CARE OF MOTHER AND CHILD AT RISK – ACUTE/CHRONIC (OBGYNECOLOGY)

Lesson 2 – Medical Conditions Affecting Pregnancy Outcome (pre-gestational condition)

1. Which of the following is the most likely effect on the fetus if the woman is severely anemic during
pregnancy?
a. Large for gestational age (LGA) fetus
b. Hemorrhage
c. Small for gestational age (SGA) baby
d. Erythroblastosis fetalis

2. Hyperglycemia results from poor diabetic control during pregnancy and can result to perinatal morbidity
& mortality. When evaluating the pregnant client, the nurse knows that the recommended serum
glucose rage during pregnancy is
a. 70mg/dL to 120mg/dL
b. 50mg/dL to 140mg/dL
c. 140mg/dL to 200mg/dL
d. 60mg/dL to 80mg/dL

3. A pregnant client asks the nurse, Can I have coffee in the morning? The nurse best reply is
a. Pregnant mothers can’t have coffee.
b. You can have coffee or tea but its limited to 3 cups per day.
c. You can consume caffeine containing beverages up to 500 mg.

4. A patient has gestational diabetes and is currently 34 weeks pregnant. Which assessment findings
below should you immediately report to the physician?
a. Blood glucose 200mg/dL
b. Negative glycosuria
c. Proteinuria
d. Linea nigra

5. Of the following conditions, the one recognized as a known teratogen is

a. Coronary heart disease
b. Smoking
c. Corona virus
d. Scarlet fever

6.
a. The renal insufficiency in pregnancy.
b. The increased effect of insulin during pregnancy.
c. A decrease in serum glucose during pregnancy.
d. The effect of pregnancy hormones on carbohydrates and lipid metabolism.

7. Multigravida Divine is in the first stage of labor, active phase. Considering that Divine has a
complicating heart disease due to rheumatic fever, which of the following interventions will you include
in the care plan?
a. Encourage ambulation to improve labor contraction.
b. Anticipate preparing for an operative obstetrics.
c. Reinforce instructions in correct pushing.
d. Give continuous O2 per nasal canula.

8. When are most pregnant patients tested for gestational diabetes?

a. 6 to 12 weeks gestation
b. 12 to 20 weeks gestation
c. 34 to 36 weeks gestation
d. 24 to 28 weeks gestation
9. Mrs. Cortez, primigravida client at 20 weeks gestation and with history of heart disease, has been
instructed on home management. Which of the following statements, if made by Mrs. Cortez, indicates
that she needs further teaching?
a. "I need to observe some restriction on people who visit me."
b. "I should avoid stressful situation."
c. "My weight gain is not important."
d. "I should report early signs of infection."

10. The nurse prepares a teaching plan for a newly diagnosed diabetic pregnant client. Which of the
following should not be included in the teaching plan?
a. Effects of diabetes on the pregnancy & fetus.
b. Nutritional requirements for pregnancy & diabetic control.
c. To avoid exercise due to its negative effects on insulin production.
d. To be aware of any infections & report signs of infection immediately to the health care
provider.

11. You're providing education to a patient about how to take their prescribed iron supplement. Which
statement by the patient requires you to re-educate the patient on how to take this supplement?
a. "I will take this medication on an empty stomach."
b. "I will avoid taking this medication with orange juice."
c. "I will wait and take my calcium supplements 2 hours after I take my iron supplement."
d. "This medication can cause constipation. So, I will drink plenty of fluids and take a stool
softer as needed."

12. The nurse is conducting a clinic visit with prenatal client with heart disease. The nurse carefully
evaluates vital sign, weight gain, and fluid & nutritional status to detect complication caused by
a. Hypertrophy & increased contractility
b. Increase in circulating volume
c. Fetal cardiomegaly
d. Rh incompatibility

13. A client with acquired immunodeficiency syndrome (AIDS) has a nursing diagnosis of Imbalanced
nutrition: less than body requirements. The nurse plans which of the following goals with this client?
a. Consume foods and beverages that are high in glucose.
b. Plan large menus and cook meals in advance.
c. Eat low-calorie snacks between meals.
d. Eat small, frequent meals throughout the day.

14. A pregnant client who has learned she is pregnant tells the nurse that she smokes two pack of
cigarettes a day. In counseling, the nurse encourages her to stop smoking because studies show that
newborns of mothers who smokes are often
a. Born with congenital facial malformations
b. Excessively large for gestational age
c. Small for gestational age
d. Postmature with meconium aspiration syndrome

15. According to the Western Word, alcohol is the leading known teratogens.
a. True
b. False

16. Which of the following interventions, if selected by the nurse, is appropriate for a pregnant client with
AIDS with the nursing diagnosis of High Risk for Infection?
a. Offer spiritual support.
b. Enforce total bed rest.
c. Provide information on safe sex practices.
d. Administer ferrous sulfate.
 17. A patient is admitted with iron- deficiency anemia and has been receiving iron supplementation. The
patient voices concern about how their stool is dark black. As the nurse, you would?
a. Notify the doctor.
b. Hold the next dose of iron.
c. Reassure the patient this is a normal side effect of iron supplementation.
d. None of the options are correct.

18. An adolescent primigravida who is 8 weeks pregnant asks you, "How much alcohol is safe to drink
during pregnancy? Which of the following is your best response?
a. Up to 3oz daily
b. No alcohol
c. Social drinking only
d. Up to 0.5oz daily

19. You are planning a home visit to evaluate the condition of Beth, 12 weeks pregnant with a history of
cardiac disease that has been treated with digitalis therapy before this pregnancy. Which of the
following would you anticipate happening with Beth's drug therapy regimen?
a. Need to change the medication
b. Continuation of the same dosage
c. Switching to a more potent brand
d. Addition of diuretic and an antibiotic to the regimen

20. A diabetic client is unsure of the date of her last menstrual period (LMP), she says that she missed 3
menses, but her fundus palpated slightly below the umbilicus. Other than Naegele's rule will be used to
determine the estimated date of delivery. The nurse would expect the physician to estimate the date by
a. Hearing the first audible fetal heart tone with fetoscope
b. Serial estriols
c. Ultrasonography
d. Non stress test

Lesson 3 – Gestational Conditions Affecting Pregnancy Outcomes

1. Which of the following signs and symptoms will most likely make the nurse suspect that the patient is
having hydatidiform mole?
a. Slight bleeding
b. Passage of clear vesicular mass per vagina
c. Absence of fetal heartbeat
d. Enlargement of the uterus

2. When a woman who is confirmed to be 12 weeks gestation has sudden vaginal bleeding and uterine
cramps, she would be suspected to be experiencing?
a. Hydatidiform mole
b. Abortion
c. Placenta previa
d. Abruptio placenta

3. The factors that play a significant role in the causation of spontaneous abortion include
a. Smoking, paternal factors, young age
b. Accidents, early pregnancy coitus, high parity
c. Infection, defective ovum, diabetes mellitus, incompetent cervix
d. Competent cervix, high parity, heart defects

4. A 21-year-old client, 6 weeks pregnant is diagnosed with hyperemesis gravidarum. This excessive
vomiting during pregnancy will often result in which of the following conditions?
a. Pregnancy-induced hypertension (PIH)
b. Miscarriage
 c. Electrolyte imbalance
d. Bowel perforation

5. A client is being admitted to the antepartum unit for hypovolemia secondary to hyperemesis
gravidarum. Which of the following factors predisposes a client to the development of this?
a. Trophoblastic disease
b. Maternal age > 35 years old
c. Malnourished or underweight clients
d. Low levels of HCG

6. Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?
a. Risk for infection
b. Pain
c. Knowledge deficit
d. Anticipatory grieving

7. A nurse is caring for a group of newly pregnant clients. Which client is at the highest risk for a molar
pregnancy?
a. A 38-year-old client
b. A client who suffers from autoimmune disease
c. A client with a history of a prior molar pregnancy
d. A client who hasn’t been pregnant before

8. At 16 weeks gestation, a pregnant client is admitted to the maternity unit to have a McDonald cerclage
procedure done. When asked about the purpose of this procedure, the nurse answers ___________.
a. Reinforce an incompetent cervix permanently.
b. Evaluate cephalopelvic disproportion.
c. Dilate the cervix.
d. Reinforce an incompetent cervix temporarily.

9. The most common cause of ectopic pregnancy

a. Congenital anomalies of the tube
b. Inflammation of the tubes
c. Uterine abnormalities
d. Using oral contraceptives

10. A nurse is providing discharge instructions for a client who has undergone a D&C for a trophoblastic
molar pregnancy. What should be included in the teaching?
a. Contraception use for 1 year.
b. No intercourse for 3 months.
c. Take blood pressures at home.
d. Take weekly home pregnancy tests to monitor hCG.

11. Which of the following signs will distinguish threatened abortion from imminent abortion?
a. Severity of bleeding
b. Dilation of the cervix
c. Nature and location of pain
d. Presence of uterine contraction

12. What is the most common cause of miscarriage?

a. Excessive exercising with an elevated heart rate
b. Undiagnosed type 2 diabetes in the mother
c. Alcohol abuse during the first weeks of pregnancy
d. Improper development due to genetic factors
13. Which of the following statements best describes hyperemesis gravidarum?
a. Severe nausea and diarrhea that can cause gastrointestinal irritation and possibly internal
bleeding.
b. Loss of appetite and continuous vomiting that commonly results in dehydration and ultimately
decreasing maternal nutrients.
c. Severe nausea and vomiting leading to electrolyte, metabolic, and nutritional imbalances
in the absence of other medical problems.
d. Severe anemia leading to electrolyte, metabolic, and nutritional imbalances in the absence of
other medical problems.

14. Mrs. Max at 10 weeks gestation complain to the physician of slight vaginal bleeding & mild cramps. On
examination, her physician determines that her cervix is closed. The client is exhibiting signs of ______.
a. Inevitable abortion
b. Incomplete abortion
c. Threatened abortion
d. Missed abortion

15. A 21-year-old has arrives to the ER with complain of cramping abdominal pain and mild vaginal
bleeding. Pelvic exam shows a left adnexal mass that's tender when palpated. Culdocentesis shows
blood in the culdesac. This client probably has which of the following conditions?
a. Abruptio placentae
b. Ectopic pregnancy
c. Hydatidiform mole
d. Pelvic Inflammatory Disease

16. 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:
a. An empty gestational sac.
b. Grapelike clusters.
c. A severely malformed fetus.
d. An extrauterine pregnancy

17. Nurse Hazel is preparing to care for a client who is newly admitted to the hospital with a possible
diagnosis of ectopic pregnancy. Nurse Hazel develops a plan of care for the client and determines that
which of the following nursing actions is the priority?
a. Monitoring temperature
b. Assessing for edema
c. Monitoring apical pulse
d. Monitoring weight

18. The doctor suspects that the client has an ectopic pregnancy. Which symptom is consistent with a
diagnosis of ectopic pregnancy?
a. Painless vaginal bleeding
b. Throbbing pain in the upper quadrant
c. Sudden, stabbing pain in the lower quadrant
d. Abdominal cramping

19. Maureen is admitted with a diagnosis of ectopic pregnancy. Which of the following would you
anticipate?
a. NPO
b. Bed rest
c. Immediate surgery
d. Enema
 20. Upon assessment the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last
menstrual period (LMP) 5 months ago, fetal heartbeat (FHB) not appreciated. Which of the following is
the most possible diagnosis of this condition?
a. Ectopic Pregnancy
b. Pelvic inflammatory disease
c. Missed abortion
d. Hydatidiform mole

Lesson 4 – Hemorrhagic Condition of Late Pregnancy

1. The nurse knows that preeclampsia tends to occur during what time in a pregnancy?
a. Before 20 weeks
b. In the third trimester and postpartum
c. After 20 weeks
d. In the first and second trimester

2. A woman with severe preeclampsia is receiving a magnesium sulfate infusion. The nurse becomes
concerned after assessment when the woman exhibits
a. A sleepy, sedated affect
b. A respiratory rate of 10 breaths/min
c. Deep tendon reflexes of 2+
d. Absent ankle clonus

3. A client with pregnancy-induced hypertension (PIH) receives magnesium sulfate, 4g in 50% solution IV
over 20 minutes. What is the purpose of administering magnesium sulfate to this client?
a. To lower blood pressure
b. To prevent seizures
c. To inhibit labor
d. To block dopamine receptors

4. A G4P3 Mrs. Andres is admitted to the prenatal clinic at 34 weeks gestation, with a diagnosis of
placenta previa, incomplete. Chief complain is painless vaginal bleeding. Which action should you
perform INITIALLY?
a. Anticipate and set up for emergency CS.
b. Elevate the foot of the bed, check cervical dilatation, check VS.
c. Assess the amount & character of bleeding.
d. Check FHT, anticipate & set-up for O2 therapy.

5. Which of the following is described as premature separation of a normally implanted placenta during
the second half of pregnancy, usually with severe hemorrhage?
a. Placenta previa
b. Ectopic pregnancy
c. Incompetent cervix
d. Abruptio placenta

6. A woman with severe preeclampsia is being treated with an IV infusion of magnesium sulfate. This
treatment is considered successful if
a. Blood pressure is reduced to prepregnant baseline.
b. Seizures do not occur.
c. Deep tendon reflexes become hypotonic.
d. Diuresis reduces fluid retention.

7. In pregnant women with pre-existing hypertension, the risk of superimposed pre-eclampsia is related to
the degree of hypertension.
a. True
b. False
8. Complications of abruptio placenta do NOT include
a. Hemorrhage
b. Disseminated intravascular coagulation (DIC)
c. Couvelaire uterus
d. Postmaturity

9. Your patient with preeclampsia is started on Magnesium Sulfate. The nurse knows to have what
medication on standby?
a. Acetylcysteine
b. Calcium carbonate
c. Oxytocin
d. Calcium gluconate

10. In taking care of patients with placenta previa, the health care provider should do the following EXCEPT
a. Internal vaginal examination
b. Inform relatives to prepare blood for possible transfusion.
c. Notify pediatrician/nursery nurse for a possible admission of a preterm baby.
d. Prepare double set-up delivery when in labor.

11. Which of the following would the nurse assess in a client experiencing abruptio placenta?
a. Bright red, painless vaginal bleeding
b. Concealed or external dark red bleeding
c. Palpable fetal outline
d. Soft and nontender abdomen

12. The assessment findings in placenta previa include:

1. Hard board-like abdomen
2. Soft uterus
3. Painless vaginal bleeding
4. Sign of shock
a. 2, 3, & 4
b. 1, 3, & 4
c. 2 & 3
d. 1 & 2

13. A 39-week pregnant patient is in labor. The patient has preeclampsia. The patient is receiving IV
Magnesium Sulfate. Which finding below indicates Magnesium Sulfate toxicity and requires you to
notify the physician?
a. Deep tendon reflex 4+
b. Respiratory rate of 13 breaths per minute.
c. Urinary output of 600 mL over 12 hours.
d. Clonus presenting in the lower extremities.

14. The nurse is assessing Mrs. Jones, 33 weeks AOG, with vaginal bleeding is aware that an abruptio
placenta is accompanied by which of the following assessment findings?
a. Abdomen soft upon palpation.
b. No complaint of abdominal pain.
c. Lack of uterine irritability.
d. Uterine tenderness upon palpation.

15. Which of the following findings BEST indicates abruptio placenta and not placenta previa?
a. The amount of external bleeding.
b. The presence of soft uterus.
c. The absence of pain.
d. Strong, tetanic contraction.
 16. The nurse realize that the abdominal pain associated with abruptio placenta INITIALLY may be caused
by
a. Hemorrhagic shock
b. Inflammatory reaction
c. Concealed hemorrhage
d. Blood in the uterine muscle

17. 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

18. An ultrasound is performed on a client at term gestation that is experiencing moderate vaginal bleeding.
The results of the ultrasound indicate that an abruptio placentae is present. Based on these findings,
the nurse would prepare the client for
a. Complete bed rest for the remainder of the pregnancy.
b. Delivery of the fetus.
c. Strict monitoring of intake and output.
d. The need for weekly monitoring of coagulation studies until the time of delivery.

19. A client asks you how come she developed placenta previa when she has been submitting self to
regular prenatal check-up. You will base your response on an understanding of the etiology of placenta
previa which include
a. Advancing age, nulliparity, previous low transverse cesarian section (LTCS).
b. Young age, tumor in the lower uterine segment, previous LTCS.
c. Multiparity, multifetal pregnancy, scarring or tumor in upper third of the uterus.
d. Low age & parity, previous LTCS.

20. 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. Client has a twin sister.
c. Sister-in-law had gestational hypertension.
d. This is the client's second pregnancy.

Lesson 5 – Intrapartum Complications

1. Major factors for women infertility.
a. Age
b. Weight
c. Anovulation
d. All of the above

2. A pregnant woman's amniotic membranes rupture. Prolapsed umbilical cord is suspected. What
intervention would be the top priority?
a. Placing the woman in the knee-chest position.
b. Covering the cord in sterile gauze soaked in saline.
c. Preparing the woman for a cesarean birth.
d. Starting oxygen by face mask.

3. Infection in the uterus may cause PROM and may also be a complication following PROM.
a. True
b. False
4. Which of the following complications during a breech birth the nurse needs to be alarmed?
a. Abruption placenta.
b. Caput succedaneum.
c. Pathological hyperbilirubinemia.
d. Umbilical cord prolapsed.

5. What is the difference between fraternal twins and identical twins?

a. Fraternal twins are created with 2 separate eggs released and fertilized simultaneously
and identical twins are created with 1 egg split.
b. Fraternal twins’ lookalike, identical twins were born around each other.
c. Fraternal twins have more fun.
d. Identical twins have more fun.

6. What is considered the major complication of premature rupture of membranes (PROM)?

a. Post-term delivery
b. Low birth weight neonate
c. Intrauterine infection
d. Large for gestational age

7. Which is an explanation for the increasing number of multiple births?

a. Increased use of fertility medicine.
b. More women older than age 30 giving birth.
c. More men older than age 30 becoming fathers.
d. A and B.

8. The physician ordered Betamethasone to a pregnant woman at 34 weeks of gestation with sign of
preterm labor. The nurse expects that the drug will _______________.
a. Treat infection.
b. Suppress labor contraction.
c. Stimulate the production of surfactant.
d. Reduce the risk of hypertension.

9. What test helps to distinguish amniotic fluid from other fluid?

a. Nitrazine test
b. Fern test
c. Both A and B
d. None of the above

10. When are most women diagnosed with twins or other multiples?
a. In the first trimester
b. In the second trimester
c. In the third trimester
d. In the delivery room

11. To prevent preterm labor from progressing, drugs are usually prescribed to halt the labor. The drugs
commonly given are _____________.
a. Terbutaline
b. Prostaglandin and oxytocin
c. Progesterone and estrogen
d. Dexamethasone and prostaglandin

12. Mrs. Lopez is admitted to your unit for induction of labor due to post- term, she is now 42 weeks. During
the period of induction of labor, Mrs. Lopez should be observed carefully for signs of _____________.
a. Severe pain
b. Uterine tetany
c. Early deceleration
 d. Severe drowsiness

13. When considering assessment history of a G3P2 admitted for preterm labor, which risk factor in the
woman’s history places her at greatest risk for preterm labor?
a. Pre-pregnancy BMI of 18.5
b. ½ PPD smoker during pregnancy
c. History of preterm labor
d. Previous cesarean delivery

14. When assessing a laboring client, the nurse finds a prolapsed cord. The nurse should NOT
a. Attempt to reposition the cord.
b. Place the client on her left side.
c. Elevate the client’s hips.
d. Cover the cord with a dry, sterile gauze.

15. Which of the following best describes preterm labor?

a. Labor that begins after 20 weeks gestation and before 37 weeks gestation
b. Labor that begins after 15 weeks gestation and before 37 weeks gestation
c. Labor that begins after 24 weeks gestation and before 28 weeks gestation
d. Labor that begins after 28 weeks gestation and before 40 weeks gestation

16. A client in preterm labor (32 weeks) who is dilated to 5cm has been given magnesium sulfate and the
contractions have stopped. If the labor can be delayed for the next 2 days, which of the following
medication does the nurse expect that will be prescribed?
a. Fentanyl (Sublimaze)
b. Sufentanil (Sufenta)
c. Betamethasone (Celestone)
d. Butorphanol tartrate (Stadol)

17. PROM may occur if the uterus is over-stretched by malpresentation of the fetus, multiple pregnancy, or
excess amniotic fluid.
a. True
b. False

18. A couple is seeking advice regarding actions that they can take to increase their potential of becoming
pregnant. Which of the following recommendations should the nurse give to the couple?
a. The couple should use vaginal lubricants during intercourse.
b. The couple should delay having intercourse until the day of ovulation.
c. The woman should refrain from douching.
d. The man should be on top during intercourse.

19. The physician order terbutaline for a primigravida patient w/ symptoms of preterm labor at 33 weeks.
After administering the 1st dose, which of the following would the nurse assess to the patient?
a. Tachycardia and palpitation
b. Anorexia and constipation
c. Hypotension and sleeplessness
d. All of the above

20. Infertility can be attributed to male causes such as the following EXCEPT
a. Cryptorchidism
b. Orchitis
c. Sperm count of less than 20 million per milliliter.
d. Premature ejaculation
Lesson 6 – Intrapartum Complications
1. The nurse is assessing the lochia on a 1-day PP patient. The nurse notes that the lochia is red and has
a foul-smelling odor. The nurse determines that this assessment finding is _________________.
a. Normal
b. Indicates the presence of infection
c. Indicates the need for increasing oral fluids
d. Indicates the need for increasing ambulation

2. Gina a postpartum client is diagnosed with endometritis. Which position would you expect to place her
based on this diagnosis?
a. Supine
b. Left side lying
c. Trendelenburg
d. Semi-fowlers

3. The nurse is caring for the client on the second postpartum day. The nurse should expect the client’s
lochia to be _____________.
a. Red and moderate
b. Continuous with red clots
c. Brown and scanty
d. Thin and white

4. A postpartum client has a temperature of 38.6°C, with a uterus that is tender when palpated, remains
unusually large, and not descending as normally expected. Which of the following should the nurse
assess next?
a. Lochia
b. Breasts
c. Incision
d. Urine

5. A patient is 3 days postop from a cesarean birth. She has tenderness, localized heat, and redness of
the left leg. She is afebrile. As a result of these symptoms, she most likely will be ____________.
a. Give aspirin 650mg by mouth
b. Encouraged to ambulate
c. placed on bed rest
d. Give methergine IM

6. Which method of initial assessment would best indicate whether a patient has a urinary complication?
a. Urine specific gravity
b. Calculation of intake
c. Calculation of the urine output
d. Urine pH

7. To prevent infection, the nurse teaches the postpartum client to perform which of the following tasks?
a. Apply antibiotic ointment to the perineum daily.
b. Void at least every two hours.
c. Spray the perineum with a povidone-iodine solution after toileting.
d. Change the peripad at each voiding.

8. A nurse is preparing a list of self-care instructions for a postpartum client who was diagnosed with
mastitis. Which of the following instructions should NOT be included on the list?
a. Wear a supportive bra.
b. Rest during the acute phase.
c. Maintain a fluid intake of at least 3000mL.
d. Avoid decompression of the breasts by breast-feeding or breast pump.
9. The nurse should expect to observe which behavior in a 3-week multigravida postpartum client with
postpartum depression?
a. Feelings of infanticide.
b. Difficulty with breastfeeding latch.
c. Feelings of failure as a mother.
d. Concerns about sibling jealousy.

10. A nurse in a PP unit is instructing a mother regarding lochia and the amount of expected lochia
drainage. The nurse instructs the mother that the normal amount of lochia may vary but should never
exceed the need for __________.
a. One peripad per day
b. Two peripads per day
c. Three peripads per day
d. Eight peripads per day

11. A nurse is preparing to perform a fundal assessment on a postpartum client. The initial nursing action in
performing this assessment is which of the following?
a. Ask the client to turn on her side.
b. Ask the client to lie flat on her back with the knees and legs flat and straight.
c. Ask the mother to urinate and empty her bladder.
d. Massage the fundus gently before determining the level of the fundus.

12. Assessment of Homan's Sign is the most reliable indicator of a deep vein thrombosis.
a. The patient reports pain when the foot is manually dorsiflexed.
b. The patient reports pain when the foot is manually plantarflexed.
c. The patient experiences pain when the leg is extended.
d. The patient experiences pain when the leg is flexed.

13. On assessment of a client who is 30 minutes into the fourth stage of labor, the nurse finds the client's
perineal pad saturated with blood and blood soaked into the bed linen under the client's buttocks. The
nurse's initial action is which of the following?
a. Call the physician.
b. Assess the client's vital signs.
c. Gently massage the uterine fundus.
d. Administer a 300mL bolus of a 20 units/L Oxytocin (Pitocin) solution.

14. The clinic nurse is caring for a woman who is suspected of developing postpartum psychosis. Which of
the following statements characterizes this disorder?
a. Symptoms start within several days of delivery.
b. The disorder is common in postpartum women.
c. Suicide and infanticide are uncommon in this disorder.
d. Delusions and hallucinations accompany this disorder.

15. The client is experiencing an early postpartum hemorrhage. Which item in the client’s care plan
requires revision for care?
a. Inserting an indwelling urinary catheter.
b. Fundal massage.
c. Administration of oxytocin.
d. Perineal pad count.

16. A postpartum nurse is preparing to care for a woman who has just delivered a healthy newborn infant.
In the immediate postpartum period, the nurse plans to take the woman's vital signs ______________.
a. Every 30 minutes during the first hour and then every hour for the next two hours.
b. Every 15 minutes during the first hour and then every 30 minutes for the next two hours.
c. Every hour for the first 2 hours and then every 4 hours
d. Every 5 minutes for the first 30 minutes and then every hour for the next 4 hours.
17. A postpartum patient was in labor for 30 hours and had ruptured membranes for 24 hours. For which of
the following would the nurse be alert?
a. Endometritis
b. Endometriosis
c. Salpingitis
d. Pelvic thrombophlebitis

18. Assessment of Homan's Sign is the most reliable indicator of a deep vein thrombosis.
a. True
b. False

19. The postpartum patient who delivered 2 days ago has developed endometritis. Which of the following
factors can lead to endometritis?
a. Cesarean Birth performed secondary to arrest of cervical dilatation.
b. External fetal monitoring used throughout labor.
c. Patient has history of pregnancy induced hypertension.
d. Rupture of membranes occurred 2 hours prior to delivery.

20. A client who is breast-feeding her newborn infant is experiencing nipple soreness. To relieve the
soreness, the nurse suggests that the client _______________.
a. Avoid rotating breast-feeding positions.
b. Stop nursing until the nipples heal
c. Substitute a bottle-feeding until the nipples heal.
d. Position the infant with the ear, shoulder, and hip in straight alignment with the infant's
stomach against the mother.