COLLEGE OF NURSING

Name: Jamaica Leslie M. Noveno Score: ____________

Year and Section: BSN-2A Date: April 21,2020

1. A woman, who is 22 weeks pregnant, has a routine ultrasound performed. The ultrasound shows that the
placenta is located at the edge of the cervical opening. As the nurse you know that which statement is FALSE about
this finding:
A. This is known as marginal placenta previa.
B. The placenta may move upward as the pregnancy progresses and needs to be reevaluated with another
ultrasound at about 32 weeks gestation.
C. The patient will need to have a c-section and cannot deliver vaginally.
D. The woman should report any bleeding immediately to the doctor.
Ans. C
2. Your patient who is 34 weeks pregnant is diagnosed with total placenta previa. The patient is A positive. What
nursing interventions below will you include in the patient's care? Select all that apply:
A. Routine vaginal examinations
B. Monitoring vital signs
C. Administer RhoGAM per MD order
D. Assess internal fetal monitoring
E. Placing patient on side-lying position
F. Monitoring pad count
G. Monitoring CBC and clotting levels
Ans. B, E, F, G

3. A 28-year-old female, who is 33 weeks pregnant with her second child, has uncontrolled hypertension. What risk
factor below found in the patient's health history places her at risk for abruptio placentae?
A. childhood polio
B. preeclampisa
C. c-section
D. her age
Ans. B

4. A 36-year-old woman, who is 38 weeks pregnant, reports having dark red bleeding. The patient experienced
abruptio placentae with her last pregnancy at 29 weeks. What other signs and symptoms can present with
abruptio placentae? Select all that apply:
A. Decrease in fundal height
B. Hard abdomen
C. Fetal distress
D. Abnormal fetal position
E. Tender uterus
Ans. B, C, E

5. Select all the patients below who are at risk for developing placenta previa:
A. A 37-year-old woman who is pregnant with her 7th child.
B. A 28-year-old pregnant female with chronic hypertension.
C. A 25-year-old female who is 36 weeks pregnant that has experienced trauma to abdomen.
D. A 20-year-old pregnant female who is a cocaine user.
Ans. A, D

6. You're performing a head-to-toe assessment on a patient admitted with abruptio placentae. Which of the
following assessment findings would you immediately report to the physician?
A. Oozing around the IV site
B. Tender uterus
C. Hard abdomen
D. Vaginal bleeding
Ans. A

7. Which statement is TRUE regarding abruptio placenta?

A. This condition occurs due to an abnormal attachment of the placenta in the uterus near or over the cervical
opening.
B. A marginal abruptio placenta occurs when the placenta is located near the edge of the cervical opening.
C. Nursing interventions for this condition includes measuring the fundal height.
D. Fetal distress is not common in this condition as it is in placenta previa.
Ans. C

8. Select all the signs and symptoms associated with placenta previa:
A. Painless bright red bleeding
B. Concealed bleeding
C. Hard, tender uterus
D. Normal fetal heart rate
E. Abnormal fetal position
F. Rigid abdomen
Ans. A, D, E

9. Disseminated intravascular coagulation (DIC) can occur in __________________. This happens because when
the placenta becomes damaged and detaches from the uterine wall, large amounts of _____________ are released
into mom’s circulation, leading to clot formation and then clotting factor depletion.
A. Placenta previa, fibrinogen
B. Placenta previa, platelets
C. Abruptio placentae, fibrinogen
D. Abruptio placentae, thromboplastin
Ans. D
10. A patient who is 25 weeks pregnant has partial placenta previa. As the nurse you're educating the patient
about the condition and self-care. Which statement by the patient requires you to re-educate the patient?
A. "I will avoid sexual intercourse and douching throughout the rest of the pregnancy."
B. "I may start to experience dark red bleeding with pain."
C. "I will have another ultrasound at 32 weeks to re-assess the placenta's location."
D. "My uterus should be soft and non-tender."
Ans. B

11. A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would
the nurse interpret as indicating a therapeutic level of medication? 1 point
A. Urinary output of 20 mL per hour
B. Respiratory rate of 10 breaths/minute
C. Deep tendons reflexes 2+
D. Difficulty in arousing
Ans. C

12. The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse includes
interventions focusing on which of the following because of the woman's increased risk?
A. Oligohydramnios
B. Preeclampsia
C. Post-term labor
D. Chorioamnionitis
Ans. B
13. After reviewing a client's history, which factor would the nurse identify as placing her at risk for gestational
hypertension?
A. Mother had gestational hypertension during pregnancy.
B. Mother had gestational hypertension during pregnancy.
C. Sister-in-law had gestational hypertension.
D. This is the client's second pregnancy.
Ans. A

14. The nurse is reviewing the laboratory test results of a pregnant client. Which one of the following findings
would alert the nurse to the development of HELLP syndrome?
A. Hyperglycemia
B. Elevated platelet count
C. Leukocytosis
D. Elevated liver enzymes
Ans. D

15. A nurse is teaching a pregnant woman with preterm premature rupture of membranes who is about to be
discharged home about caring for herself. Which statement by the woman indicates a need for additional
teaching?
A."I need to keep a close eye on how active my baby is each day."
B. "I need to call my doctor if my temperature increases."
C. "It's okay for my husband and me to have sexual intercourse."
D. "I can shower but I shouldn't take a tub bath."
Ans. C
16. A nursing student is reviewing an article about preterm premature rupture of membranes. Which of the
following would the student expect to find as factor placing a woman at high risk for this condition? (Select all that
apply)
A. High Body mass index
B. Urinary tract infection
C. Low socio-economic status
D. Single gestations
E. Smoking
Ans. B, C, E

17. A client has severe preeclampsia. The nurse would expect the primary health care practitioner to order tests to
assess the fetus for which of the following?
A. Severe anemia.
B. Hypoprothrombinemia.
C. Craniosynostosis.
D. Intrauterine growth restriction.
Ans. D

18. A 26-week-gestation woman is diagnosed with severe preeclampsia with HELLP syndrome. The nurse will
assess for which of the following signs/symptoms?
A. Low serum creatinine.
B. High serum protein
C. Bloody stools
D. Epigastric pain.
Ans. D

19. An appropriate gestation age to do glucose screening is:

A. 22 weeks of gestation
B. 26 weeks of gestation
C. 30 weeks of gestation
D. 34 weeks of gestation
Ans. B

20. The goal of magnesium sulfate therapy in treating preeclampsia is to:

A. Reduce blood pressure
B. Delay delivery
C. Prevent seizures
D. Increase placental perfusion
Ans. C

21. Management of women with pregestational diabetes should begin:

A. Before conception
B. At the end of the first trimester
C. At the end of 20 weeks
D. Before the onset of labor
Ans. A

22. A pregnant clients biophysical profile score is 8. She asks the nurse to explain the results. What is the nurses
best response?
A. The test results are within normal limits.
B. Immediate birth by cesarean birth is being considered.
C. Further testing will be performed to determine the meaning of this score.
D. An obstetric specialist will evaluate the results of this profile and, within the next week, will inform you of your
options regarding birth.
Ans. A

23. What is the purpose of amniocentesis for a client hospitalized at 34 weeks of gestation with pregnancy-induced
hypertension?
A. Determine if a metabolic disorder is genetic.
B. Identify the sex of the fetus.
C. Identify abnormal fetal cells.
D. Determine fetal lung maturity.
Ans. D

24. What does nursing care after amniocentesis include?

A. Forcing fluids by mouth
B. Monitoring uterine activity
C. Placing the client in a supine position for 2 hours
D. Applying a pressure dressing to the puncture site
Ans. B

25. What is the term for a nonstress test in which there are two or more fetal heart rate accelerations of 15 or
more bpm with fetal movement in a 20-minute period?
A. Positive
B. Negative
C. Reactive
D. Nonreactive
Ans. C

26. What is the purpose of initiating contractions in a contraction stress test (CST)?
A. Increase placental blood flow.
B. Identify fetal acceleration patterns.
C. Determine the degree of fetal activity.
D. Apply a stressful stimulus to the fetus.
Ans. D

27. A biophysical profile is performed on a pregnant client. The following assessments are noted: nonreactive
stress test (NST), three episodes of fetal breathing movements (FBMs), limited gross movements, opening and
closing of hang indicating the presence of fetal tone, and adequate amniotic fluid index (AFI) meeting criteria.
What would be the correct interpretation of this test result?
A. A score of 10 would indicate that the results are equivocal.
B. A score of 8 would indicate normal results.
C. A score of 6 would indicate that birth should be considered as a possible treatment option.
D. A score of 9 would indicate reassurance.
Ans. B

28. In preparing a pregnant client for a nonstress test (NST), which of the following should be included in the plan
of care?
A. Have the client void prior to being placed on the fetal monitor because a full bladder will interfere with results.
B. Maintain NPO status prior to testing.
C. Position the client for comfort, adjusting the tocotransducer belt to locate fetal heart rate.
D. Have an infusion pump prepared with oxytocin per protocol for evaluation.
Ans. C

29. A woman hospitalized with severe preeclampsia is being treated with hydralazine to control blood pressure.
Which of the following would the lead the nurse to suspect that the client is having an adverse effect associated
with this drug?
A. Gastrointestinal bleeding
B. Blurred vision
C. Tachycardia
D. Sweating
Ans. C

30. Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate
to treat severe preeclampsia?
A. Calcium gluconate
B. Potassium chloride
C. Ferrous sulfate
D. Calcium carbonate
Ans. A

31. Which of the following long-term goals is appropriate for a client, 10 weeks’ gestation, who is diagnosed with
gestational trophoblastic disease (hydatiform mole)?
A. Client will be cancer-free 1 year from diagnosis.
B. Client will deliver her baby at full term without complications.
C. Client will be pain-free 3 months after diagnosis.
D. Client will have normal hemoglobin and hematocrit at delivery.
Ans. A

32. Which of the following findings should be reported to the primary health care practitioner when assessing a
first-trimester gravida suspected of having gestational trophoblastic disease (hydatiform mole)?
A. Hematocrit 39%.
B. Grape-like clusters passed from the vagina.
C. White blood cell count 8000/mm3.
D. Hypertrophied breast tissue.
Ans. B

33. A woman has been diagnosed with a ruptured ectopic pregnancy. Which of the following signs/symptoms is
characteristic of this diagnosis?
A. Dark brown rectal bleeding.
B. Severe nausea and vomiting.
C. Sharp unilateral pain.
D. Marked hyperthermia.
Ans. C

34. Which of the following pregnant clients is most high risk for preterm premature rupture of the membranes
(PPROM)?
A. 30-week gestation with prolapsed mitral valve (PMV).
B. 32-week gestation with urinary tract infection (UTI).
C. 34-week gestation with gestational diabetes (GDM).
D. 36-week gestation with deep vein thrombosis (DVT).
Ans. B

35. On ultrasound, it is noted that the pregnancy of a hospitalized woman who is carrying monochorionic twins is
complicated by twin-to-twin transfusion. The nurse should carefully monitor this client for which of the following?

A. Rapid fundal growth.

B. Vaginal bleeding.
C. Projectile vomiting.
D. Congestive heart failure.
Ans. A

36. Mother-fetus Rh blood type incompatibility problems can occur if the mother is _____ and her fetus is _____ .
A. Rh positive; Rh positive
B. Rh positive; Rh negative
C. Rh negative; Rh positive
D. Rh negative; Rh positive
Ans. C

37. If the father of a fetus is Rh positive and the mother is Rh negative, what are the chances that there will be a
mother-fetus incompatibility problem? Assume that the couple has already had a child and that there has been no
medical treatment to prevent this problem.
A. 100%
B. at least 50%
C. less than 50%
D. 0%
Ans. B

38. When a fetus' blood is agglutinated by its mother's Rh antibodies, the severe anemia that results is called:
A. immunization
B. ectopic pregnancy
C. erythroblastosis fetalis
D. DIC
Ans. C

39. Which of the following are true of mother-fetus Rh incompatibility problems?

A. They can be prevented by injecting Rho-GAM into the mother's blood system.
B. They are much less likely to occur during the first pregnancy compared to later pregnancies.
C. Medical treatment can be nearly 100% effective in preventing such problems.
D. All of the above
Ans. D

40. Mother-fetus incompatibility problems result from:

A. the mother's antibodies agglutinating the fetus' Rh positive red blood cells
B. the fetus' antibodies agglutinating its own red blood cells
C. the fetus' antibodies agglutinating its mother's red blood cells
Ans. A

Identification:

1. A young mother gives birth to twin boys who shared the same placenta. What serious complication are they at
risk for? Twin-to-twin transfusion syndrome (TTTS)
2. A pregnant client has a Rh-negative blood type. Following the birth of the client's infant, the nurse administers
her Rho(D) immune globulin. The purpose of this is to: Prevent maternal D antibody formation
3. A nurse is monitoring a client with PROM who is in labor and observes meconium in the amniotic fluid. What
does the observation of meconium indicate? Fetal distress related to hypoxia
4. Prenatal screening method that uses ultrasound measurement of fluid in the nape of the fetal neck between 10
and 14 weeks of gestation to identify possible fetal abnormalities." Nuchal Translucency (NT)
5. Excessive vomiting that leads to dehydration and electrolyte imbalance. Hyperemesis Gravidarum