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    Exam Review

    1. A nurse is preparing to administer acetaminophen 10 mg/kg/dose to a child who weighs 28 lb. The amount available is acetaminophen 120 mg/5 mL. How many mL should the nurse administer? (Round the answer to the nearest tenth).
    2. Arrange the following cardinal movements of labor in the correct order that the fetus typically goes through during a vaginal birth: 1. Extension 2. Engagement 3. External rotation 4. Descent 5. Flexion 6, Internal rotation
      A)4-2-5-6-1-3
      B)2-5-4-6-3-1
      C)5-2-4-6-1-3
      D)2-4-5-6-1-3
    3. A nurse is counseling a pregnant patient at 30 weeks gestation who is at risk for preterm delivery. The nurse explains the role of pulmonary surfactant in fetal lung maturity. Which of the following statements best demonstrates a comprehensive understanding of surfactant's production, function, and clinical significance?
      A)The surfactant layer increases alveolar surface tension to stabilize the alveoli during both inhalation and exhalation, preventing overexpansion of the lungs and ensuring steady oxygen diffusion.
      B)Surfactant is secreted continuously from the fetal trachea throughout gestation to lubricate airways and enhance mucus clearance, facilitating respiratory function immediately after birth.
      C)Surfactant production peaks at 20 weeks gestation and remains stable throughout pregnancy: therefore, preterm infants born after this point typically do not experience respiratory complications related to lung immaturity.
      D)Pulmonary surfactant production begins between 24 to 28 weeks gestation, primarily from type II alveolar cells: its primary role is to lower alveolar surface tension, preventing atelectasis and promoting lung compliance, which is critical for effective gas exchange after birth.
    4. A nurse is caring for four laboring patients. Match each patient's description to the correct stage of labor: Patient A is experiencing regular contractions every 2-3 minutes with complete cervical dilation and begins involuntary pushing efforts. Patient B has mild, irregular contractions and reports only slight cervical effacement and dilation. Patient C has just delivered her baby and is now experiencing mild contractions with a gush of blood. Patient D is resting comfortably, reporting relief after delivery, with uterine firmness and lochia present.
      A)Patient A-Second stage Patient B-First stage (latent phase Patient C-Third stage Patient D-Fourth stage
      B)Patient A-First stage Patient B-Second stage Patient C-Third stage Patient D-Fourth stage
      C)Patient A-Second stage Patient B-Fourth stage Patient C-First stage Patient D-Third stage
      D)Patient A-Third stage Patient B-Second stage Patient C-Fourth stage Patient D-First stage (transition phase)
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    Exam Review

    1. A pregnant client in her third trimester complains of lower back pain. The nurse explains that this discomfort is common due to postural changes. Which of the following best explains the role of lordosis in pregnancy-related back pain?
      A)Lordosis refers to a straightening of the spine to accommodate fetal weight, which reduces flexibility and causes back pain.
      B)Lordosis is caused by compression of spinal nerves from the expanding uterus and is typically a sign of neurologic compromise.
      C)Increased lumbar lordosis is a compensatory change in spinal curvature that shifts the center of gravity forward to balance the enlarging uterus.
      D)Lordosis develops due to increased thoracic spine curvature and leads to shoulder pain in late pregnancy.
    2. A primigravida at 40 weeks gestation is admitted in active labor. The fetus is in a left occiput anterior (LOA) position with progressive cervical dilation and fetal descent. Vaginal exam reveals a well-applied fetal head, and the labor is progressing without complications. Based on these findings, which maternal pelvic type is most likely contributing to this optimal labor pattern?
      A)Platypelloid pelvis
      B)Gynecoid pelvis
      C)Anthropoid pelvis
      D)Android pelvis
    3. A nurse is caring for a laboring client who has reached the second stage of labor. Which nursing interventions are most appropriate during this stage? (Select All that Apply.)(SATA)
      A)Prepare for immediate delivery of the placenta
      B)Limit vaginal examinations to reduce risk of infection during contractions
      C)Provide emotional support and coaching to the client during pushing efforts
      D)Assist the client into a position that maximizes comfort and fetal descent, such as semi-Fowler's or side-lying
      E)Encourage the client to push with contractions using controlled breathing and effort
      F)Monitor fetal heart rate every 15 minutes or more frequently if indicated
    4. A pregnant patient who avoids dairy products asks the nurse for alternative sources of calcium. Which of the following responses by the nurse is most appropriate?
      A)"You should take a calcium supplement instead of trying to get calcium from food."
      B)Try eating calcium-fortified orange juice, tofu, almonds, or canned salmon with bones."
      C)"Calcium is only available in dairy, so you may have trouble meeting your needs without it."
      D)"Focus on eating more red meat and whole grains, as they are high in calcium.
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    Exam Review

    1. A nurse is educating a pregnant client about striae gravidarum. Which statement best explains the pathophysiology and risk factors associated with the development of these skin changes during pregnancy?
      A)They occur exclusively in the third trimester due to rapid fetal growth, and their severity is unrelated to genetic or hormonal factors.
      B)They develop due to the breakdown of elastin and collagen fibers in the dermis caused by mechanical stretching and hormonal influences.
      C)Striae gravidarum are caused by autoimmune destruction of dermal tissue, commonly seen in women with preexisting autoimmune diseases.
      D)Striae gravidarum result from increased collagen synthesis and thickening of the dermis due to elevated estrogen levels. making the skin more elastic.
    2. A nurse is assessing a laboring client at term. The provider reports that the fetus is in a longitudinal lie based on abdominal palpation and ultrasound findings. Which fetal presentations are most consistent with a longitudinal lie? Select all that apply.(SATA)
      A)Oblique presentation
      B)Frank breech presentation
      C)Transverse presentation
      D)Compound presentation
      E)Shoulder presentation
      F)Cephalic (vertex) presentation
    3. A nurse admits a client in early labor. As part of the admission assessment, the nurse reviews the prenatal record and conducts an interview. Why is it critical for the nurse to verify the client's Group B Streptococcus (GBS) status and other prenatal data during this phase?
      A)To assess the client's pain tolerance and plan analgesia accordingly
      B)To establish the exact time of rupture of membranes to schedule delivery
      C)To determine if prophylactic antibiotics are needed during labor to prevent neonatal infection
      D)To decide whether the client requires an immediate cesarean delivery
    4. During pregnancy, maternal vascular volume increases by approximately ________ % to optimize uteroplacental blood flow by maintaining adequate perfusion pressure despite reduced systemic vascular resistance, thereby supporting fetal oxygenation and nutrient delivery.
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    Exam Review

    1. A couple presents to the clinic with concerns about infertility after trying to conceive for 14 months without success. The nurse knows which of the following is the most appropriate initial response?
      A)Recommend the woman undergo immediate in vitro fertilization (IVF)
      B)Explain that infertility is defined as the inability to conceive after 1 year of regular unprotected intercourse
      C)Advise the man to begin testosterone supplementation
      D)Suggest the couple consider adoption as a primary alternative
    2. A third-trimester pregnant client reports that her shoes no longer fit comfortably. She asks if it's normal for her feet to feel larger. Which of the following is the nurse's best response?
      A)"It's normal for feet to increase in size during pregnancy due to ligament relaxation and arch flattening, and the change may be permanent."
      B)"It's uncommon, but you may have developed a foot infection that's causing swelling and enlargement."
      C)This is likely due to calcium loss from the bones, which can cause foot deformities during pregnancy."
      D)"This may indicate poor fetal growth and should be reported to your provider immediately."
    3. A client presents to the clinic reporting a missed period and a positive home pregnancy test. The nurse explains the mechanism of pregnancy tests detect the presence of _________ in urine or blood.
    4. A client who is pregnant asks the nurse for her due date. The client's last menstrual period began on September 9, 2024. What is the client's due date?(SATA)
    Page 4 of 13

    Exam Review

    1. The nurse caring for a patient in labor knows factors that affect the progression of labor and birth are: Select all that apply.(SATA)
      A)voluntary bearing down efforts.
      B)the shape of the woman's bony pelvis.
      C)antibiotic administration for a GBS + patient.
      D)size of the fetal head.
      E)presentation of the fetus.
    2. You are admitting a pregnant female patient. She tells you she has 2 children: both were single births. Her oldest was born at 39 weeks and her youngest was born at 30 weeks. She had 2 miscarriages between her oldest and youngest. One at 12 weeks and the other at 8 weeks. What is her GP?
    3. You are admitting a pregnant female. She tells you she has 3 children. She has 3-year-old twins that were born at 35 weeks but her 8-year-old was born at 40 weeks. She also tells you she has not had any abortions or miscarriages. What is her GTPAL?
      A)3.1.0.1.1.
      B)41.0.1.1
      C)4.1.1.0.3
      D)3.1.1.0.3
    4. The nurse is caring for a client who visits the prenatal clinic stating she thinks she may be pregnant because she is able to feel the baby move. Which of the following statements by the nurse is an appropriate response?
      A)This is a probable sign of pregnancy."
      B)"This is a positive sign of pregnancy."
      C)"This is a possible sign of pregnancy."
      D)"This is a presumptive sign of pregnancy."
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    Exam Review

    1. A 22 kg patient has an order for cefazolin 500 mg IV every 6 hours. The safe dose is 50 mg/kg/day. Is the ordered dose safe for the patient?(SATA)
    2. A nurse is completing a prenatal assessment for a 30-year-old client at 26 weeks gestation. The client reports frequently craving and eating small amounts of laundry starch. Which of the following additional findings would most strongly support a diagnosis of Pica?
      A)The client has a history of disordered eating and avoids dairy products due to mild lactose intolerance.
      B)The client reports occasional cravings for spicy food but denies eating anything unusual or non-food related.
      C)The client reports eating starch and dirt regularly for the past month and states the cravings are difficult to resist.
      D)The client reports that she dislikes vegetables and prefers high-carbohydrate foods during pregnancy.
    3. From the nurse's perspective, what measure should be the focus of the health care system to reduce the rate of infant mortality further?
      A)Increasing the length of stay in a hospital after vaginal birth from 2 to 3 days
      B)Mandating that all pregnant women receive care from an obstetrician
      C)Expanding the number of neonatal intensive care units (NICUS)
      D)implementing programs to ensure women's early participation in ongoing prenatal care
    4. Prenatal testing for human immunodeficiency virus (HIV) is recommended for
      A)a woman who has had a sexually transmitted infection.
      B)a woman who has had more than one sexual partner.
      C)a woman who is monogamous with her partner.
      D)all women, regardless of risk factors.
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