Reproductive Choices

1. In a lecture on sexual functioning, the nurse plans to include the fact that ovulation occurs
when the:
a. Oxytocin level is high
b. Blood level of LH is high
c. Progesterone level is high
d. Endometrial wall is sloughed off
2. After ovulation has occurred the ovum is believed to remain viable for:
a. 1 to 6 hours
b. 12 to 18 hours
c. 24 to 36 hours
d. 48 to 72 hours
3. The time of ovulation can be determined by taking the basal temperature. During ovulation,
the basal temperature:
a. Drops markedly
b. Drops slightly and then rises
c. Rises suddenly and then falls
d. Rises markedly and remains high
4. The nurse explains that the efficiency of rhythm is dependent on the basal body
temperature. A factor that will alter its effectiveness is:
a. Presence of stress
b. Length of abstinence
c. Age of those involved
d. Frequency of intercourse
5. A couple are desirous of using the rhythm method of contraception but do not understand
how it works. The nurses explanation to this couple when to refrain from intercourse will be
based on the fact that ovulation occurs:
a. Fourteen days prior to the onset of menstruation
b. Seven days before the menstrual cycle
c. Seven days after the completion of menstrual period
d. Fourteen days after the completion of the menstrual period
6. A biphasic antiovulatory medication of combined progestin and estrogen is prescribed for a
female client. The nurse, instructing the client about the medication, should include the need
to:
a. Report any vaginal bleeding
b. Have bimonthly Pap smears
c. Increase the intake of calcium
d. Temporarily restrict sexual activity
7. Following delivery a cardiac client with type II diabetes asks the nurse, Which
contraceptives will I be able to use to prevent pregnancy in the near future? The nurses
best response would be:
a. You may use oral contraceptives. They are almost 100% effective in preventing a
pregnancy.

b. You may want to use a foam and a condom to prevent pregnancy until you consult
your doctor at your postpartum visit.
c. The intrauterine device is best for you because it does not allow the fertilized ovum
to become implanted into the uterine lining.
d. You do not need to worry about becoming pregnant in the near future. Clients with
cardiac conditions usually become infertile.
8. The nurse teaches that the most frequent side effect associated with the use of IUDs is:
a. Ectopic pregnancy
b. Expulsion of the IUD
c. Rupture of the uterus
d. Excessive menstrual flow
9. The nurse should explain that a very common problem that has been associated with IUDs
when they are used is:
a. Perforation of the uterus
b. Discomfort associated with coitus
c. Development of vaginal infections
d. Spontaneous expulsion of the device
10. A client seeking advice about contraception asks the nurse about an IUD. The nurse
explains that the IUD provides contraception by:
a. Blocking the cervical os
b. Increasing the mobility of the uterus
c. Preventing the sperm from reaching the fallopian tube
d. Setting up a nonspecific inflammatory cell reaction in the endometrium
11. During the salinization method of elective abortion, the nurse should be alert for side effects
such as:
a. Edema
c. Headache
b. Oliguria
d. Bradycardia
12. Following a salinization procedure for an elective abortion of a 20-week pregnancy, the client
is told that labor will probably begin within:
a. Two hours after the procedure
b. Eight hours following the procedure
c. Several minutes following the procedure
d. Twenty-four to 72 hours after the procedure
13. In the dilation and suction evacuation method of elective abortion, Laminarias are used in
the dilation stage of the procedure because:
a. Dilation occurs within 2 hours
b. They are hygroscopic and expand
c. They are stronger in action than instruments
d. Less anesthesia is necessary with this method
Reproductive Problems
14. In dealing with a couple who has been identified as having an infertility problem, the nurse
should know that:

a.
b.
c.
d.

Infertility is usually psychologic in origin

Infertility and sterility are essentially the same problem
The couple has been unable to have a child after trying for a year
One partner has a problem hat makes them unable to have children

15. A nonhemophilic woman who had a hemophilic father is married to a man with normal blood
clotting. Genetically it can be predicted that:
a. All children will be hemophiliacs
b. Female children will be unaffected
c. All male children will be hemophiliacs
d. Half the male children will be hemophiliacs
16. A high concentration of estrogen in the blood:
a. Causes ovulation
b. Stimulates lactation
c. Inhibits secretion of FSH
d. Is one cause of osteoporosis
17. A test commonly used to determine the number, motility and activity of sperm is the:
a. Rubin test
c. Friedman test
b. Huhner test
d. Papanicolaou test
18. In the female, evaluation of all the pelvic organs of reproduction is accomplished by:
a. Biopsy
c. Culdoscopy
b. Cystoscopy
d. Hysterosalpingogram
19. A factor in infertility may be related to the pH of the vaginal canal. A frequent medication that
is ordered to alter the vaginal pH is:
a. Estrogen theraphy
b. Sulfur insufflations
c. Lactic acid douches
d. Sodium bicarbonate douches
20. A diagnostic test used to evaluate fertility is the postcoital test. It is best tied:
a. 1 week after ovulation
b. Immediately after menses
c. Just prior to the next menstrual period
d. Within 1 to 2 days of presumed ovulation
21. A tubal insufflation test is done to determine whether there is tubal obstruction. Infertility
caused by a defect in the tube is most often related to a:
a. Past infection
b. Fibroid tumor
c. Congenital anomaly
d. Previous injury to a tube
22. When assessing a client with a tentative diagnosis of hydatidiform mole, the nurse should be
alert for:
a. Hypotension
b. Decreased FHR
c. Unusual uterine enlargement

d. Painless, heavy vaginal bleeding

23. The nurse would suspect an ectopic pregnancy if the client complained of:
a. An adherent painful ovarian mass
b. Lower abdominal cramping for a long period of time
c. Leukorrhea and dysuria a few days after the first missed period
d. Sharp lower right or lrft abdominal pain radiating to the shoulder
24. The most common type of ectopic pregnancy is tubal. Within a few weeks after conception
the tube may rupture suddenly, causing:
a. Painless vaginal bleeding
b. Intermittent abdominal contractions
c. Continuous dull, upper-quadrant abdominal pain
d. Sudden knifelike, lower-quadrant abdominal pain
25. A client who has missed two menstrual periods comes to the prenatal clinic complaining of
vaginal bleeding and one-sided lower-quadrant pain. The nurse suspense that this client
has:
a. Abruptio placentae
b. An ectopic pregnancy
c. An incomplete abortion
d. A rupture of the graafian follicle
26. After a spontaneous abortion the nurse should observe the client for:
a. Hemorrhage and infection
b. Dehydration and hemorrhage
c. Subinvolution and dehydration
d. Signs of pregnancy-induced hypertension
27. Most spontaneous abortions are caused by:
a. Physical trauma
c. Congenital defects
b. Unresolved stress
d. Germ plasm defects
28. A client, whose husband is overseas in the military, is admitted to the hospital with vaginal
staining but no pain. The clients history reveals amenorrhea for the last 2 months and
pregnancy confirmation by her physician after her first missed period. She is admitted for
observation with a possible diagnosis of:
a. Missed abortion
c. Ectopic prenancy
b. Inevitable abortion
d. Threatened abortion
29. A few hours after being admitted with a diagnosis of inevitable abortion, a client begins to
experience bearing-down sensations and suddly expels the products of conception in bed.
To give safe nursing care, the nurse should first:
a. Check the fundus for firmness
b. Give her the sedation ordered
c. Immediately notify the physician
d. Take her immediately to the delivery room
30. After an incomplete abortion, a client tells her nurse that although her doctor explained what
an incomplete abortion was, she did not understand. The nurse could best respond:
a. I really dont think you should focus on what happened right now.
b. This is when the fetus dies but is retained in the uterus for 8 weeks or more.

c. I think it would be best if you asked your doctor for the answer to that question.
d. An incomplete abortion is when the fetus is expelled but part of the placenta and
membranes are not.
31. A client is admitted to the emergency room with vaginal bleeding. When taking a history, the
nurse learns that the client has had five missed periods. Later the nurse reads the chart,
which states, stillborn delivered at 8 P.M The nurse understands this to mean that the
fetus and other products of conception:
a. were previable
b. weighed over 600 g
c. were completely expelled
d. measured 13.4 cm in length
Healthy Childbearing
32. The outermost membrane that helps form the placenta is:
a. Amnion
c. Yolk sac
b. Chorion
d. Allantois
33. Progesterone is normally secreted in relatively large quantities by the:
a. Endometrium
c. Andrenal cortex
b. Pituitary gland
d. Corpus luteum
34. The developing cells are called a fetus from the:
a. Time the fetal heart is heard
b. Eighth week to the time of birth
c. Implantation of the fertilized ovum
d. End of the second week to the onset of labor
35. During pregnancy, the volume of tidal air increases because there is:
a. An increase in total blood volume
b. Increased expansion of the lower ribs
c. Upward displacement of the diaphragm
d. A relative increase in the height of the rib cage
36. The uterus rises out the pelvis and becomes an abdominal organ at about the:
a. Tenth week of pregnancy
b. Eighth week of pregnancy
c. Twelfth week of pregnancy
d. Eighteenth week of pregnancy
37. The inner membrane that provides a fluid medium for the embryo is:
a. Funis
c. Chorion
b. Amnion
d. Yolk sac
38. First fetal movements felt by the mother are known as:
a. Lightening
c. Ballottement
b. Quickening
d. Engagement

39. In prenatal development, growth is most rapid in:

a. First trimester
c. Second trimester
b. Third trimester
d. Implantation period
40. The chief function of progesterone is the:
a. Development of female reproductive organs
b. Stimulation of follicles for ovulation to occur
c. Establishment of the secondary male sex characteristics
d. Preparation of the uterus to receive a fertilized ovum
41. During the process of gametogenesis, the male and female sex cells divide, and each
mature sex cell contains:
a. Twenty-two pairs of autosomes in their nuclei
b. Forty-six pairs of chromosomes in their nuclei
c. A diploid number of chromosomes in their nuclei
d. A haploid number of chromosomes in their nuclei
42. The placenta does not produce:
a. Somatotropin
b. Chorionic gonadotropin
c. Follicle-stimulating hormone
d. Progesterone precursor substances
43. After the first 3 months of pregnancy the chief source of estrogen and progesterone is the:
a. Placenta
c. Corpus luteum
b. Adrenal cortex
d. Anterior hypophysis
44. In fetal blood vessels the oxygen content is highest in the:
a. Umbilical artery
c. Pulmonary artery
b. Ductus venosus
d. Ductusanteriosus
45. A client relates that the first day of her last menstrual period was July 22. the estimated date
of birth would be:
a. May 5
c. April 15
b. May 14
d. April 29
46. During pregnancy a polypeptide that stimulates the melanocycle hormone is responsible for:
a. Urinary frequency
b. Softening of the cervix
c. Symptoms of morning sickness
d. Linea nigra and melasma (chloasma)
47. During pregnancy, the uterine musculature hypertrophies and is greatly stretched as the
fetus grows. This stretching:
a. By itself inhibits uterine contraction until oxytocin stimulates the birth process
b. Is prevented from stimulating uterine contraction by high levels of estrogen during
late pregnancy
c. Inhibits uterine contraction along with the combined inhibitory effects of estrogen and
progesterone
d. Would ordinarily stimulate uterine contraction but is prevented by high levels of
progesterone during pregnancy

48. When assessing a pregnant clients physical condition, the nurse is aware that a normal
adaptation of pregnancy is an increased blood supply to the pelvic region that results in
purplish discoloration of the vaginal muscosa and is known as:
a. Ladins sign
c. Goodells sign
b. Hegars sign
d. Chadwicks sign
49. Physiologic anemia during pregnancy is a result of:
a. Decreased dietary intake of iron
b. Increased blood volume of the mother
c. Decreased erythropoiesis after the first trimester
d. Increased detoxification demands on the mothers liver
50. When assessing a client, the nurse should be aware that the characteristics of the normal
female pelvis include:
a. Flat sacrum, coccyx movable, spines prominent, pubic arch wide
b. Flat sacrum, coccyx movable, spines prominent, pubic arch narrow
c. Well-hollowed sacrum, coccyx movable, spines not prominent, pubic arch wide
d. Deeply hollowed sacrum, coccyx immovable, spines not prominent, pubic arch
narrow
51. The anterior/posterior diameter of the birth canal is one of the important measurements of
the pelvis and is known as the:
a. Conjugate vera
c. Transverse diameter
b. Diagonal conjugate
d. Transverse conjugate
52. A common method of locating the precise position of a fetus and placenta prior to an
amniocentesis is:
a. Fetoscopy
c. Sonography
b. Fluoroscopy
d. X-ray examination
53. On thr first prenatal visit, a client asks the nurse, Is it true the doctor will do an internal
examination today? The nurse should respond:
a. Yes, an internal is done on all mothers on the first visit.
b. Are you fearful of having an internal examination done?
c. Yes. Have you ever had an internal examination done before?
d. Yes, an internal is done on all mothers, but it is only slightly uncomfortable.
54. A normal cardiopulmonary symptom experienced by most pregnant women is:
a. Tachycardia
b. Dyspnea at rest
c. Progressive dependent edema
d. Shortness of breath on exertion
55. A primigravida in her tenth week of gestation is concerned because she has read that
nutrition during pregnancy is important for proper growth and development of the baby. She
wants to know something about the foods she should eat. The nurse should:
a. Instruct her to continue eating a normal diet
b. Assess what she eats by taking a diet history
c. Give her a list of foods so she can better plan her meals

d. Emphasize the importance of limiting salt and highly seasoned food

56. A client who has missed one menstrual period thinks she is pregnant. The nurse suggests a
pregnancy test. This is possible because in early pregnancy the urine contains:
a. Prolactin
c. Luteinizing hormone
b. Estrogen
d. Chorionic gonadotropin
57. A client visits her gynecologist to continue a suspected pregnancy. During the nursing
history a client states that her last menstrual period began on April 11. The client states that
some spotting occurred on May 8. The nurse calculates that the clients due date is:
a. January 10
c. February 12
b. January 18
d. February 15
58. A client asks the nurse why menstruation ceases once pregnancy occurs. The nurses best
response would be that this occurs because of the:
a. Reduction in the secretion of hormones by the ovaries.
b. Production of estrogen and progesterone by the ovaries.
c. Secretion of luteinizing hormone produced by the pituitary.
d. Secretion of follicle-stimulating hormone produced by the pituitary.
59. The nurse is aware that the nausea and vomiting commonly experienced by many women
during the first trimester of pregnancy is an adaptation to the increased level of:
a. Estrogen
c. Luteinizing hormone
b. Progesterone
d. Chorionic gonadotropin
60. A pregnant client works as a keypunch operator. This would necessarily have implications
for her plan of care during pregnancy. The nurse should recommend that the client:
a. Try to walk about every few hours during the workday
b. Ask for time in the morning and afternoon to elevate her legs
c. Tell her employer she cannot work beyond the second trimester
d. Ask for time in the morning and afternoon to obtain nourishment
61. The nurse in the prenatal clinic should provide nutritional counseling to all newly pregnant
women because:
a. Most weight gain during pregnancy is fluid retention
b. Dietary allowances should not increase during pregnancy
c. Pregnant women must adhere to a specific pregnancy diet
d. Different sources of essential nutrients are favored by different cultural groups
62. A client in her eighth week of pregnancy complains of having to go to the bathroom often to
urinate. The nurse explains to the client that urinary frequency often occurs because the
capacity of the bladder during pregnancy is diminished by:
a. Atony of the detrusor muscle
b. Compression by the ascending uterus
c. Compromise of the autonomic reflexes
d. Constriction of the ureteral entrance at the trigone
63. A client who is 10 weeks pregnant calls the clinic and complains of the morning sickness. To
promote relief, the nurse should suggest:
a. Eating dry crackers before arising
b. Increasing her fat intake before bedtime
c. Having two small meals daily and a snack at noon

d. Drinking more high-carbohydrate fluids with her meals

64. A client, 7 weeks pregnant, confides to the nurse in the prenatal clinic that she is very sick
every morning with nausea and vomiting and is sure that is being punished for having
initially thought of aborting the pregnancy. The nurse assures her that this is not punishment
but a common occurrence in early pregnancy and will probably disappear by the end of the:
a. 5th month
c. 3rd month
th
b. 4 month
d. 2nd month
65. A nurse tells a pregnant woman not to wear tight clothing around her abdomen because of
possible damage to the fetus. The principle responsible for the potential damage is:
a. Pascals
c. Einsteins
b. Newtons
d. Archimedes
66. A client who is pregnant is being prepared for a pelvic examination. The client complains of
feeling very tired and sick to her stomach, especially in the morning. The best response for
the nurse to make is:
a. Perhaps you might ask the doctor about it.
b. This is common. There is no need to worry.
c. Can you tell me how you feel in the morning?
d. Lets discuss some ways to deal with these common problems.
67. During a prenatal examination the nurse draws blood from a young client and explain that
the determination of Rh is routinely performed on expectant mothers to predict whether the
fetus is at risk for developing:
a. Acute hemolytic anemia
b. Protein metabolism deficiency
c. Physiologic hyperbilirubinemia
d. Respiratory distress syndrome
68. The best advice the nurse can give to a pregnant woman in her first trimester is to:
a. Cut down on drugs, alcohol and cigarettes
b. Avoid all drugs and refrain from smoking and ingesting alcohol
c. Avoid smoking, limit alcohol consumption and do not take any aspirin
d. Take only prescription drugs, especially in the second and third trimester
69. When attending the prenatal clinic, a newly pregnant client, having her first child, expresses
concern about her dark nipples and a dark line from her navel to the pubis. The nurse
explains that this adaptation are due to the hyperactivity of the:
a. Ovaries
c. Adrenal gland
b. Thyroid gland
d. Pituitary gland
70. The nurse can try to help a pregnant client overcome first-trimester morning sickness by
suggesting that the client:
a. Eat protein before sleep
b. Take an antacid before bedtime
c. Eat nothing until the nausea subsides
d. Request her physician to prescribe an antiemetic
71. A client is concerned about gaining weight during pregnancy. The nurse explains that the
largest part of weight gain during pregnancy is due to:

a.
b.
c.
d.

The fetus
Fluid retention
Metabolic retention
Increased blood volume

72. The client who is pregnant for the first time attends the prenatal clinic. She tells the nurse,
Im worried about gaining too much weight because I have heard that it is bad for me. The
nurses best response would be:
a. Yes, weight gain causes complication during pregnancy.
b. If you gain over 15 pounds, you have to follow a low-calorie diet.
c. Dont worry about gaining weight. We are more concern if you dont gain enough
weight to ensure proper growth of your baby.
d. A 25-pound weight gain is recommended; however, the pattern of your weight gain
will be of more importance than the total amount.
73. A petite client, pregnant for the first time, is concerned about regaining her figure after
delivery and wishes to diet during pregnancy. The nurse should advise her that:
a. Dieting is recommended to lessen the incidence of stillbirth
b. Dieting is recommended to make delivery easier since she is so small
c. Inadequate food intake during pregnancy can cause low-birth-weight infants
d. Inadequate food intake during pregnancy can cause pregnancy-induced
hypertension
74. A client in her fourth month of pregnancy. When she comes for her monthly examination, the
nurse asks if she would like to listen to the babys heartbeat. The woman, commenting on
how rapid it is, appears frightened and asks if this is normal. The nurse should respond:
a. The babys heart rate is usually twice the mothers pulse rate.
b. The babys heart rate is normally very rapid, so you neednt worry.
c. The babys heart rate is rapid to accommodate the nutritional needs.
d. It is far better that the heart rate is rapid; when it is low, there is no need to worry.
75. A newly pregnant client plans to continue working as a secretary in a large office during her
pregnancy. When setting up a care plan for this client, the nurse should advise her to:
a. Try to walk about every few hours of her workday
b. Ask for a break in the morning and afternoon for added nourishment
c. Inform her employer that she cannot work beyond the second trimester
d. Ask for a break in the morning and afternoon so she can elevate her legs
76. A client who is pregnant asks the nurse if she can continue to have sexual relations. The
nurses response is based on the knowledge that coitus during pregnancy would be
contraindicated only in the presence of:
a. Leukorrhea
b. Increased FHR
c. Gestation of 30 weeks or more
d. Premature rupture of membranes
77. When involved in prenatal teaching, the nurse should inform clients that an increase in
vaginal secretions during pregnancy is leucorrhea and is caused by increased:
a. Metabolic rates
b. Production of estrogen
c. Functioning of the Bartholin glands

d. Supply of sodium chloride to the cells of the vagina

78. A 21-year old client who is 6 months into her second pregnancy is experiencing increasing
edema in the lower extremities. Besides advising rest with the legs elevated, the nurse
discusses and gives instructions concerning the diet. In this instance:
a. The nutritionist should be brought in to plan a diet
b. The foods selected should have a normal salt content
c. Dietary preferences must influence the food that is eaten
d. The client should be advised to see the physician in the prenatal clinic
79. The nurse explains the treatment for fluid retention during pregnancy, which is:
a. Adequate fluid and low-salt diet
b. A low-salt diet and elevation of the lower extremities
c. Adequate fluid and elevation of the lower extremities
d. Judicious use of diuretics and elevation of the lower extremities
80. While teaching a young primigravida about labor, the nurse should tell her to come to the
hospital when:
a. Contractions are 10 to 15 minutes apart
b. She has a bloody show and back pressure
c. Membranes rupture or contractions are 5 to 8 minutes apart
d. Contractions are 2 to 3 minutes apart and she cannot walk about
81. True labor can be differentiated from false labor because in true labor contractions will:
a. Bring about progressive cervical dilation
b. Occur immediately after membrane rupture
c. Stop when the client is encouraged to walk around
d. Be less uncomfortable if client is in a side-lying position
82. When teaching a prenatal class about infant feeding, the nurse is asked a question about
the relationship between the size of breasts and breastfeeding. The nurses best response
would be:
a. Everybody can be successful at breastfeeding.
b. You seem to have some concern about breastfeeding.
c. The size of the breasts has nothing to do with the production of milk.
d. The amount of fat and glandular tissue in the breasts determines the amount of milk
produced.
83. A woman in a class on infant feedings asks how anyone who is breastfeeding gets anything
done with a baby on demand feedings. The nurses best response would be:
a. Most mothers find that feeding the baby whenever the baby cries works out fine.
b. Perhaps a schedule might be better because the baby is already accustomed to the
hospital routine.
c. Most babies find babies on breast do better on demand feeding because the
amount of milk ingested varies at each feeding.
d. Although the baby is on demand feedings, the baby will eventually set a schedule,
so there will be time for your household chores.
84. he nurse should teach the client that breastfeeding is always contraindicated with:
a. Mastitis
c. Inverted nipples
b. Pregnancy
d. Herpes genitalis

85. The ischial spines are designated as an important landmark in labor and delivery because
the distance between the spines is:
a. The narrowest diameter of the pelvis
b. The widest measurement of the pelvis
c. A measurement on the floor of the pelvis
d. A measurement of the inlet of the birth canal
86. A client in active labor begins to tremble, becomes very tense with contractions, and is quite
irritable. She frequently states, I cannot stand this a minute longer. This kind of behavior
may be indicative of the fact that the client:
a. Is entering the transition phase of labor
b. Needs immediate administration of an analgesic or anesthetic
c. Has bee very poorly prepared for labor in the parents classes
d. Is developing some abnormality in terms of uterine contractions
87. The nurse observes the clients amniotic fluid and decides that it appears normal, since it is:
a. Clear and dark-amber colored
b. Milky, greenish-yellow, containing shreds of mucus
c. Clear, almost colorless, containing little white specks
d. Cloudy, greenish-yellow, containing little white specks
88. A multigravida has a normal spontaneous vaginal delivery of a healthy infant. Five minutes
after delivery of a healthy infant the placenta is expressed. The nurse upon assessing the
fundus at this time would expect to the fundus to be:
a. Difficult to find
b. Just below the xiphoid process
c. At the umbilicus in the upper right quadrant
d. Halfway between the symphysis pubis and the umbilicus
89. One problem that confronts the client when an external fetal monitor is being used is the:
a. Restriction of movement
b. Inability to take sedatives
c. Interference with Lamaze techniques
d. Increased frequency of vaginal xaminations
90. A primigravida, 40 weeks gestation, is admitted with q 3 to 5 min contractions, a bloody
show and intact membranes. Vaginal examination reveals that the cervix is fully effaced, 6
cm dilated, and the head is at +1 station. The nurse is aware that according to this data the
client is in the:
a. Latent phase of labor
b. Active phase of labor
c. Transition phase of labor
d. Accelerated phase of labor
91. A client, 41 weeks gestation, comes to the labor suite with a bloody show and no
contractions. A vaginal exam reveals that the babys head is at +1 station. An acceptable
method of inducing labor at this time is:
a. A tap-water enema
b. An IM injection of oxytocin
c. Artificial rupture of membranes
d. Administration of prostaglandins

92. A primigravida, 40 weeks gestation, arrives at the birthing suite with abdominal cramping
and a bloody show. Her membranes ruptured about 30 minutes before arrival. A vaginal
examination reveals 1 cm dilation and presenting part at +1 station. After obtaining the fetal
heart rate and maternal vital sign, the nurse should:
a. Teach the client how to avoid pushing
b. Review Lamaze breathing techniques with the client
c. Provide the client with comfort measures used for women in labor
d. Prepare to type and cross-match the clients blood for a possible transfusion
93. A primigravida at term is admitted with contractions q 5 to 8 minutes and a bloody show. She
and her husband attended childbirth preparation classes. Vaginal examination reveals 3 cm
dilation and 75% effacement, +1 station with occiput anterior, and intact membranes. The
client is cheerful and relaxed and asks the nurse if it is all right for her to walk aound. Based
on the observations of the clients contractions and knowledge of the physiology and
mechanism of labor, the nurse could best respond:
a. I cant make a decision on that, you will have to ask the doctor.
b. Please stay in bed; walking may interfere with proper uterine contractions.
c. It is quite all right for you to be up and about as long as you feel comfortable and
your membranes are intact.
d. You will have to stay in bed; otherwise your contractions cannot be timed and no
one can listen to the fetal heart.
94. A client in active labor spontaneously ruptures membranes. The nurse should first:
a. Monitor the FHR
c. Check BP and pulse
b. Call the physician
d. Time the contractions
95. The membranes of a client who is 36 weeks pregnant have ruptured spontaneously. She
comes to the hospital accompanied by her husband. Her cervix is 2 cm dilated and 75%
effaced. The fetal heart rate is 136. the nurse should:
a. Place the mother in bed and attach an external fetal monitor
b. Let the mother undress while the nurse takes the history from the father
c. Introduce the staff nurses to the couple and try to make them feel welcome
d. Have them wait in the examining room while the nurse notifies the physician that
they have arrived
96. A client and her husband are working together during the wifes labor. The client is now 7 cm
dilated and the presenting part is low in the mid-pelvis. To alleviate discomfort during
contractions, the nurse should instruct the husband to encourage his wife to:
a. Pant
c. Deep breathe slowly
b. Pelvic rock
d. Athletic chest breathe
97. A laboring client complains of low-back pain. To increase the clients comfort the nurse
should recommend that the clients husband:
a. Instruct her to flex her knees
b. Place her in the supine position
c. Apply back pressure during contractions
d. Help her perform neuromuscular control exercises
98. the nurse withholds foods and limits fluid as a laboring client approaches the second stage
of labor because:

a. The mechanical and chemical digestive process requires energy that is needed for
labor
b. Undigested food and fluid may cause nausea and vomiting and limit the choice of
anesthesia
c. Food will further aggravate gastric peristalsis, which is already increased due to the
stress of labor
d. The gastric phase of digestion stimulates the release of hydrochloric acid and may
cause dyspepsia
99. A few hours after being admitted in active labor, a primigravida becomes very restless,
flushed, irritable and perspires profusely. The client states that she is going to vomit. The
nurse suspects that these symptoms are indicative of:
a. Late stage
c. Second stage
b. Third stage
d. Transition stage
100. When a client is positioned for delivery, both legs should be positioned simultaneously to
prevent:
a. Venous stasis in the legs
b. Pressure on the perineum
c. Excessive pull on the fascia
d. Trauma to he uterine ligaments
101.

A laboring mother should be prepared for delivery when the nurse observes:
a. The mother becoming irritable and not following instructions
b. That the perineum is beginning to bulge with each contraction
c. An increase in the amount of bloody discharge from the vagina
d. The contractions are occurring every 2 to 3 minutes and lasting 60 seconds

102.

During the period of induction of labor, a client should be observed carefully for signs of:
a. Severe pain
c. Hypoglycemia
b. Uterine tetany
d. Prolapsed of the umbilical cord