Name: Rou’z Ven E.

Semilla BSN -A1 Date: 11-21-2021

1. Nurse Myra is teaching a prenatal class in Barangay Sinagtala, where she is going over the roles of the female
reproductive system. Mrs. Thelma, a student in the class, inquires about the fallopian tubes' work. The nurse
tells the client that:
a. The fallopian tubes secrete estrogen and progesterone.
b. The fallopian tubes are the passageway for the fetus
c. The fetus develops in the fallopian tubes
d. The fallopian tubes are where fertilization takes place.
Answer: D
Rationale: Fertilization usually takes place in  a fallopian tube that links an ovary to the uterus. If the fertilized egg
successfully travels down the fallopian tube and implants in the uterus, an embryo starts growing.

2. When counseling an adolescent who has just started menstruating, which of the following guidelines
regarding behaviors during menstruation does the nurse include?
a. If menstrual discomfort continues, stay away from cold foods.
b. If menstrual pain persists, take a mild analgesic.
c. Stop exercising while you're on your period.
d. When menstruating, avoid sexual activity.
Answer: B
Rationale: Over-the-counter pain relievers, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium
(Aleve), at regular doses starting the day before you expect your period to begin can help control the pain of
cramps. Prescription nonsteroidal anti-inflammatory drugs also are available. The remain options reflect common
beliefs and myths about menstrual cramps therefore are considered incorrect.

3. When a nurse working in a prenatal clinic looks at a client's chart, she notices that the doctor has noted that
the woman has a gynecoid pelvis. The nurse devises a treatment plan for this client, knowing this form of
pelvis:
a. is not favorable of labor
b. has a narrow pubic arc
c. is a wide pelvis with a short diameter
d. is the most favorable for labor and birth
Answer: D
Rationale: The gynecoid pelvis is the most common pelvis shape in females and is favorable for a vaginal birth.

4. When the nurse tells a primigravid client that the placenta produces which of the following hormones, she
decides that the client requires further education.
a. Estrogen
b. Progesterone
c. Human chorionic gonadotropin (hCG).
d. Testosterone
Answer: D
Rationale: HCG is made by the placenta during pregnancy. After you conceive  (when the sperm fertilizes the egg),
the developing placenta begins to produce and release hCG. It takes about 2 weeks for your hCG levels to be high
enough to be detected in your urine using a home pregnancy test. Estrogen is also produced by the placenta
during pregnancy to help maintain a healthy pregnancy. Progesterone. This hormone is produced by the ovaries
and by the placenta during pregnancy.

5. A nursing student is assigned to a client in labor. A nursing instructor asks the student to describe fetal
circulation specifically the ductus venosus. The nursing instructor determines that the student understands
fetal circulation if the student states that the ductus venosus:
a. Connects the pulmonary artery to the aorta
b. is an opening between the right and left atria
c. connects the umbilical artery to the inferior vena cava
d. Connects the umbilical vein to the inferior vena cava
Answer: D
Rationale: The ductus venosus is a shunt that allows oxygenated blood in the umbilical vein to bypass the liver  and
is essential for normal fetal circulation. [1] Blood becomes oxygenated in the placenta and travels to the right
atrium via umbilical veins through the ductus venosus, then to the inferior vena cava.

6. A physician has prescribed transvaginal ultrasonography for a woman in the first trimester of pregnancy. The
woman asks the nurse about the procedure. The nurse accurately provides which of the following
information to the client?
a. The procedure takes about 2 hours
b. Transmission gel is spread over the abdomen and a transducer will be moved over the abdomen to
obtain the picture
c. It will be necessary to drink 1 to 2 quarts of water prior to examination
d. The transvaginal probe encased in a disposable cover and coated with a gel is inserted into the
vagina.
Answer: D
Rationale: To prevent cross contamination between patients a disposable cover, usually a latex condom, should be
placed over the probe and secured by rubber bands or other suitable means. Option A is incorrect since the entire
Transvaginal UTZ procedure take only about 30 – 60 minutes in durations. Option B and C is also incorrect since the
reflect methods for the use of an abdominal UTZ – not Transvaginal.

7. At 35 weeks of pregnancy, a multigravid client who works in a factory and stands for long periods of time
visits the prenatal clinic, saying, "The varicose veins in my legs have really been bothering me lately." Which
of the instructions below will be most useful?
a. “Twice a day, do gradual contractions and relaxations of the feet and ankles.”
b. “Rest often with your legs elevated above your hips.”
c. “Support hose that cross above the leg varicosities should be avoided.”
d. “To prevent long periods of standing, take a leave of absence from your work”

Answer: B
Rationale: Resting in a Sims’ position or on the back with the legs raised against the wall (a small firm pillow under
their right hip) or elevated on a footstool for 15 to 20 minutes twice a day is a good measure against varicosities.

8. Which of the following suggestions would you make to a primigravid client suffering from leg cramps at 37
weeks' gestation?
a. Throughout the day, change positions frequently.
b. Extend and flex the legs alternately.
c. Extend the toes toward the chin and straighten the leg.
d. In bed, lie prone with your legs raised.
Answer: C
Rationale: Relieving a leg cramp in pregnancy. Pressing down on the knee and pressing the toes backward
(dorsiflexion) relieves most cramps
 9. A nurse is reviewing a nutritional plan of care with a pregnant client and is identifying the food items that are
highest in folic acid. The nurse determines that the client understands which foods supply the highest
amounts of folic acid if the client states that she will include which of the following in the daily diet?
a. a banana
b. leafy, green vegetables
c. Milk
d. yogurt
Answer: B
Rationale:  The word folate actually derives from foliage, which refers to the leafy green veggies that contain some
of the highest natural concentrations of the vitamin found in any food. Just one cup of spinach contains around
100 mcg of folate

10. A pregnant client tells a nurse that she has been craving unusual foods. The nurse gathers additional
assessment date from the client and discovers that the client has been ingesting daily amounts of white clay
dirt from her backyard. Laboratory studies are performed on the client. The nurse reviews the laboratory
results and determines that which of the following indicates a physiological consequence of this client’s
practice?
a. Hematocrit 38%
b. Hemoglobin 9.1 g/dl
c. Glucose 86 mg/dl
d. White blood cell count 12,400/mm3

Answer: D
Rationale: Normally the total WBC count for an adult ranges from 5,000 to 10,000/mm  3. Leukocytosis (WBC >
10,000/mm 3) can indicate infection, inflammation (possibly from allergies), tissue damage or burns, dehydration,
thyroid storm, leukemia, stress, or steroid use on this case, the ingestion of the white clay from the backyard cause
a form of maternal infection.

11. A pregnant client asks a nurse about the types of exercises that are allowable during the pregnancy. The
nurse would instruct the client that the safest exercise to engage in is which of the following?
a. Bicycling with legs in the air
b. Swimming
c. Scuba diving
d. low-weight gymnastics
Answer: B

Rationale: Swimming is a good activity for pregnant women and, like bathing, is not contraindicated as long as the
membranes are intact. It may help relieve backache during pregnancy

12. A pregnant client who is at 30 weeks gestation comes to a clinic for a routine visit. A nurse performs an
assessment on the client. Which observation made by the nurse during the assessment indicates a need for
teaching?
a. The client is wearing panty hose
b. The client is wearing flat shoes
c. The client is wearing non-slip shoes
d. The client is wearing knee-high hose
Answer: D
Rationale: Women have a multitude of clothing options to wear during a pregnancy. Recommend loose-fitting,
comfortable garments. Caution women to avoid tight-fitting items such as garters, girdles with panty legs, and
knee-high stockings during pregnancy. These items impede lower-extremity circulation.

13. Alma, a 31 -year-old multigravida from Barangay Pangapisan who works as an office clerk, is 37 weeks
pregnant. She is receiving magnesium sulfate at a rate of 3 g/hour as part of her treatment for serious
preeclampsia. The priority nursing diagnosis for the nurse is: risk of central nervous system damage due to
hypertension, edema of the cerebrum. In order to keep this client healthy, the nurse should:
a. Maintain fetal monitoring at all times.
b. Encourage family members to stay by the patient's side.
c. Examine her reflexes, clonus, vision problems, and headache.
d. Every four hours, check the results of the maternal liver tests.

Answer: C
Rationale: With the patient’s current state, she may be at risk of Eclampsia. Extreme edema can lead to cerebral
and pulmonary edema and seizures. This causes nervous system damage and as such should be monitored
carefully. Vision changes are one of the most serious symptoms of preeclampsia. They may be associated with
central nervous system irritation or be an indication of swelling of the brain (cerebral edema).

14. The nurse is caring for a 22-year-old G 2,P2 client who has disseminated intravascular coagulation as a result
of delivering a stillborn baby. Which results should be reported to your health-care provider as soon as
possible?
a. Activated partial thromboplastin time (APTT) of 30 seconds.
b. Hemoglobin of 11.5 g/dL.
c. Urinary output of 25 mL in the past hour.
d. Platelets at 149,000/mm3
Answer: C
Rationale: Urinary output of less than 30 mL/h indicates renal compromise and would be the most important
assessment finding to report to the health care provider. The APTT is within normal limits and the hemoglobin is
lower than values for an adult female but within normal limits for a pregnant female. Although the platelet level is
slightly low and may impact blood clotting, when compared to renal failure, it is less important.

15. 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 a 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 bed rest throughout the remainder of the pregnancy”.”
b. “I will avoid sexual intercourse until the bleeding has stopped, and for 2 weeks following the last of
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”.”
Answer: A
Rationale: In conditions such as this, bed rest is a must. It is the most important and the number 1 management
when it comes to threatened abortion however bed rest is not required on the remainder of the pregnancy but for
12 to 24 hours only. Hence it is the answer to the question. Options B, C and D are all correct.

16. A nurse is providing instructions to a maternity client with history of cardiac disease regarding appropriate
dietary measures. Which of the following statements if made by the client indicates understanding of the
measures to take?
a. “I need to increase my fluid intake and intake of high-fiber foods.”
b. “I need to maintain a low-calorie diet to prevent any weight gain.”
c. “I need to lower my blood volume by limiting my fluids.”
 d. “I do not need to be concerned about sodium intake during pregnancy.”

Answer: C
Rationale: When a patient has cardiac disease,  additional fluid intake can build up causing swelling in your feet,
legs or belly this causes the patient’s heart work to harder. Fluid can also build up in your lungs, which may cause
you to have trouble breathing. In this sense, option A is consider wrong, option B is incorrect as well since we have
to consider that the patient is pregnant and hence need high caloric diet to supplement fetal requirement.
However it is important to consider that this must be done within the limits required. Option D also describes an
incorrect understanding since sodium has a direct influence in the retention of water. Disregarding this can greatly
affect the outcome of the condition.

17. A primigravid patient with gestational diabetes mellitus is being assisted by Nurse Felix, a barangay health
nurse. Which of the following does a nurse consider while teaching a primigravid client with diabetes about
common causes of hyperglycemia during pregnancy?
a. Fetal macrosomia.
b. Obesity before conception
c. Maternal infection
d. Pregnancy-induced hypertension
Answer: B
Rationale: The Primary risk factor for GDM is obesity.

18. A home care nurse visits a pregnant client with a diagnosis of mild preeclampsia 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
Answer: C
Rationale: Vision changes are one of the most serious symptoms of preeclampsia. They may be associated with
central nervous system irritation or be an indication of swelling of the brain (cerebral edema when this occurs –
Eclampsia is expected.

19. A nurse implements a teaching plan for a pregnant client who is newly diagnosed with gestational diabetes
mellitus. Which statement if made by the client indicates a need for further education?
a. “I need to stay on the diabetic diet.”
b. “I will perform glucose monitoring at home.”
c. “I need to avoid exercise because of the negative effects on insulin production.”
d. “I need to be aware of any infections and report signs of infection immediately to my health care
provider.”
Answer: C
Rationale: With exercise, the blood glucose level decreases because the muscles increase their need for glucose.
This effect lasts for at least 12 hours after exercise. Insulin-independent glucose uptake by muscles remains
elevated for approximately two hours. Insulin sensitivity also increases after exercise. In this sense, we can deduce
that exercise does not have a negative effect on the production of insulin and hence the option that requires
further teaching. Option A,B and D are correct and does not require further teaching.

20. A client has just had surgery to deliver a nonviable fetus resulting from abruptio placenta. As a result of the
abruptio placenta, the client develops disseminated intravascular coagulopathy (DIC) and is told about the
complication. The client begins to cry and screams “God, just let me die now!”. Which nursing diagnosis
should direct care for this client?
a. Hopelessness related to loss of baby and personal health
 b. Knowledge deficit related to disease process
c. Self-esteem disturbance related to being ill
d. Grief related to loss of the baby.
Answer: A
Rationale: Hopelessness can result when someone is going through difficult times or unpleasant experiences. A
person may feel overwhelmed, trapped, or insecure, or may have a lot of self-doubts due to multiple stresses and
losses. He or she might think that challenges are unconquerable or that there are no solutions to the problems
and may not be able to mobilize the energy needed to act on his or her own behalf.