01Multiple Choice

1/ 1
SITUATION: Alex on her 12 weeks gestation with her third baby sough
consultation to a nurse’s clinic for observation. She has a history of spontaneous
abortion and is spotting.

She told the nurse she had minimal vaginal bleeding, without passage of
placenta with embryonic sac and slight uterine cramping. On examination, the
physician on duty determines that her cervix is closed. The nurse would think that
the client is exhibiting signs of:

Missed abortion

02Multiple Choice
1/ 1
The client at 12 weeks comes to the clinic with signs/symptoms of abdominal
cramping and moderate vaginal bleeding and ultrasound results of absent fetal
heart tones. On internal examination, the physician determines that her cervix is
1cm dilated. Which nursing intervention is most appropriate to the client?

Prepare the client for curettage

03Multiple Choice
1/ 1
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?

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

04Multiple Choice
0/ 1
What hormone maintains pregnancy and prevents spontaneous abortion?

Progesterone

05Multiple Choice
1/ 1
A client 12 weeks’ pregnant come to the emergency department with abdominal
cramping and moderate vaginal bleeding. Speculum examination reveals 2 to 3
cm cervical dilation. The nurse would document these findings as which of the
following?

Imminent abortion
06Multiple Choice
1/ 1
In which of the following types of spontaneous abortions would the nurse assess
dark brown vaginal discharge and a negative pregnancy tests?

Missed

07Multiple Choice
1/ 1
Situation: A client arrives in the emergency department with amenorrhea for two
months. She was previously treated for a Chlamydial infection.

The nurse would assess the client suspected of ectopic pregnancy. Which
assessment findings by the nurse do not indicate the presence of this condition?

Profuse vaginal bleeding

08Multiple Choice
0/ 1
A multigravid client seen in the ER complaining of sharp abdominal pain and
vaginal spotting is diagnosed with an ectopic pregnancy. When complaining to
the client and family members about an ectopic pregnancy, which of the following
would the nurse include as the most common site of implantation?

Fallopian tube

09Multiple Choice
0/ 1
A client is admitted with a diagnosis of “probable ectopic pregnancy”. Which of
the following would be the most appropriate nursing diagnosis for the client?

Anticipatory Grieving related to the loss of the pregnancy

10Multiple Choice
1/ 1
Elena, is diagnosed to have ectopic pregnancy. She is to receive medical
intervention rather than a surgical interruption. Which of the following
intramuscular medications would the physician prescribe?

Amethopterin (methotrexate)

11Multiple Choice
1/ 1
A client diagnosed with ectopic pregnancy asks the nurse why she has shoulder
pain. Which of the following is the best answer?

Blood accumulation under the diaphragm

12Multiple Choice
0/ 1
The client subsequently had one of her tubes removed. Which of the following is
an indication that she needs further explanation?
“After this operation, I will never have another menstrual period”

13Multiple Choice
1/ 1
Situation: A prenatal client at 14 weeks gestation with no prenatal are present to
the labor and delivery unit with nausea and vomiting and a severe headache.
The client has elevated blood pressure. .

When assessing the client, which of the following signs and symptoms by the
nurse would confirm the presence of a hydatidiform mole?

Unusual uterine enlargement

14Multiple Choice
1/ 1
There are several risk factors for having H-mole. Nurse Mira is teaching a group
of student nurses about it. Which of the following would most likely develop the
disease.
Prior molar gestation

15Multiple Choice
1/ 1
The nurse, in assessing a client attending a maternity clinic, should recognize
that early symptoms of a hydatidiform mole include:

Uterine growth above normal, increased blood pressure, and marked nausea and vomiting

16Multiple Choice
1/ 1
The pregnant client with molar pregnancy was treated with suction curettage.
The nurse recognizes that additional discharge teaching is required when the
client states which of the following discharge health instructions?
“I will need to see the doctor yearly for follow-up.”

17Multiple Choice
0/ 1
After a dilatation and curettage to a client diagnosed with H-mole, assessing the
client for signs and symptoms of which of the following would be most important?

Hemorrhage

18Multiple Choice
1/ 1
When preparing a client who has undergone evacuation of H-mole for discharge,
the nurse explains the need for follow-up care. The nurse determines that the
client understands the instruction when she says that she is at risk for developing
which of the following?
Choriocarcinoma

19Multiple Choice
1/ 1
A client makes a routine visit to the prenatal clinic. Although she’s 14 weeks
pregnant, the size of her uterus approximates that in an 18- to 20-week
pregnancy. Dr. Diaz diagnoses gestational trophoblastic disease and orders
ultrasonography. The nurse expects ultrasonography to reveal:

grapelike clusters.

20Multiple Choice
1/ 1
Which of the following cause a “complete” molar pregnancy: select all that apply

response - correct

placenta grows and produces hCG

sperm fertilizes empty egg

no fetus is formed

21Multiple Choice
0/ 1
Which of the following is a risk factor of trophoblastic disease: (select all that
apply)

over 40
low economic status
previous molar pregnancy
diets deficient in protein and folic acid

22Multiple Choice
1/ 1
Which of the following best describes gestational trophoblastic disease?

An alteration of early embryonic growth, causing placental disruption, rapid proliferation of

abnormal cells, and destruction of the embryo.

23Multiple Choice
1/ 1
Rho (D) immune globulin (RhoGAM) is prescribed for a woman following delivery
of a newborn infant and the nurse provides information to the woman about the
purpose of the medication. The nurse determines that the woman understands
the purpose of the medication if the woman states that it will protect her next
baby from which of the following?

Being affected by Rh incompatibility

24Multiple Choice
1/ 1
In the 12th week of gestation, a client completely expels the products of
conception. Because the client is Rh negative, the nurse must:

Administer RhoGAM within 72 hours

25Multiple Choice
1/ 1
During a prenatal examination, the nurse draws blood from a young Rh negative
client and explain that an indirect Coombs test will be performed to predict
whether the fetus is at risk for:

Acute hemolytic disease

26Multiple Choice
1/ 1
Situation: A client who experienced mild vaginal bleeding and was diagnosed
with incompetent cervix has had a McDonald cerclage procedure done at 18
weeks in the current pregnancy.

The client calls the clinic at 37 weeks because she is having irregular
contractions every 5 to 7 minutes. Which response by the nurse is most
appropriate?

“Come to the hospital to have your cerclage removed before your baby is born.”

27Multiple Choice
1/ 1
This type of spontaneous abortion is one of the cause of incompetent cervix

Habitual abortion

28Multiple Choice
1/ 1
Situation: Mrs. Madamdamin, a G4P3 is admitted to the prenatal clinic at 8
months pregnant with complaint of painless vaginal bleeding. Diagnosis is
incomplete placenta previa.

Upon admission, the nursing measure to which the nurse should perform
INITIALLY is to:

Assess the amount and character of the vaginal bleeding

29Multiple Choice
0/ 1
Which of the following is the first priority goal for the client experiencing placenta
previa?

No signs of maternal distress

30Multiple Choice
1/ 1
The client diagnosed to have a placenta previa should not undergo cervical
examination primarily because it could:

Cause profound hemorrhage

31Multiple Choice
1/ 1
A 35 year old multigravid client who is at 32 weeks gestation is admitted to the
obstetric unit for observation. The admission diagnosis is total placenta previa.
Based on the client’s clinical presentation, which admission information should
the nurse obtain first?

Blood pressure and pulse rate

32Multiple Choice
1/ 1
Basha, a pregnant client who reports painless vaginal bleeding at 28 weeks
gestation is diagnosed with placenta previa. It was described as the placental
edge reaches but not covers the internal os. The nurse would suspect the client
has which type of placenta previa?

Marginal placenta previa

33Multiple Choice
1/ 1
Ana Marie is G3P2 at 38 weeks AOG. She arrives at Philippine General Hospital
with painless bright red vaginal bleeding. What is the expected treatment for Ana
Marie?

1. If fetus is mature and Ana Marie has hypovolemia, a cesarean delivery.

2. If fetus is immature and the bleeding subsides, pregnancy will be allowed to

continue

34Multiple Choice
1/ 1
Situation: Micah is a 30-year-old multigravid client who is in her last trimester of
pregnancy. She arrives at the hospital with red vaginal bleeding. She states that
the bleeding started suddenly.

The client on admission presents with rigid, board like tender abdomen, maternal
shock and fetal distress. Which assessment finding is considered a predisposing
factor for the development of abruption placenta?

Pregnancy induced hypertension

35Multiple Choice
1/ 1
If the client develops a complete abruption, the nursing care plan should include
careful assessment for signs and symptoms of which of the following?

Hypovolemic shock

36Multiple Choice
1/ 1
In abruption placenta, if placenta separates first at the center, blood will pool
under it and be hidden from view. Uterine musculature is infiltrated and will lead
to formation of couvelaire uterus. The nurse should expect that upon palpation
the uterus is:

hard and board-like

37Multiple Choice
1/ 1
Mrs. Aray Co, has been involved in an automobile accident. She was 34 weeks
pregnant. She does not complain of any physical injury. Due to the nature of the
accident, the nurse, would monitor the client for which complication of
pregnancy?

Placental abruption

38Multiple Choice
1/ 1
Situation: A 22 year old primigravid client is in her 22 nd week of pregnancy. The
physician informed the client that she has pregnancy induced hypertension. She
is admitted to the hospital.

The nurse concludes that the client was diagnosed with pregnancy induced
hypertension when the vital signs taken today show that the blood pressure has
increased during pregnancy from 100/60 to 130/80. When assessing the client,
the nurse should thoroughly explore which finding at each visit?

Any sudden weight gain

39Multiple Choice
1/ 1
A client with gestational hypertension is experiencing abdominal pain and vaginal
bleeding. Which assessment should the nurse perform first?

Assess fetal heart tones

40Multiple Choice
1/ 1
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?

The client complains of a headache and blurred vision

41Multiple Choice
0/ 1
The nurse might suspect early pre-eclampsia if the patient complains:

“I can’t wear my wedding ring anymore”

42Multiple Choice
0/ 1
Which of the following would the nurse use as the basis for the teaching plan
when caring for a pregnant client at risk for PIH about the ideal weight gain
during pregnancy?

A total gain of 25 to 30 pounds

43Multiple Choice
1/ 1
Situation: A pregnant client in her last trimester has been admitted to the
hospital. Her initial admitting vital signs are blood pressure 160/90; pulse 88;
respirations 24 and temperature 98 F.

The client complains of epigastric pain and headache. What should the nurse do
INITIALLY?

Provide supportive care for impending convulsions

44Multiple Choice
1/ 1
When preparing a room for admission to the client, which of the following should
the nurse obtain?

Padding for side rails

45Multiple Choice
1/ 1
The physician ordered magnesium sulfate deep IM. While the client is receiving
magnesium sulfate, the nurse routinely assesses the client’s vital signs and notes
the following: BP 160/90, and blurring of vision. In caring for the client the nurse
should:

Protect her against strenuous stimuli

46Multiple Choice
0/ 1
When teaching a multigravid client diagnosed with severe pre-eclampsia about
nutritional needs, which of the following types of diet would the nurse discuss?
High protein

47Multiple Choice
0/ 1
A client with eclampsia is afraid of another convulsion and asks when the
likelihood of convulsions will end. The nurse replies that the danger of a
convulsion in a woman with eclampsia ends:

48-72 hours postpartum

48Multiple Choice
1/ 1
A primigravida is receiving magnesium sulfate for the treatment of pregnancy
induced hypertension (PIH). The nurse who is caring for the client is performing
assessments every 30 minutes. Which assessment finding would be of most
concern to the nurse?

Respiratory rate of 10 BPM

49Multiple Choice
1/ 1
A nurse is caring for a pregnant client with Preeclampsia. The nurse prepares a
plan of care for the client and documents in the plan that if the client progresses
from Preeclampsia to eclampsia, the nurse’s first action is to:

Clean and maintain an open airway

50Multiple Choice
0/ 1
A nurse is monitoring a pregnant client with pregnancy induced hypertension who
is at risk for Preeclampsia. The nurse checks the client for which specific signs of
Preeclampsia (select all that apply)?

Elevated blood pressure

51Multiple Choice
0/ 1
A woman with preeclampsia is receiving magnesium sulfate. The nurse assigned
to care for the client determines that the magnesium therapy is effective if:

Seizures do not occur

52Multiple Choice
1/ 1
A nurse is caring for a pregnant client with severe preeclampsia who is receiving
IV magnesium sulfate. Select all nursing interventions that apply in the care for
the client.
response - correct
Monitor renal function and cardiac function closely
Keep calcium gluconate on hand in case of a magnesium sulfate overdose

Monitor deep tendon reflexes hourly

Monitor I and O’s hourly

Notify the physician if urinary output is less than 30 ml per hour.

53Multiple Choice
1/ 1
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?

Calcium gluconate

54Multiple Choice
1/ 1
Situation: Regina is G1P0 35 weeks AOG and visits the Brgy. Balibago Rural
Health Unit for a routine prenatal care. The nurse discovers that she gained 8 lbs
in the past month and feels and looks “fat” as she wakes up in the morning. She
also complains of pounding headache, visual changes and Epigastric pain. Her
urine test reveals proteinuria.

What does weight gain indicate?

It may be due to fluid retention

55Multiple Choice
0/ 1
Which of the following signs indicate cortical brain spasm?

Epigastric pain

56Multiple Choice
1/ 1
Which of the following describes the benefits of bed rest on a left lateral position
for hypertension in pregnancy?

Increases uteroplacental circulation

57Multiple Choice
1/ 1
The physician orders betamethasone (Celestone) to the client. The nurse
explains that this drug is given for which of the following reasons?

To enhance fetal lung maturity

58Multiple Choice
1/ 1
Situation: A 25 year old woman is four months pregnant. She had rheumatic
fever at age 15 and developed a systolic murmur. She reports exertional
dyspnea.

The client has been instructed on home management. Which instruction should
the nurse give her?

“Avoid heavy housework, shopping, stair climbing, and all unnecessary physical effort.”

59Multiple Choice
1/ 1
A nurse is assessing a client with cardiac disease at the 30-week gestation
antenatal visit. The nurse assesses lung sounds in the lower lobes after a routine
blood pressure screening. The nurse performs this assessment to:

Assess for early signs of congestive heart failure

60Multiple Choice
1/ 1
Which of the following should the nurse include when planning intrapartum care
to a woman with cardiac problem?

Hook client to a cardiac monitor

61Multiple Choice
1/ 1
When teaching the pregnant woman with class II heart disease, the nurse should
advise her to:

Avoid strenuous activity

62Multiple Choice
0/ 1
When teaching a primigravid client with diabetes about common causes of
hyperglycemia during pregnancy, which of the following would the nurse include?

Obesity before conception

63Multiple Choice
1/ 1
Which of the following is the normal blood glucose level in an adult person?

80-120 mg/dl

64Multiple Choice
1/ 1
A nurse implements a teaching plan for a pregnant client who is newly diagnosed
with gestational diabetes. Which statement if made by the client indicates a need
for further education?
“I need to avoid exercise because of the negative effects of insulin production.”

65Multiple Choice
1/ 1
The client is in her last trimester of pregnancy and her diabetes has been well
controlled. She tells the nurse that she is excited but also scared that something
could be wrong with her baby because of her diabetes. Which response of the
nurse is most appropriate?

“Your baby may be large and initially will need blood glucose monitoring.”

66Multiple Choice
1/ 1
Clients with gestational diabetes are usually managed by which of the following
therapies?

Diet

67Multiple Choice
0/ 1
Insulin needs for a pregnant diabetic.

Varies depending on the stage of gestation

68Multiple Choice
0/ 1
Student nurse Juliet is educating a pregnant client in the community who has
gestational diabetes. Which of the following statements should nurse Juliet give
to the client? Select all that apply.

response - incorrect

Cakes, candies, cookies, and regular soft drinks should be avoided.

Gestational diabetes increases the risk that the mother will develop diabetes later in life.
Gestational diabetes usually resolves after the baby is born.
The baby will likely be born with diabetes

69Multiple Choice
1/ 1
Nurse Ely Pante is caring for a neonate of a diabetic para who weighs 4536g
(10lbs). the infant was born via cesarean delivery 1 hour ago. The mother asks
the nurse, “Why is my baby in the neonatal care unit?” the nurse’s best response
on the understanding that neonates of diabetic mothers frequently develop which
of the following?

Hypoglycemia

70Multiple Choice
1/ 1
Nurse Oliver is teaching a diabetic pregnant client about nutrition and insulin
needs during pregnancy. The nurse determines that the client understands
dietary and insulin needs if the client states that the second half of pregnancy
require:

Increased insulin

71Multiple Choice
1/ 1
Jose brought his pregnant wife to the clinic to confirm her blood sugar levels.
Which laboratory test result should the physician use to diagnose the client
having Gestational diabetes mellitus?

FBS of 145mg/dl for 2 readings

72Multiple Choice
1/ 1
The goal for postprandial blood glucose for those with gestational diabetes
mellitus is:

<155 mg/dl

73Multiple Choice
1/ 1
A glycosylated hemoglobin level is ordered for a pregnant diabetic because it:

Indicates mean glucose level over to 1 to 3 months period

74Multiple Choice
1/ 1
A nurse discusses high-risk complications with a group of women at a prenatal
clinic. Margate, age 22, primipara during her 2nd trimester has asked the nurse
regarding her hemogblobin result of 9 g/dL. and has been prescribed 300 mg of
ferrous sulfate daily for her pregnancy-related anemia. To assess compliance,
the nurse should do which of the following?

Assess hemoglobin and hematocrit level

75Multiple Choice
0/ 1
Margarita, age 15, primigravida during her 1st trimester has asked the nurse for
antepartal care at 12 weeks gestation. Based on her clinical findings, it is
determined that she has iron deficiency anemia. Which of the following findings
supports the diagnosis?

A hematocrit less than 35%

76Multiple Choice
1/ 1
As a knowledgeable student in NCM 109 you are providing education to
a pregnant patient on how to take her prescribed iron supplement. Which
statement by the patient requires you to re-educate the patient on how to take
this supplement?

"This medication can cause constipation. So, I will drink plenty of fluids and take a stool
softener as needed."

77Multiple Choice
1/ 1
Mrs. Badjao has been receiving iron supplementation from the rural health unit.
The patient voices concern about how her stool is dark black. As
the student nurse on duty, you would:

Reassure the patient this is a normal side effect of iron supplementation

78Multiple Choice
1/ 1
During the consultation, you also provided diet teaching to Mrs. Badjao to
increase her iron levels. Which foods would you encourage the patient to eat
regularly?

Egg yolks, beef, and red meat

79Multiple Choice
1/ 1
Aside from iron supplement, Mrs. Badjao was also instructed by the midwife to
take her Folic acid supplement, as a nursing student you are aware that folic acid
is a:

B vitamin

80Multiple Choice
1/ 1
Folic acid reduces the risk for:

All of the above

81Multiple Choice
0/ 1
On arrival at the ER, a client tells the nurse that she suspects that she may be
pregnant but has been having a small amount of bleeding and has severe pain in
the lower abdomen. The client BP is 70/50 mmHg and her PR is 120 bpm. The
nurse notifies the physician immediately because which of the following is
suspected?
Ectopic pregnancy

82Multiple Choice
1/ 1
A nurse is assigned to care for a client with pre-eclampsia. The nurse should
plan to initiate which action to provide a safe environment?

Turn off the room lights and draw the window shades

83Multiple Choice
1/ 1
A pregnant client on her third trimester, is admitted to the labor and delivery unit
with vaginal bleeding. To differentiate between placenta previa and abruptio
placentae, the nurse should assess which of the following?

Presence of abdominal pain.

84Multiple Choice
1/ 1
When preparing a client for cesarean delivery, which of the following key
concepts should be considered when implementing nursing care?

Modify preoperative teaching to meet the needs of either a planned or emergency cesarean
birth

85Multiple Choice
1/ 1
A patient with HIV is 6 weeks pregnant. What would you educate the patient
about?

Practice safe but total abstinence from sexual intercourse during the pregnancy is
recommended

86Multiple Choice
0/ 1
A client asks, what are the effects of alcohol in pregnancy?

Interferes with nutrient absorption, cell growth, DNA synthesis, and suppresses fetal
breathing

87Multiple Choice
1/ 1
You have a pregnant client who stated she has used Metamphetamine. Which of
the following is the most appropriate follow-up question during assessment?

“how often do you use it now”

88Multiple Choice
1/ 1
A patient tells you she has used marijuana during the first 10 weeks of her
pregnancy because she "didn't know she was pregnant". Which statement is
correct about substance abuse during pregnancy?
Substance abuse places the pregnancy at risk for fetal growth restriction and abruptio
placenta

89Multiple Choice
1/ 1
Diana, a primigravid client asks the nurse if she can continue to have a glass of
wine with dinner during her pregnancy. Which of the following would be the
nurse’s best response?

“you should abstain from drinking alcoholic beverages”

90Multiple Choice
1/ 1
A nurse is performing an assessment of a client who is scheduled for a cesarean
delivery. Which assessment finding would indicate a need to contact the
physician?

Fetal heart rate of 180 beats/min