Question

1.A client makes a routine visit to the prenatal clinic. Although she is 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Durante diagnoses ectopic pregnancy and orders ultrasonography. The midwife expects ultrasonography to reveal:

A. an empty gestational sac.

B. grapelike clusters.

C. a severely malformed fetus.

D. an extrauterine pregnancy.

2.In which of the following types of spontaneous abortions would the midwife assess absence of cervical dilatation and spot bleeding? *

A. Threatened

B. Imminent

C. Missed

D. Incomplete

3.A patient with eclampsia probably exhibits which of the following symptoms? *

A. hypertension, edema, and bradycardia

B. edema, hypertension, proteinuria +2

C. seizure, edema, hypertension, proteinuria +3

D. hypotension, edema, proteinuria +3

4.A nurse midwife is performing an assessment of a pregnant client and is assessing the client for the presence of ballottement. Which of the following would the nurse implement to test for the presence of ballottement? *

A. Auscultating for fetal heart sounds

B. Palpating the abdomen for fetal movement

C. Assessing the cervix for thinning

D. Initiating a gentle upward tap on the cervix

5.Gravida refers to which of the following descriptions? *

A. A serious pregnancy

B. Number of times a female has been pregnant

C. Number of children a female has delivered

D. Number of term pregnancies a female has had.

6.What is unexpected in a pregnant woman with gestational diabetes? *

A. she will be given OGTT as a diagnosis

B. she will give birth to a child who is LGA

C. she will give birth to a child with hyperglycemia

D. she will be monitored for hypertension

7.A patient with mild pre-eclampsia probably exhibits which of the following symptoms? *

A. hypertension, edema, and bradycardia

B. edema, hypertension, proteinuria +2

C. seizure, edema, hypertension, proteinuria +3

D. hypotension, edema, proteinuria +1

8.A client makes a routine visit to the prenatal clinic. Although she is 14 weeks pregnant, the size of her uterus approximates that in an 18- to 20-week pregnancy. Dr. Charles diagnoses gestational trophoblastic disease and orders ultrasonography. The midwife expects ultrasonography to reveal: *

A. an empty gestational sac.

B. grapelike clusters.

C. a severely malformed fetus.

D. an extrauterine pregnancy.

9.A midwife is caring for a pregnant client with Preeclampsia. The midwife prepares a plan of care for the client and documents in the plan that if the client progresses from Preeclampsia to eclampsia, the first action is to: *

A. Administer magnesium sulfate intravenously

B. Assess the blood pressure and fetal heart rate

C. Clean and maintain an open airway

D. Administer oxygen by face mask

10.All of the following can predispose a pregnant woman to cervical incompetence except *

A. multiple pregancy

B. old age

C. habitual abortion

D. PCOS

11.The medication of choice for a patient diagnosed with rhesus incompatibility is: *

A. Methotrexate

B. Hydralazine (Apresoline)

C. Tylenol

D. RhoGAM

12.A pregnant woman at 32 weeks’ gestation complains of feeling dizzy and lightheaded while her fundal height is being measured. Her skin is pale and moist. The midwife’s initial response would be to: *

A. Assess the woman’s blood pressure and pulse

B. Have the woman breathe into a paper bag

C. Raise the woman’s legs

D. Turn the woman on her left side.

13.Which of the following conditions is usually associated with choriocarcinoma *

A. placenta previa

B. abruptio placenta

C. gestational trophoblastic disease

D. toxoplasmosis

14.In which of the following types of spontaneous abortions would the midwife assess dark brown vaginal discharge and a negative pregnancy test? *

A. Threatened

B. Imminent

C. Missed

D. Incomplete

15.Type of abortion that results to cervical dilatation and bleeding *

A. threatened

B. imminent

C. habitual

D. missed

16.Which of the following would the nurse most likely expect to find when assessing a pregnant client with abruption placenta? *

A. Excessive vaginal bleeding

B. Rigid, board-like abdomen

C. Titanic uterine contractions

D. Premature rupture of membranes

17.All of the following can be seen in a patient with HELLP syndrome, except *

A. bleeding

B. elevated AST

C. hypertension

D. elevated platelets

18.An expected cardiopulmonary adaptation experienced by most pregnant women is: *

A. Tachycardia

B. Dyspnea at rest

C. Progression of dependent edema

D. Shortness of breath on exertion

19.The antagonist for magnesium sulfate should be readily available to any client receiving IV magnesium. Which of the following drugs is the antidote for magnesium toxicity? *

A. Calcium gluconate

B. Hydralazine (Apresoline)

C. Narcan

D. RhoGAM

20.A pregnant woman with gestational diabetes is learning about diabetes. The midwife should instruct the woman that the best test to check for glucose control is: *

A. CBG

B. CBC

C. glycosylated hemoglobin

D. ABG

21.A homecare nurse visits a pregnant client who has a diagnosis of mild Preeclampsia and who is being monitored for pregnancy induced hypertension (PIH). Which assessment finding indicates a worsening of the Preeclampsia and the need to notify the physician? *

A. Blood pressure reading is at the prenatal baseline

B. Urinary output has increased

C. The client complains of a headache and blurred vision

D. Dependent edema has resolved

22. A woman with preeclampsia is receiving magnesium sulfate. The midwife assigned to care for the client determines that the magnesium therapy is effective if: *

A. Ankle clonus in noted

B. The blood pressure decreases

C. Seizures do not occur

D. Scotomas are present

23.Which of the following would the midwife assess in a client experiencing placenta previa? *

A. Bright red, painless vaginal bleeding

B. Concealed or external dark red bleeding

C. Palpable fetal outline

D. Soft and nontender abdomen

24. Which of the following is treated with tracheloplasty? *

A. Placenta previa

B. Ectopic pregnancy

C. Incompetent cervix

D. Abruptio placentae

25.The midwife teaches a pregnant woman to avoid lying on her back. The midwife has based this statement on the knowledge that the supine position can: *

A. Unduly prolong labor

B. Cause decreased placental perfusion

C. Lead to transient episodes of hypotension

D. Interfere with free movement of the coccyx

26.What condition causes ecchymosis on the periumbilical region? *

A. Placenta previa

B. Ectopic pregnancy

C. Incompetent cervix

D. Abruptio placentae

27. Which of the following is found in the urine of a patient with uncontrolled gestational diabetes? *

A. bicarbonates

B. ketones

C. hemoglobin

D. protein

28. Which of the following would the midwife identify as a classic sign of PIH? *

A. Edema of the feet and ankles

B. Edema of the hands and face

C. Weight gain of 1 lb/week

D. Early morning headache

29.Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage? *

A. Placenta previa

B. Ectopic pregnancy

C. Incompetent cervix

D. Abruptio placentae

30.A client in the first trimester of pregnancy arrives at a health care clinic and reports that she has been experiencing vaginal bleeding. A threatened abortion is suspected, and the nurse instructs the client regarding management of care. Which statement, if made by the client, indicates a need for further education? *

A. “I will maintain strict bedrest throughout the remainder of the pregnancy.”

B. “I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last evidence of bleeding.”

C. “I will count the number of perineal pads used on a daily basis and note the amount and color of blood on the pad.”

D. “I will watch for the evidence of the passage of tissue.”

31.Type of abortion that can lead to septic shock and DIC *

A. threatened

B. imminent

C. habitual

D. missed

32. A patient with severe pre-eclampsia probably exhibits which of the following symptoms? *

A. hypertension, edema, and bradycardia

B. edema, hypertension, proteinuria +3

C. seizure, edema, hypertension, proteinuria +2

D. hypotension, edema, proteinuria +1

33. The medication of choice for a patient diagnosed with H-mole is: *

A. Methotrexate

B. Hydralazine (Apresoline)

C. Tylenol

D. RhoGAM

34. A pregnant client is diagnosed with partial placenta previa. In explaining the diagnosis, the nurse tells the client that the usual treatment for partial placenta previa is which of the following? *

A. Activity limited to bed rest

B. Platelet infusion

C. Immediate cesarean delivery

D. Labor induction with oxytocin

35. Which of the following symptoms occurs with a hydatidiform mole? *

A. Heavy, bright red bleeding every 21 days

B. Fetal cardiac motion after 6 weeks gestation

C. Benign tumors found in the smooth muscle of the uterus

D. Excessive vomiting and fast-growing abdomen

36. A 21-year old client, 6 weeks’ pregnant is diagnosed with hyperemesis gravidarum. This excessive vomiting during pregnancy will often result in which of the following conditions? *

A. Bowel perforation

B. Electrolyte imbalance

C. Miscarriage

D. Pregnancy induced hypertension (PIH)

37. A primigravida is receiving magnesium sulfate for the treatment of pregnancy induced hypertension (PIH). The midwife who is caring for the client is performing assessments every 30 minutes. Which assessment finding would be of most concern to the midwife? *

A. Urinary output of 20 ml since the previous assessment

B. Deep tendon reflexes of 2+

C. Respiratory rate of 10 BPM

D. Fetal heart rate of 120 BPM

38. Dr. Durante diagnoses ectopic pregnancy in a pregnant patient and orders ultrasonography. The midwife expects ultrasonography to reveal: *

A. an empty gestational sac.

B. grapelike clusters.

C. a severely malformed fetus.

D. an extrauterine pregnancy.

39. Which of the following would the midwife assess in a client experiencing abruptio placenta? *

A. Bright red, painless vaginal bleeding

B. Concealed or external dark red bleeding

C. Palpable fetal outline

D. Soft and nontender abdomen

40. A woman who had 3 or more abortions is described as: *

A. threatened

B. imminent

C. habitual

D. missed

Answer 1

1. D. an extrauterine pregnancy.

2. A. Threatened

3. C. seizure, edema, hypertension, proteinuria +3

4. D. Initiating a gentle upward tap on the cervix

5. B. Number of times a female has been pregnant

6. D. she will be monitored for hypertension

7. B. . edema, hypertension, proteinuria +2

8. B. grapelike clusters.

9. A. Administer magnesium sulfate intravenously

10.A. multiple pregancy

11.D. RhoGAM

12. D. Turn the woman on her left side.

13.C. gestational trophoblastic disease

14. Incomplete

15. B. imminent

16.A. Excessive vaginal bleeding

17.D. elevated platelets

18. A. Tachycardia

19.A. Calcium gluconate

20. C. glycosylated hemoglobin

21. C. The client complains of a headache and blurred vision

22. B. The blood pressure decreases

23. A. Bright red, painless vaginal bleeding

24. C. Incompetent cervix

25. C. Lead to transient episodes of hypotension

26. B. Ectopic pregnancy

27. B. Ketones

28. A. Edema of the feet and ankles

29. D. Abruptio placentae

30.A. I will maintain strict bedrest throughout the remainder of the pregnancy.

31. D. Missed

32. B. edema, hypertension, proteinuria +3

33. A. Methotrexate

34. A. Activity limited to bed rest

35. D. Excessive vomiting and fast-growing abdomen

36.B. Electrolyte imbalance

37.B. Deep tendon reflexes of 2+

38.D. an extrauterine pregnancy

39. B. Concealed or external dark red bleeding

40.C. habitual