that occurred during pregnancy.
81.
After the delivery, the astute nurse should check
for client’s Hgb and Hct for anemia and the blood pressure, sitting and
lying for orthostatic hypotension. What is the reason for women having
syncopal spell on the first ambulation after delivery?
A.
linea nigra changes
B.
ovasomotor changes
C.
hormonal changes
D.
irritant vulvitis
Answer: B
Explanation: Women often have a syncopal spell (faint) on the first
ambulation after delivery (usually related to ovasomotor changes,
orthostatic hypotension).
82.
Women often have a syncopal spell (faint) on the
first ambulation after delivery (usually related t ovasomotor changes,
orthostatic hypotension).
What do the Kegel post-natal exercises help at?
A.
Improve mobility
B.
Improve urine retention
C.
Improve blood circulation
D.
Speed up the healing process of the postpartum blues
Answer: B
Explanation: Kegel exercises: increase integrity of introitus and improve
urine retention. Teach
client to alternate contraction and relaxation of the pubococcygeal
muscles.
83.
Postpartum blues” are usually normal, especially 5
to 7 days after delivery. In what case is RhoGAM given to a mother after
delivery?
A.
If mother is Rh-positive
B.
If mother is Rh-negative
C.
If the mother has a positive Coombs
D.
If the mother delivers a Rh-negative fetus
Answer: B
Explanation: Remember RhoGAM is given to a Rh-negative mother who
delivers a Rh-positive fetus and has a negative direct Coombs.
If the mother has a positive Coombs, there is no need to give
RhoGAM since the mother is already sensitized.
84.
Regardless of who performs the physical assessment,
the nurse must know normal versus abnormal variations of the newborn.
What is the difference between caput succedaneum and cephalhematoma?
A.
cephalhematoma crosses suture lines and is usually
present at birth
B.
cephalhematoma does NOT cross suture lines and
manifests a few hours after birth
C.
cephalhematoma: edema under the scalp
D.
caput succedaneum: blood under the periosteum
Answer: B
Explanation: It is difficult to differentiate between caput succedaneum
(edema under the scalp) and cephalhematoma (blood under the periosteum).
The caput crosses suture lines and is usually present at birth,
while the cephalhematoma does NOT cross suture lines and manifests a few
hours after birth.
85.
The caput crosses suture lines and is usually
present at birth, while the cephalhematoma does NOT cross suture lines
and manifests a few hours after birth.
What is the danger of cephalhematoma increased by?
A.
hypobilirubinemia
B.
hyperbilirubinemia
C.
hypocalcemia
D.
hypercalcemia
Answer: B
Explanation: The danger of cephalhematoma is increased by
hyperbilirubinemia due to excess RBC breakdown.
86.
Hyperbilirubinemia reflexes are transient, and, as
such, disappear usually within the first year of life.
What does the prolonged presence of these reflexes indicate in
pediatric clients?
A.
Pulse oximetry
B.
CNS defects
C.
heart defects
D.
Defects of neuronal migration
Answer: B
Explanation: In the pediatric client, prolonged presence of these
reflexes can indicate CNS defects.
87.
The umbilical cord should always be checked at
birth. What should the
umbilical cord contain in a newborn?
A.
3 vessels, 2 veins which carry oxygenated blood to
the fetus and 1 artery which carries unoxygenated blood back to the
placenta
B.
4 vessels, 2 veins which carry oxygenated blood to
the fetus and 2 arteries which carry unoxygenated blood back to the
placenta
C.
3 vessels, 1 vein which carries oxygenated blood to
the fetus and 2 arteries which carry unoxygenated blood back to the
placenta
D.
3 vessels, 1 artery which carries oxygenated blood
to the fetus and 2 veins which carry unoxygenated blood back to the
placenta
Answer: C
Explanation: It should contain 3 vessels, 1 vein which carries oxygenated
blood to the fetus and 2 arteries which carry unoxygenated blood back to
the placenta. This is the
opposite of normal circulation in the adult.
88.
The umbilical cord in a newborn should contain 3
vessels, 1 vein which carries oxygenated blood to the fetus and 2
arteries which carry unoxygenated blood back to the placenta.
What do cord abnormalities usually indicate?
A.
Neurologic anomalies
B.
renal anomalies
C.
Congenital vertebral anomaly
D.
Chromosome anomaly
Answer: B
Explanation: Cord abnormalities usually indicate cardiovascular or renal
anomalies.
89.
Cord abnormalities usually indicate cardiovascular
or renal anomalies. What happens if fetal structures of foramen ovale,
ductus arteriosus and ductus venosus do not close postnatal?
A.
cardiac and pulmonary compromise
B.
renal compromise
C.
gastro-intestinal compromise
D.
neurological compromise
Answer: A
Explanation: Postnatally, the fetal structures of foramen ovale, ductus
arteriosus and ductus venosus should close.
If they do not, cardiac and pulmonary compromise will develop.
90.
If the structures of foramen ovale, ductus
arteriosus and ductus venosus don’t close postnatally, cardiac and
pulmonary compromise will develop. What should be suctioned by the nurse
firstly?
A.
Nose
B.
Moth
C.
Lungs
D.
Kidney
Answer: B
Explanation: Suctioning the mouth first and then the nose.
Stimulating the nares can initiate inspiration which could cause
aspiration of mucus in oral pharynx.
91.
The use of brown fat (special fat deposits fetus
puts on in last trimester which are important to thermoregulation) for
energy, can result in ketoacidosis and possible shock in a newborn. What
does hypothermia lead to?
A.
depletion of calcium
B.
depletion of glucose
C.
depletion of iron
D.
depletion of proteins
Answer: B
Explanation: HYPOTHERMIA (heat loss) leads to depletion of glucose and,
therefore, the use of brown fat (special fat deposits fetus puts on in
last trimester which are important to thermoregulation) for energy,
resulting in ketoacidosis and possible shock.
92.
Physiologic jaundice is the normal inability of the
immature liver to keep up with normal RBC destruction. When does
jaundice occur in newborns?
A.
5-6 day of life
B.
2-3 day of life
C.
7-8 day of life
D.
9-10 day of life
Answer: B
Explanation: Physiologic jaundice (normal inability of the immature liver
to keep up with normal RBC destruction) occurs at 2 to 3 days of life.
93.
Physiologic jaundice (normal inability of the
immature liver to keep up with normal RBC destruction) occurs at 2 to 3
days of life. When does jaundice become pathologic?
A.
When it occurs before 24 hours or persists beyond 7
days
B.
When it occurs before 14 hours or persists beyond 8
days
C.
When it occurs before 12 hours or persists beyond 3
days
D.
When it occurs before 10 hours or persists beyond 2
days
Answer: A
Explanation: Physiologic jaundice (normal inability of the immature liver
to keep up with normal RBC destruction) occurs at 2 to 3 days of life.
If it occurs before 24 hours or persists beyond 7 days, it
becomes pathologic.
94.
Physiologic jaundice which occurs 2 to 3 days after
birth due to the liver’s inability to keep up with RBC destruction. Who
is the culprit in this case?
A.
conjugated bilirubin
B.
unconjugated bilirubin
C.
unconjugated penile
D.
conjugated penile
Answer: B
Explanation: Typically, NCLEX-RN questions ask about normal problem of
physiologic jaundice which occurs 2 to 3 days after birth due to the
liver’s inability to keep up with RBC destruction and bind bilirubin.
Remember, unconjugated bilirubin is the culprit.
95.
A nurse is caring for a newborn baby and the feeding
hour arrived. In what case shouldn’t the nurse feed him and inform the
physician and anticipate gavage feedings in order to prevent further
energy utilization and possible aspiration?
A.
when the respiratory rate is over 50
B.
when the respiratory rate is over 40
C.
when the respiratory rate is over 60
D.
when the respiratory rate is over 30
Answer: Do not feed a newborn when the respiratory rate is over 60.
Inform the physician and anticipate gavage feedings in order to
prevent further energy utilization and possible aspiration.
96.
A 7 lb. 8 oz. baby would need 50 calories X 7 lbs =
350 calories plus 25 calories (1/2 lb. or 8 oz.) = 375 calories per day.
Taking into consideration that most infant formulas contain 20
calories/ounce, how many ounces of formula are needed per day?
A.
18.75
B.
14.75
C.
13.75
D.
16.75
Answer: A
Explanation: Dividing 375 by 20 = 18.75 ounces of formula needed per day
for a 7 lb. 8 oz. baby.
97.
A nurse caring for a 7 lb. 8 oz. baby feeds him with
18.75 ounces of infant formula needed per day. If every infant formula
contains 20 calories/ounce, which is the total amount of calories a baby
needs per day?
A.
175 calories per day
B.
375 calories per day
C.
575 calories per day
D.
275 calories per day
Answer: B
Explanation: A 7 lb. 8 oz. baby would need 50 calories X 7 lbs = 350
calories plus 25 calories (1/2 lb. or 8 oz.) = 375 calories per day.
Most infant formulas contain 20 calories/ounce.
Dividing 375 by 20 = 18.75 ounces of formula needed per day.
98.
A nurse should teach newbie parents to take both
axillary and rectally temperature of the child. How long should the
thermometer be hold in place if it is rectally placed?
A.
2 minutes
B.
3 minutes
C.
4 minutes
D.
5 minutes
Answer: D
Explanation: Rectal temperature: the thermometer should be used with
BLUNT end. Insert
thermometer ¼ to ½ inch and hold in place for 5 minutes.
Hold feet and legs firmly.
99.
A client with prior traumatic delivery and history
of D&C may experience miscarriage or preterm. What is the most common
cause of miscarriages?
A.
Incompetent cervix
B.
Incompetent pelvis
C.
Incompetent uterus
D.
Incompetent vagina
Answer: A
Explanation: Clients with prior traumatic delivery, history of D&C,
multiple abortions (spontaneous or induced), or daughters of DES mothers
may experience miscarriage or preterm labor related to INCOMPETENT
CERVIX. The cervix may be
surgically repaired prior to pregnancy, or DURING gestation.
100.
A woman of childbearing age presents at an emergency
room with unilateral and bilateral abdominal pain. What should the nurse
correctly suspect in this case?
A.
Appendicitis
B.
ectopic pregnancy
C.
entopic pregnancy
D.
etiopic pregnancy
Answer: B
Explanation: Suspect ectopic pregnancy in any woman of childbearing age
who presents at an emergency room, clinic, or office with unilateral or
bilateral abdominal pain.
Most are misdiagnosed with appendicitis.
101.
A client who is 32 weeks gestation is experiencing
dark, red vaginal bleeding and the nurse determines the FHR to be 100
bpm and her abdomen is rigid and boardlike. What action should the nurse
take first?
A.
Abdominal manipulation
B.
vaginal manipulation
C.
Abdominal exam
D.
Administer O2 per face mask
Answer: D
Explanation: The nurse should immediately notify the healthcare provider
and no abdominal or vaginal manipulation or exams should be done.
Administer O2 per face mask and monitor for bleeding at IV sites
and gums due to the increased risk of DIC.
102.
A client who is 32 weeks gestation has the following
symptoms: dark, red vaginal bleeding, 100 bpm FHR, rigid abdomen and
severe pain. What is the difference between abruptio placentae and
placenta previa?
A.
abruptio placentae: painless bright red bleeding
occurring in the third trimester
B.
placenta previa: painless bright red bleeding
occurring in the third trimester
C.
abruptio
placentae: occurs in the 2nd trimester
D.
placenta previa: occurs in the 2nd
trimester
Answer: B
Explanation: The nurse must use knowledge base to differentiate between
abruptio placentae (dark, red vaginal bleeding, 100 bpm FHR, rigid
abdomen and severe pain) from placenta previa (painless bright red
bleeding occurring in the third trimester).
103.
A nurse must use knowledge base to differentiate
between abruptio placentae (dark, red vaginal bleeding, 100 bpm FHR,
rigid abdomen and severe pain) from placenta previa (painless bright red
bleeding occurring in the third trimester). What assessments should be
done in case of a client suspected of abruptio placentae or placenta
previa?
A.
Monitor for bleeding at IV sites and gums due to the
increased risk of DIC
B.
abdominal or vaginal manipulation
C.
Leopold’s maneuvers
D.
internal monitoring
Answer: A
Explanation: Clients with abruptio placentae or placenta previa (actual
or suspected) should have NO abdominal or vaginal manipulation.
NO Leopold’s maneuvers.
NO vaginal exams. NO
rectal exams, enemas, or suppositories.
NO internal monitoring.
104.
A client suspected of abruptio placentae or placenta
previa should be monitorized for bleeding at IV sites and gums due to
the increased risk of DIC. What isn’t DIC related to?
A.
fetal demise
B.
infection/sepsis
C.
pregnancy-induced hypertension
D.
cervical carcinoma
Answer: D
Explanation: DIC is related to fetal demise, infection/sepsis,
pregnancy-induced hypertension (Preeclampsia) and abruptio palcentae.
Cervical carcinoma is related to Podophyllin.
105.
Podophyllin, which is usually used to treat HPV, but
is contraindicated in pregnancy because its negative effects on it. What
is Podophyllin usually related to?
A.
abruptio palcentae
B.
Preeclampsia
C.
infection/sepsis
D.
fetal death
Answer: D
Explanation: Podophyllin, which is usually used to treat HPV, is
contraindicated in pregnancy because it is associated with fetal death,
preterm labor, and cervical carcinoma.
106.
Podophyllin, which is usually used to treat HPV, is
contraindicated in pregnancy because it is associated with fetal death,
preterm labor, and cervical carcinoma. What is Toxoplasmosis usually
related to?
A.
exposure to cats
B.
Preeclampsia
C.
Hypertension
D.
fetal demise
Answer: A
Explanation: Toxoplasmosis is usually related to exposure to cats,
gardening (where cat feces may be found), or eating raw meat.
107.
All women should have their titers checked during
pregnancy. What can Rubella
cause to the fetus in the first trimester?
A.
renal failure
B.
congenital heart disease
C.
neurological retard
D.
pulmonary defects
Answer: B
Explanation: Rubella is teratogenic to the fetus during the FIRST
trimester, causing congenital heart disease and/or congenital cataracts.
All women should have their titers checked during pregnancy.
108.
All women should have their titers checked during
pregnancy. In what case should a woman receive the vaccine AFTER
delivery and be instructed not to get pregnant within 3 months?
A.
If titer’s are high
B.
If titer’s are low
C.
If congenital cataracts are present
D.
If it is risk of congenital heart disease
Answer: B
Explanation: If a women’s titer’s are low, she should receive the vaccine
AFTER delivery and be instructed not to get pregnant within 3 months.
Breastfeeding mothers may take the vaccine.
109.
Metronidazole (Flagyl) is the treatment of choice
for some vaginal infections. Why is it contraindicated for pregnant
women in the first trimester?
A.
Causes hypertension
B.
effect on the fetus
C.
causes nausea
D.
causes vomiting
Answer: B
Explanation: Although Metronidazole (Flagyl) is the treatment of choice
for some vaginal infections, its use is contraindicated in the first
trimester of pregnancy, and its use during the second trimester is
controversial. Medications
usually recommended for the non-pregnant client with STDs may be
CONTRAINDICATED for the pregnant client due to effect on the fetus.
110.
The side effects of magnesium sulfate are well known
and watched for during a pregnancy, however they still are important for
the organism. What should the serum blood levels of magnesium sulfate be
in order to prevent convulsions and reach therapeutic range?
A.
above 2 mg/dl
B.
above 4 mg/dl
C.
above 9 mg/dl
D.
above 7 mg/dl
Answer: B
Explanation: Although the toxic side effects of magnesium sulfate are
well known and watched for, it is just as important to get serum blood
levels of magnesium sulfate above 4 mg/dl in order to prevent
convulsions and reach therapeutic range.
111.
Although the toxic side effects of magnesium sulfate
are well known and watched for, it is just as important to get serum
blood levels of magnesium sulfate above 4 mg/dl in order to prevent
convulsions and reach therapeutic range. What are the toxic symptoms of
magnesium sulfate?
A.
>12 respirations/minute
B.
urine output <200 cc/4 hours
C.
absent DTRs
D.
Magnesium sulfate > 10 mg/dl
Answer: C
Explanation: A client should notify healthcare provider if any toxic
symptoms occur (<12 respirations/minute, urine output <100 cc/4 hours,
absent DTRs, Magnesium sulfate > 8 mg/dl).
112.
Although the toxic side effects of magnesium sulfate
are well known and watched for, it is just as important to get serum
blood levels of magnesium sulfate above 4 mg/dl in order to prevent
convulsions and reach therapeutic range. What is the magnesium sulfate
toxicity antidote?
A.
Ammonium phosphate, 20 ml vial of 10% solution
B.
calcium gluconate, 20 ml vial of 10% solution
C.
calcium oxide, 20 ml vial of 10% solution
D.
Yutopar
Answer: B
Explanation: When administering magnesium sulfate, always have antidote
available (calcium gluconate, 20 ml vial of 10% solution).
113.
Bete adrenergic agents such as terbutaline
(Brethine) or ritodrine (Yutopar) used to stop preterm labor.
What is the major side effect of this drug?
A.
Digitalis toxicity
B.
Tachycardia
C.
Renal failure
D.
Hypoglycemia
Answer: Tachycardia is the major side-effect of tocolytic drugs, which
are bete adrenergic agents such as terbutaline (Brethine) or ritodrine
(Yutopar) used to stop preterm labor.
114.
Brethine is used to stop preterm labor in a client.
In what instance should the client withhold taking the drug?
A.
if pulse >120 to 140
B.
if pulse <120 to 140
C.
if pulse >100 to 120
D.
if pulse <120 to 140
Answer: A nurse should teach the client to to take her pulse prior to
administration and withhold medication if pulse is not within the
prescribed parameters (usually whitheld if pulse >120 to 140).
115.
Dystocia frequently requires the use of oxytocin for
augmentation or induction of labor, but uterine tetany is a harmful
complication and careful monitoring is required. What is the desired
effect when uterine tetany is administered?
A.
contractions q4 to 5 minutes
B.
contractions q1 to 2 minutes
C.
contractions q2 to 3 minutes
D.
contractions q5 to 6 minutes
Answer: C
Explanation: The desired effect is contractions q2 to 3 minutes, with
duration of contractions no longer than 90 seconds.
116.
If tetany occurs, turn off Pitocin, turn client to a
side-lying position, and administer O2 by facemask. Which is oxytocin’s
most important side effect that can cause water intoxication?
A.
ADH
B.
ADD
C.
DAD
D.
HAD
Answer: A
Explanation: Oxytocin’s most important side effects is its antidiuretic
(ADH) effect, which can cause water intoxification.
117.
Oxytocin’s most important side effects is its
antidiuretic (ADH) effect, which can cause water intoxification.
What can decrease risk of water intoxification?
A.
IV fluids containing sulfate
B.
IV fluids containing chloride
C.
IV fluids containing electrolytes
D.
IV fluids containing potassium
Answer: C
Explanation: Using IV fluids containing electrolytes decreases the risk
of water intoxification.
118.
The uterus is most sensitive to becoming tetanic at
the beginning of infusion.
How long should the contraction of a client be for preventing fetal
hypoxia?
A.
30 sec
B.
40 sec
C.
60 sec
D.
90 sec
Answer: D
Explanation: The client must ALWAYS be attended and contractions
monitored. Contractions
should last NO longer than 90 seconds to prevent fetal hypoxia.
119.
A client with previous uterine scars is prone to
uterine rupture especially if oxytocin or forceps are used. When should
a nurse suspect a uterine rupture?
A.
When the client complains of a sharp headache
accompanied by nausea
B.
When the client complains of a sharp pain
accompanied by the abrupt cessation of contractions
C.
When the client complains of diarrhea accompanied by
vomiting
D.
When the client shows signs of amnesia accompanied
by irritability
Answer: B
Explanation: Women with previous uterine scars are prone to uterine
rupture especially if oxytocin or forceps are used.
If a woman complains of a sharp pain accompanied by the abrupt
cessation of contractions, suspect uterine rupture, a MEDICAL EMERGENCY.
Immediate surgical delivery is indicated to save the fetus and
the mother.
120.
Antihypertensive drugs are used in a preeclamptic
client only rarely. In what case are these drugs administered to a
client?
A.
If diastolic blood pressure is over 11 mmHg
B.
If diastolic blood pressure is over 110 mmHg
C.
If diastolic blood pressure is over 81 mmHg
D.
diastolic blood pressure over 91 mmHg
Answer: B
Explanation: Rarely are antihypertensive drugs used in the preeclamptic
client. They are given only
in the event of diastolic blood pressure over 110 mmHg. (CVA danger).
121.
Antihypertensive drugs are used in the preeclamptic
client only in the event of diastolic blood pressure over 110 mmHg. (CVA
danger). What are the drugs of choice in this case?
A.
Hydralazine HCL (Apresoline)
B.
Sucralfate
C.
Doxazosin
D.
Gentamicin
Answer: A
Explanation: Rarely are antihypertensive drugs used in the preeclamptic
client. They are given only
in the event of diastolic blood pressure over 110 mmHg. (CVA danger).
Drug of choice is Hydralazine HCL (Apresoline).
122.
Delivery is often described as the “cure” for
preeclampsia. How many hours can the client convulse after delivery?
A.
up to 18 hours
B.
up to 48 hours
C.
up to 24 hours
D.
up to 62 hours
Answer: B
Explanation: Altough delivery is often described as the “cure” for
preeclampsia, the client can convulse up to 48 hours after delivery.
123.
Delivery is often described as the “cure” for
preeclampsia, the client can convulse up to 48 hours after delivery.
What is the main nursing care goal for a client with preeclampsia?
A.
maintain kidney infusion perfusion and prevent
seizures
B.
maintain uteroplacental perfusion and prevent
seizures
C.
prevent renal failure
D.
prevent digitalis toxicity
Answer: B
Explanation: The major goal of nursing care for a client with
preeclampsia is to maintain uteroplacental perfusion and prevent
seizures.
124.
The major goal of nursing care for a client with
preeclampsia is to maintain uteroplacental perfusion and prevent
seizures. What medications should be administered in a client with
preeclampsia?
A.
magnesium chloride
B.
magnesium sulfate
C.
ammonium chloride
D.
ammonium sulfate
Answer: B
Explanation: Preeclampsia requires the administration of magnesium
sulfate.
125.
The major goal of nursing care for a client with
preeclampsia is to maintain uteroplacental perfusion and prevent
seizures. When should the
administering of magnesium sulfate be withheld?
A.
If respirations <15/minute, absence of DTRs, and
urine output <50 ml/hour.
B.
If respirations <15/minute, presence of DTRs, and
urine output <50 ml/hour.
C.
If respirations <12/minute, absence of DTRs, and
urine output <30 ml/hour.
D.
If respirations <12/minute, presence of DTRs, and
urine output <30 ml/hour.
Answer: C
Explanation: Withhold administration of magnesium sulfate if signs of
toxicity exist: respirations <12/minute, absence of DTRs, and urine
output <30 ml/hour.
126.
A nurse is caring for a female client during the
labor. What should focus on the nursing care, if the client has a
cardiac disease?
A.
maintenance of vaginal perfusion
B.
maintenance of uterine perfusion
C.
maintenance of uterine infusion
D.
maintenance of vaginal infusion
Answer: B
Explanation: Nursing care during labor and delivery for the client with
cardiac disease is focused on prevention of cardiac embarrassment,
maintenance of uterine perfusion, and alleviation of anxiety.
127.
A female client is experiencing preterm labor, but
the use of beta-adrenergic agents such as terbutaline (Brethine) and
ritodrine HCL (Yutopar) are contraindicated for her. What side effect
can this medication have on a client with cardiac disease?
A.
chance of myocardial anemia
B.
chance of myocardial ischemia
C.
chance of myocardial leukemia
D.
chance of hypertension
Answer: B
Explanation: Should these clients experience preterm labor, the use of
beta-adrenergic agents such as terbutaline (Brethine) and ritodrine HCL
(Yutopar) are contraindicated due to the chance of myocardial ischemia.
128.
Normal dieresis usually occurs in the postpartum
period and can pose serious problems to the new mother with cardiac
disease. What is the reason of due to which can occur severe
complications?
A.
hypotension
B.
the increased cardiac output
C.
risk of cardiac failure
D.
chance of myocardial ischemia
Answer: B
Explanation: Normal diuresis, which occurs in the postpartum period, can
pose serious problems to the new mother with cardiac disease because of
the increased cardiac output.
129.
Coumadin may NOT be taken during pregnancy due to
its ability to cross the placenta and affect the fetus. What is the drug
of choice during the pregnancy in this case?
A.
Ximelagatran
B.
Heparin
C.
Digoxin
D.
Amiodarone
Answer: B
Explanation: Coumadin may NOT be taken during pregnancy due to its
ability to cross the placenta and affect the fetus.
HEPARIN is the drug of choice; it does NOT cross the placental
membrane.
130.
Pregnancy and non-pregnancy risk factors for
hyperemesis gravidarum include first pregnancy, multiple fetuses, age
under 24, and history of this condition in other pregnancies, obesity,
and high fat diets. What have recent researches found that it is another
possible causative factor in hyperemesis?
A.
Gastric Helicobacters
B.
Helicobacter pylori
C.
Intestinal helicobacters – Elsevier
D.
Campylobacters
Answer: B
Explanation: Recent research has found that Helicobacter pylori, (the
bacterium that causes stomach ulcers) infection is another possible
causative factor in hyperemesis.
131.
A female client is in a severe case of hyperemesis
gravidarum. What may the healthcare provider prescribe for retrieving
nausea?
A.
abatacept
B.
antihistamines
C.
acebutolol
D.
Anturane (sulfinpyrazone)
Answer: B
Explanation: In severe cases of hyperemesis gravidarum, the healthcare
provider may prescribe antihistamines, vitamin B6, or phenothiazines to
relieve nausea.
132.
In severe cases of hyperemesis gravidarum, the
healthcare provider may prescribe antihistamines, vitamin B6, or
phenothiazines to relieve nausea. What should also be prescribed for
increasing the rate the stomach moves food into the intestines, or
antacids to absorb stomach acid and help prevent acid reflux?
A.
Macrodantin (nitrofurantoin)
B.
metoclopramide (Reglan)
C.
magnesium salicylate-oral
D.
Mandelamine (methenamine-oral)
Answer: B
Explanation: The provider also prescribe metoclopramide (Reglan) to
increase the rate the stomach moves food into the intestines, or
antacids to absorb stomach acid and help prevent acid reflux.
133.
In severe cases of hyperemesis gravidarum, the
healthcare provider may prescribe antihistamines, vitamin B6, or
phenothiazines to relieve nausea. What are usually women suffering from
hyperemesis gravidarum deficient of?
A.
in thiamin, riboflavin, vitamin B6, and vitamin A
B.
in thiamin, ammonium chlorides, vitamin B12, vitamin
K
C.
in tetamin, riboflavin, vitamin B1, vitamin C
D.
in thiamin, potassium, vitamin B2, vitamin B1
Answer: A
Explanation: Women who suffer from hyperemesis gravidarum are often
deficient in thiamin, riboflavin, vitamin B6, vitamin A, and
retinol-binding proteins.
134.
For glucose screening, a client is giving 50 gm of
glucose and blood is drawn after one hour. In what case is the GTT test
done?
A.
the blood glucose is greater than 145 mg/dl
B.
the blood glucose is greater than 135 mg/dl
C.
the blood glucose is greater than 153 mg/dl
D.
the blood glucose is greater than 195 mg/dl
Answer: B
Explanation: If the blood glucose is greater than 135 mg/dl, the na
three-hour glucose tolerance test (GTT) is done.
135.
High incidence of fetal anomalies occurs in pregnant
diabetic women. Therefore,
fetal surveillance is very important. What medication is not taken
during the pregnancy due to potential teratogenic effects on fetus?
A.
Oral hypoglycemic
B.
magaldrate-oral
C.
mao inhibitors-oral
D.
maprotiline-oral
Answer: A
Explanation: Oral hypoglycemics are not taken in pregnancy due to
potential teratogenic effects on fetus.
Insulin is used for therapeutic management.
136.
A woman is admitted in labor with diagnosis of
diabetes mellitus. What diseases or anomalies is she more prone to?
A.
Hypotension, cardiac failure and infection
B.
hyperemesis gravidarum and cardiac failure
C.
Preeclampsia, hemorrhage and infection
D.
Hyperemesis, hemorrhage and hyperemesis gravidarum
Answer: C
Explanation: A diabetic women is more prone to preeclampsia, hemorrhage
and infection.
137.
Delivery for diabetic persons is often scheduled
between 37 to 38 weeks gestation to avoid the end of the 3rd
trimester of pregnancy because this is a VERY difficult time to maintain
diabetic control. Why it is useful to discontinue long-acting insulin
administration on the day before the delivery is planned?
A.
Insulin requirements are higher in labor and drop
precipitously after delivery.
B.
Insulin can endanger the life of the fetus
C.
Insulin requirements are less in labor and drop
precipitously after delivery.
D.
Insulin can cause cardiac failure for the fetus
Answer: C
Explanation: It is useful to discontinue long-acting insulin
administration on the day before the delivery is planned since insulin
requirements are less in labor and drop precipitously after delivery.
138.
The intrauterine device may be associated with an
increased risk of infection in vulnerable women. What can
estrogen-containing birth controlling pills cause?
A.
nausea
B.
resistance to insulin
C.
amnesia
D.
digitalis toxicity
Answer: B
Explanation: Estrogen-containing birth control pills affect glucose
metabolism by increasing resistance to insulin.
139.
A baby delivered abdominally misses out on the
vaginal squeeze and is born with more fluid in the lungs. What is the
newborn predisposed to?
A.
TTN
B.
TNN
C.
MXN
D.
RNN
Answer: A
Explanation: Babies delivered abdominally miss out on the vaginal squeeze
and are born with more fluid in the lungs, predisposing the newborn to
transient tachypnea (TTN) and respiratory distress.
140.
The classical, vertical incision on the uterus may
involve part of the fundus, resulting in more postoperative pain,
bleeding, and an increased chance of uterine rupture. What does the
low-transverse uterine incision usually results in?
A.
less bleeding
B.
more bleeding
C.
amnesia
D.
hemorrhage
Answer: A
Explanation: The preferable low-transverse uterine incision usually
results in less postoperative pain, less bleeding, and less incidents of
ruptured uterus.
141.
Due to the exploration and cleansing of the uterus
just after delivery of the placenta, the amount of lochia may be scant
in the recovery room.
What can pooling in the vagina and uterus while on bedrest result in
when the client firstly ambulates?
A.
hemorrhage
B.
blood running down the client’s leg
C.
pass out
D.
inexplicable back pain
Answer: B
Explanation: Pooling in the vagina and uterus while on bedrest may result
in blood running down the client’s leg when she first ambulates.
142.
Cesarean birth clients have the same lochial
changes, placental site healing, and aseptic needs as do vaginal birth
clients. What does laparotomy of any kind, including cesarean birth,
predisposes the client to?
A.
Postoperative trauma
B.
postoperative paralytic ileus
C.
postoperative mood changes
D.
postoperative hemorrhage
Answer: B
Explanation: Laparotomy of any kind, including cesarean birth,
predisposes the client to postoperative paralytic ileus.
143.
When the bowel is manipulated in surgery, it ceases
preistalsis, which may persist.
What symptoms can occur in this case?
A.
Diarrhea
B.
Obstipation
C.
Headache
D.
Depression
Answer: B
Explanation: Symptoms include: absent bowel sounds, abdominal distention,
tympany on percussion, nausea and vomiting, and of course, obstipation
(intractible constipation).
Early ambulation is an effective nursing intervention.
144.
A client has a postpartum infection and is in high
risk of depression. What does postpartum infection imply?
A.
Isolation from newborn
B.
Back pain
C.
Nausea
D.
Vomiting
Answer: A
Explanation: Nurse must be especially supportive of postpartum client
with infection because it usually implies isolation from newborn until
organism is identified and treatment begun.