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    Exam Review

    1. A pregnant client at 28 weeks gestation is observed walking with a waddling gait. The nurse explains that this change in walking is a normal part of pregnancy. Which of the following factors is most likely contributing to the client's waddling gait?
      A)Development of scoliosis in the spine
      B)Increased blood volume leading to leg swelling
      C)Relaxation of pelvic ligaments and joints
      D)Increased muscle strength in the lower extremities
    2. A nurse is caring for a client diagnosed with severe preeclampsia who is receiving intravenous magnesium sulfate for seizure prophylaxis. Which of the following findings should prompt the nurse to immediately intervene?
      A)Respiratory rate of 8 breaths per minute
      B)Urine output of 60 mL in the past two hours
      C)Deep tendon reflexes of +2
      D)Complaints of mild nausea and flushing
    3. A nurse is caring for an adolescent client who is gravida 1 and para 0. The client was admitted to the hospital at 38 weeks of gestation with a diagnosis of preeclampsia. Which of the following findings should the nurse identify as inconsistent with preeclampsia?
      A)1+ pitting sacral edema
      B)3+ protein in the urine
      C)Blood pressure 148/98 mm Hg
      D)Deep tendon reflexes of +1
    4. A nurse is educating a group of nursing students about the signs of pregnancy. Which of the following is considered a positive sign of pregnancy?
      A)Positive urine pregnancy test
      B)Fetal movement felt by the mother
      C)Auscultation of fetal heart tones by Doppler
      D)Breast tenderness and enlargement
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    Exam Review

    1. A nurse in a hospital is caring for a client who is at 38 weeks of gestation and has a large amount of painless, bright red vaginal bleeding. The client is placed on a fetal monitor indicating a regular fetal heart rate of 138/min and no uterine contractions. The client's vital signs are: blood pressure 98/52 mm Hg, heart rate 118/min, respiratory rate 24/min, and temperature 36.4° C (97.6° F). Which of the following is the priority nursing action?
      A)Insert an indwelling urinary catheter.
      B)Witness the signature for informed consent for surgery.
      C)Prepare the abdominal and perineal areas.
      D)Initiate IV access.
    2. A nurse is caring for a client who was admitted to the maternity unit at 38 weeks of gestation and who is experiencing polyhydramnios. The nurse should recognize that this diagnosis means which of the following?
      A)There is an elevated level of alpha-fetoprotein (AFP) in the amniotic fluid.
      B)The fetus is likely to have a congenital anomaly, be growth restricted, or demonstrate fetal distress during labor.
      C)The client is carrying more than one fetus.
      D)An excessive amount of amniotic fluid is present.
    3. A nurse is caring for a client who is in the first stage of labor. The nurse observes the umbilical cord protruding from the vagina. Which of the following actions should the nurse perform first?
      A)Place the client in knee-chest position.
      B)Prepare the client for an immediate birth.
      C)Cover the cord with a sterile, moist saline dressing.
      D)Insert a gloved hand into the vagina to relieve pressure on the cord.
    4. A nurse is caring for an antepartum client whose laboratory findings indicate a negative rubella titer. Which of the following is the correct interpretation of this data?
      A)The client requires a rubella vaccination at this time.
      B)The client requires a rubella immunization following delivery.
      C)The client is immune to the rubella virus.
      D)The client is not experiencing a rubella infection at this time.
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    Exam Review

    1. A nurse is educating a pregnant client about normal vaginal changes during pregnancy. Which statement by the client indicates a need for further teaching?
      A)I should report any pain, burning, or itching associated with the vaginal discharge.
      B)I understand that an increase in vaginal discharge is normal during pregnancy.
      C)I should be concerned if I experience a white, odorless vaginal discharge.
      D)My vaginal walls may appear bluish due to increased blood flow.
    2. A nurse in an antepartum unit is triaging clients. Which of the following clients should the nurse assess first?
      A)A client who is at 28 weeks of gestation and reports of painless vaginal bleeding
      B)A client who has missed a period and reports vaginal spotting
      C)A client who is at 38 weeks of gestation and reports a cough and fever
      D)A client who is at 14 weeks of gestation and reports intractable nausea and vomiting
    3. A nurse is admitting a client who has severe preeclampsia at 35 weeks of gestation and is reviewing the provider's orders. Which of the following orders requires clarification?
      A)Continuous fetal monitoring.
      B)Assess deep tendon reflexes every hour.
      C)Obtain a daily weight.
      D)Ambulate twice daily.
    4. A nurse is admitting a client who is at 37 weeks of gestation and diagnosed with severe gestational hypertension. Which of the following actions should the nurse expect to implement? (Select All that Apply.)(SATA)
      A)Provide a dark, quiet environment.
      B)Assess respiratory status every 4 hr.
      C)Administer magnesium sulfate IV.
      D)Ensure that calcium gluconate is readily available.
      E)Evaluate neurologic status every 8 hr.
    Page 3 of 9

    Exam Review

    1. A pregnant client with gestational diabetes mellitus (GDM) is at risk for which of the following maternal complications?
      A)Hypotension and preterm labor
      B)Placenta previa and fetal growth restriction
      C)Hyperemesis gravidarum and anemia
      D)Polyhydramnios and hypertension
    2. A nurse is assessing a pregnant client diagnosed with HELLP syndrome. Which of the following findings is most concerning?
      A)Blood pressure of 140/90 mmHg
      B)Platelets 250,000/mm3
      C)Right upper quadrant pain
      D)Fetus expected weight for gestation
    3. A nurse is educating a pregnant client about TORCH infections. Which of the following TORCH infections can be transmitted to the fetus and cause congenital abnormalities?
      A)Malaria
      B)Trichomoniasis
      C)HIV
      D)Rubella
    4. A nurse is caring for a client at the first prenatal visit who has an ideal body weight for her height. The client asks how much weight she should gain during pregnancy. Which of the following responses should the nurse make?
      A)"A gain of about 1 pound per week is recommended for you."
      B)"A gain of about about 15 to 25 pounds is recommended for you."
      C)"A gain of about 25 to 35 pounds is recommended for you."
      D)"A gain of about 30 to 40 pounds is recommended for you."
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    Exam Review

    1. A nurse at a prenatal clinic is caring for a client who is in her first trimester of pregnancy. The client tells the nurse that she is upset because, although she and her husband planned this pregnancy, she has been having many doubts and second thoughts about the upcoming changes in her life. Which of the following is an appropriate response by the nurse?
      A)"Perhaps you should see a counselor to discuss these feelings further."
      B)"Have you spoken to your mother about these feelings?"
      C)"Ambivalent feelings are quite common for women early in pregnancy."
      D)"Don't worry. You will be fine once the baby is born."
    2. A nurse is providing education to a client during the first prenatal visit. Which of the following statements by the client should indicate to the nurse a need for clarification?
      A)"I should drink about 2 liters of fluid each day."
      B)"I should not drink alcoholic beverages during my pregnancy."
      C)"I should increase my calcium intake to 1,500 milligrams per day
      D)"I can have a moderate amount of caffeine daily."
    3. A pregnant client at 28 weeks gestation reports experiencing leg discomfort and noticing bulging veins in her legs. The nurse explains that varicose veins are common during pregnancy. What is the primary physiological change during pregnancy that contributes to the development of varicose veins?
      A)Reduced cardiac output
      B)Dehydration leading to poor circulation
      C)Decreased progesterone levels
      D)Increased blood volume
    4. A nurse is caring for a client who is at 23 weeks of gestation and has been unable to control her gestational diabetes mellitus with oral hypoglycemic therapy, diet and exercise. The nurse should anticipate a prescription from the provider for which of the following medications for the client?
      A)Letrozole
      B)Lactulose
      C)Insulin
      D)Metoprolol
    Page 5 of 9

    Exam Review

    1. A nurse is caring for a client who is a primigravida, at term, and having contractions but is stating that she is "not really sure if she is in labor or not." Which of the following should the nurse recognize as a sign of true labor?
      A)Station of the presenting part
      B)Pattern of contractions
      C)Rupture of the membranes
      D)Changes in the cervix
    2. A nurse at an antepartum clinic is admitting a client who is at 30 weeks of gestation. Exhibits Which of the following actions should the nurse take after administering the prescribed medications? Select all that apply.(SATA)
      A)Keep calcium gluconate readily available.
      B)Check urinary output every 2 hr.
      C)Check deep tendon reflexes every 1 hr.
      D)Provide intermittent fetal monitoring.
      E)Report respiratory rate of less than 12 breaths/min to the provider.
    3. A nurse is completing a health history for a client who is at 6 weeks of gestation. The client informs the nurse that she smokes one pack of cigarettes per day. The nurse should advise the client that smoking places the client's newborn at risk for which of the following complications?
      A)Congenital heart defects
      B)Hearing loss
      C)Type 1 diabetes mellitus
      D)Intrauterine growth restriction
    4. A nurse in a prenatal clinic is reviewing the health record of a client who is at 28 weeks of gestation. The history includes a pregnancy terminated by elective abortion at 9 weeks: and a pregnancy that resulted in the birth of a singleton at 39 weeks, currently alive and well. According to the GTPAL system, which of the following describes the client's current status?
      A)G3 TO P2 A1 L1
      B)G2 T1 PO AO L2
      C)G2 T1 PO A1 L2
      D)G3 T1 PO A1 L1
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