2MATERNAL AND CHILD NURSING

MATERNAL AND CHILD NURSING

1.Which drug category may be safely administered during pregnancy?A.Category AB.Category BC. Category C D. Category D

2.Which of the following is a positive indication of pregnancy?A.QuickeningB.Chadwicks signC. Auscultation of fetal heart sounds D. Ballottement

3.During the last months of pregnancy, the nurse should instruct the client to:A.rest on her left side for at least 1 hour in the morning and afternoonB.sleep on her back during the night and during napsC.start nipple exercises and stimulation twice a dayD.start to cut back on water intake, especially at night

4.When teaching a pregnant woman about traveling during the pregnancy, it is important to focus on which of the following?A.If traveling by car, stop every 2 hours for 10 minutesB.Get plenty of rest before long trips made in automobilesC.Travel in any type of aircraft is acceptableD.Travel can be completed anytime throughout the pregnancy

5.Which of the following is recommended for all women during the childbearing age?A.Additional B vitaminsB.Additional vitamin AC. Folic acid supplement D. Vitamin C supplement

6.An 18-year old girl visits to obtain a contraceptive. She elected to use the intrauterine device (IUD) as a method of birth control. The major concern with the use of the IUD is:A.thrombophlebitis.B.pain on intercourse.C. infection. D. abnormal bleeding and hemorrhage.

7.The client begins to question the nurse about sexuality and becoming sexually active. During sexual counseling, the nurse should place a major point of emphasis on:A.douching after sexual intercourse.B.sex during menstruation.C. performing Kegsl exercises. D. safe and responsible sex.

8.Using Naegles Rule, calculate the estimate date of delivery if the womans LMP was October 1.A.June 23B.July 8C. December 23 D. January 8

9.Which of the following would be appropriate to teach the pregnant woman regarding exercise? A.Avoid any physical activity during the second trimesterB.Contact sports are allowed during the first trimesterC.Extremely active women should reduce the level of exertionD.Relaxation and stretching exercises should be discontinued.

10.One of the functions of the amniotic fluid is to:A.exchange nutrients from mother to fetusB.immobilize the fetusC.protect the womans uterusD.regulate temperature

11.A feeling of ambivalence about the pregnancy is:A.a sign of unwanted pregnancyB.normal in early pregnancyC. rare at any stage of pregnancy D. typical in late pregnancy

12.Which assessment relates most directly to rupture membranes and release of amniotic fluid?A.Bloody showB.Fluid with a pH of 7.0 to 7.5 with nitrazine testC.Fluid with a pH of 5.0 with nitrazine testD.Woman complains of urge to push

13.When the placenta is delivered with the dull side out (Duncan presentation), the woman is at risk for:A.excessive bleedingB.hemorrhoidsC.increased lacerations of the perineumD.sterility

14.To assess the uterine contraction during labor, the nurse:A.asks the woman if she is having a contraction.B.palpates above the symphysis pubis.C.palpates just below the xyphoid process of the sternum.D.performs a sterile vaginal examination.

15.The nurse knows that a postpartum clients susceptibility to hemorrhage is most likely related to a:A.boggy uterusB.firm fundusC. long labor D. negative Homans sign

16.Between 24 and 28 weeks, all pregnant women should be screened for:A.AnemiaB.Bladder infectionsC. Diabetes D. Neural tube defects

17.Which of these measures would be helpful for the pregnant client complaining of sleeplessness?A.Eat evening meal close to bedtimeB.Sit in a sitz bath before bedtimeC.Try to remain in one position when sleepingD.Use pillows to help find a comfortable position

18.Why is the first 8 weeks of pregnancy known as the critical period of human development?A.By the time this period ends, the embryo is completely safe from any damageB.Many embryos die during this periodC.The infants sex is determined at the end of the eight weekD.The major structures of the embryo are forming, and damage can result in major birth defects

19.Which of these statements is most accurate about the placenta?A.The blood of the baby mixes with the mothers blood to permit exchange of nutrients and oxygen.B.The blood of the baby and the mother do not mix; exchange occurs across blood vessels and the walls of the villi.C.The placenta lets the blood from the fetus cross to the mother, but the mothers blood does not cross to the fetus.D.The placenta serves as a complete barrier between the baby and mother so that any drugs the mother takes do not cross the baby.

20.Which of the following is the best recommendation about taking medicines during pregnancy?A.All over-the-counter (OTC) drugs are safe during pregnancyB.All herbal preparations are safe during pregnancyC.Dont take anything during pregnancy without asking your health care providerD.Take an OTC diuretic if you have swelling during the pregnancy

21.When providing postpartum teaching about self-care, one of the danger signs that a lactating woman should know to report to the birth attendant is:A.breast engorgement to a degree that the baby cant latch on.B.breast fullness just before feeding .C.nipple soreness after feedings.D.nipple dryness before feedings.

22.Show is usually present in:A.Braxton Hicks contraction.B.false labor.C. true labor. D. Second stage of labor only.

23.APGAR score assessments are completed at:A.birth and 10 minutes.B.1 and 5 minutes.C.5 minutes and upon arrival to the nursery.D.the time of birth.

24.A newborn of 4 hours displays grunting respirations and a respiratory rate of 70 breaths/minute. The priority nursing intervention would be to:A.begin resuscitative measures and call for help.B.continue to monitor respiratory status variations are normal.C.obtain vital signs every 15 minutes.D.transfer the newborn to the mothers room for feeding.

25.Which measure would be used to prevent loss of heat in the newborn?A.Immediately give the baby a bathB.Place the baby on the mothers bare stomachC.Offer the baby warm glucose waterD.Wrap the baby in room-temperature blankets

26.Which of the following indicates that the new mother understands how to handle breast milk safely?A.I can store fresh milk in the refrigerator for only 24 hours.B.I can store frozen breast milk for up to 1 month.C.I need to express my breast milk into a clear glass.D.I should never store my breast milk in a frozen-food locker.

27.To prevent infection of the perineal area after delivery, the nurse should instruct the client to:A.Begin sitz bath at the first sign of infectionB.Pull panties straight downC.Use hot water to cleanse the area after bowel movementD.Wipe with sweeping motion, from front to back

28.Analgesics given too late in labor can result in which of the following?A.Contractions that increase in intensityB.Early decelerationC.FHR dropping to 100 beat per minuteD.Pain during contractions

29.In evaluating the effects if oxytocin after delivery, the nurse should monitor for:A.effective breastfeeding.B.engorged breasts.C. relief of pain. D. the uterus remaining firm.

30.During active labor, the mother usually exhibits which of the following behaviors?A.Difficulty following directionsB.Excitedness and talkativenessC.Frustration and irritabilityD.Serious expression and apprehension

31.When evaluating the effectiveness of instruction regarding breastfeeding, which of the following responses by the mother indicate that she understands the teaching?A.I need to rub my nipples to toughen them up.B.I should apply lotion to my nipples to prevent cracking.C.I should nurse at least 10 minutes on one breast before offering the next breast.D.I should use soap and water to gently cleanse my breast gently.

32.Which of the following should the nurse recommend to the breastfeeding mother to limit in her diet?A.CheeseB.FruitC. Strongly flavored foods D. Vegetables

33.The fontanels are soft spots formed by the:A.blood accumulated between the bone and periosteum.B.edema of the scalp from birth pressure.C.junction of individual skull bones.D.pressure of a vacuum extractor.

34.Signs of respiratory distress in a neonate include:A.grunting with expiration.B.respiratory rate of 50 breaths per minute.C.synchronized movement of the babys chest and abdomen.D.the babys chest expanding as a whole.

35.The most efficient way for a baby to regulate temperature is to:A.burn body fat.B.move arms and legs.C. shiver. D. use brown fat.

36.Which measure would be most effective in preventing the transfer of gonorrhea or Chlamydia to the infants eyes from the mother?A.Administering Vitamin KB.Bathing the newbornC.Cleaning the infants eyes with warm salineD.Applying erythromycin ointment

37.A newborn will respond to sudden noises or jarring movement by throwing out the arms and drawing up the legs. This is called a:A.Moro reflexB.Babinski reflexC. Rooting reflex D. Tonic neck reflex

38.The nurse is caring for a newborn at 12 hours of life. The newborn has just voided. The most appropriate response by the nurse would be:A.immediately check vital signs.B.notify the physician.C.continue to monitor voiding patterns.D.obtain an order for a straight catheter.

39.Which position should newborns be placed when sleeping?A.Back B.Head of bed elevatedC. Prone D. Side lying with pillow

40.Most babies should be fed:A.Every 1 to 2 hoursB.Every 2 to 4 hoursC. Every 4 to 6 hours D. On demand

41.Which of the following drugs can be given to the mother before a preterm birth to help reduce the severity of respiratory distress syndrome?A.BetamethasoneB.DiazepamC. Phenobarbital D. RhoGAM

42.Which intervention is the priority immediately after the delivery of a newborn who does not breathe? A.Clear air passages of obstructive substancesB.Keep the mother calmC.Place bulb suction at head of the bedD.Rub the babys back

43.In which position should the newborn with intracranial hemorrhage be placed?A.ProneB.Side-lyingC. Slightly elevated head of bed D. Supine

44.Which of the following contraceptive methods also offers protection against sexually transmitted infections?A.AbstinenceB.Coitus interruptusC. Fertility awareness methods D. Oral contraceptives

45.In teaching the postoperative client who has just had a vasectomy, it is important to focus on:A.asking how his partner feels about the surgery.B.alternate methods of expressing sexual needs and desiresC.discussing that a vasectomy does not make client less of a manD.using birth control until sperm counts are zero for 6 weeks.

46.Which assessment most closely relates to a diagnosis of ectopic pregnancy?A.Brownish red, tapioca-like vesiclesB.Elevated temperatureC.Spotting or bleeding 2 to 3 weeks after a missed menstrual periodD.Sudden absence of fetal movement

47.The drug of choice to treat pregnancy-induced hypertension is:A.iron and vitaminsB.diazepam (valium) C. furosemide (Lasix) D. magnesium sulfate48.Which nursing intervention would be appropriate for a client who has a diastolic blood pressure of more than 20 mmHg on the roll-over test?A.Increase intake of oral fluidsB.Rest on left side as much as possibleC.Schedule follow-up care every 2 weeksD.Use the stairs to increase activity level

49.A mother receiving medications for pregnancy-induced hypertension should have her diastolic blood pressure maintained in the range of 90 to 100 mmHg to:A.avoid causing fetal anoxia.B.ensure progression of labor.C. prevent premature contractions. D. present sudden elevations in pulse.

50.Which of the following would be a priority intervention for a client with the prolapsed cord?A.Cover the cord with a dry sterile towerB.Monitor the mothers vital signsC.Place the woman in the Trendelenburg positionD.Start medication as ordered

51.Juday has been experiencing regular, coordinated contractions with cervical dilation moving from 4 cm to 6 cm in the last half, and her membranes are still intact. Juday is in which of the following stages of labor?A.Latent phase of the second stage of laborB.Active phase of the first stage of laborC.Placental stage or the third stage of laborD.Predelivery stage or the prelabor stage of labor

52.Lhia is admitted in active labor. The nurse locates fetal heart sounds in the upper left quadrant of her abdomen. The nurse recognizes which of the following?A.Lhia will probably deliver very quickly and without problems.B.This indicates Lhia will probably have a breech delivery.C.The fetus is in the most common anterior fetal position.D.This position is referred to as being left anteropelvic.

53.After the third stage of labor, the nurse may have which of the following responsibilities?A.Administration of intramuscular oxytocin to facilitate uterine contractility.B.Monitoring for blood loss greater than 60 cc, which would indicate gross hemorrhage.C.Noting if the placenta makes a Schultze presentation, which is a sign of gross complication.D.Pushing down on the relaxed uterus to aid in the removal of the placenta

54.Which action of the following instructions to a child would be most appropriate before a painful procedure?A.Do not tell the child anything, just proceed with the procedure.B.This wont hurt at all.C.This is going to hurt.D.Would you like t help me?

55.Which method would be helpful when administering liquid medication to a preschool-aged child?A.Ask the child if he/she would like to take the medication from a cup or spoon.B.Give the child a drop or two of liquid over an hour top help prevent spitting it out.C.Tell the child the medicine is sweet candy syrup that he/she will like.D.Tell the child firmly to take the medicine.

56.After a tubal ligation, it is not uncommon for the woman to complain of:A.shoulder pain.B.hemorrhoids.C. leg pain. D. breast tenderness.

57.When examining a postpartal woman, the nurse should immediately report:A.a fundus that is palpated 2 cm below the umbilicus on the second postpartal day.B.a fundus that cannot be located by palpation on the ninth postpartal day.C.a soft, spongy uterine fundus noted during the first four hour postpartum.D.red, bloody vaginal discharge on the perineal pad on the first day postpartum.

58.Which of the following clinical practices is appropriate to solicit initial respiration of the high-risk newborn?A.Rubbing the backB.Spanking the buttocksC.Slapping the faceD.Squeezing the thorax

59.On the third hospital day in the nursery, Mr. and Mrs. Smiths newborn baby girl Rhian is diagnosed with Rh incompatibility. Mrs. Smith is a gravida 2, para 1, abortion 1. This disease causes blood cell hemolysis that is probably directly due toA.the exchange of fetal and maternal blood in the uteroB.Rh positive fetus and Rh positive fatherC.Rh negative mother, Rh positive fatherD.the sin of the abortion of the first child

60.Baby girl Luisa was born large for gestational age. After being delivered vaginally, this infant should be carefully assessed for:A.increased intracranial pressureB.hypothermiaC.decreased red blood levels (anemia)D.hyperglycemia

61.Which of the following should the examiner do to assess for scoliosis?A.Assist the child to look in a mirror for characteristic curing.B.Have the child place the chin on the chest, place hands together, bend over, and let the hands hang freely.C.Have the child turn sideways, and look for bulging in the thoracic region.D.Palpate the spine for indentation in the lower back.

62.During an episode of somnambulism, it would be appropriate for the nurse to:A.ask the child what he/she is doingB.immediately wake the child.C.pull the child back to bed.D.observe for safety measures to avoid injury.

63.Which instruction should the nurse provide the adolescent who is experiencing acne?A.Avoid chocolate in the diet.B.Inspect skin for adverse reactions to treatment.C.Pop pimples only when they are white with pus.D.Scrub skin twice a day with prescribed medication.

64.Which of the following is an inappropriate technique to use when giving a back rub?A.Long, even upward strokesB.Tapping lightly with the edge of the handC.Firm scratching motionD.Application of lotion

65.You are giving a parenting class. You will discuss which of the following with the parents of Dora, a 2-year old child?A.Dora can be expected to be cooperative and easily cooperative and easily controlled at this stage of development.B.Dora may prefer finger foods and clothing she can put on without assistance at this age.C.Expect Dora to want to be held and cuddled a great deal at this stage of her development.D.At this age, Dora will take the initiative in activities and will question everything.

66.When obtaining vital signs, which of the following is appropriate?A.Oral temperature in children younger that 6 yearsB.Radial pulse in children older than 2 yearsC.Rectal temperature in child with hematology disorderD.Tympanic temperature in child with ventilating tubes

67.When discharging a child from the hospital, it is most important for the nurse to document:A.that childs belongings were sent with caregivers.B.reaction of child to staff.C.teaching follow-up care to family caregivers.D.weight of the child on discharge.

68.Which assessment findings most closely correlate with the diagnosis of Tetralogy of Fallot?A.CyanosisB.Elevated blood pressureC. Normal weight D. Weak pulse in lower extremities

69.Which action would be most appropriate when caring for a child with idiopathic thrombocytopenic purpura?A.Administer enemas to promote bowel movements.B.Do not give intramuscular injections.C.Place child with head of bed elevated.D.Weigh daily at the same time.

70.The most common chronic childhood illness is:A.common cold.B.diabetes mellitus.C. mumps. D. asthma.

71.Which of the following considerations is appropriate regarding children undergoing diagnostic procedures?A.Parents should be asked to restrain infants when indicated.B.Toddlers should be given procedures quickly and without warning to decrease resistance.C.Adolescents should be expected to tolerate procedures maturely and without fear.D.School-age children should be given thorough explanations for procedures.

72.After an endoscopy study, which of the following interventions would be most important?A.Pushing oral fluids immediately to promote elimination of dye.B.Monitoring airway and respiratory function for the first 4 hours.C.Applying a warm compress to the neck to reduce spasm.D.Administering atropine to reduce pulmonary secretions.

73.The nurse is aware that of the following food supplies, the better source of iron for the infant is which of the following?A.Human breast milkB.Iron-fortified cerealsC. Vegetables D. Fruit

74.Which of the following interventions might be most effective in preventing glomerulonephritis?A.Daily administration of childrens multivitamins and iron.B.Increasing all childrens fluid intake to 3 liters daily.C.Prompt evaluation of childhood complaints of sore throat.D.Teaching children to avoid promptly when the urge is felt.

75.Which of the following would most likely be noted in a child with acute glomerulonephritis?A.Blood pressure of 90/40 mmHgB.Hypovolemia and signs of dehydrationC.Hematuria and pulmonary edemaD.Severe, foul-smelling diarrhea

76.A key developmental task of parenting is learning to determine if their child is crying from hunger, discomfort, or some other reason.A.PreschoolerB.InfantC. Toddler D. School-age child

77.Alice is 4 months of age. Her mother is singing to her. What type of response should be expected of Alice?A.Imitating the soundsB.Smiling, cooing, and gurglingC.Saying da-daD.Watching her mothers face without making a sound

78.At what age should an infant begin to locate an object hidden under a blanket?A.6 monthsB.8 monthsC. 10 monthsD. 12 months

79.Which of the following would be most effective in reducing the workload of the heart of a child with heart failure? A.Bed rest in a semi-Fowlers positionB.Digoxin administration daily, IV or orallyC.Oxygen therapy by mask, cannula or tentD.Intravenous infusion of 2 to 3 liters daily

80.Crying is to avoided in a child who has had a cleft lip repair because itA.sustains a traumatic experience.B.places tension on the suture line.C.threatens maternal-infant bonding.D.predisposes to respiratory difficulties.

81.To visualize the inner surface of a childs lower eyelid and most of the bottom globe, the nurse wouldA.press on the lower lid with a finger tip.B.pull the top eyelid outward and up.C.invert the top eyelid with a special apparatus.D.use a cotton tip to flip the lower lid.

82.When teaching Carlo, 14 years old, to walk with crutches, the nurse should instruct his toA.move one crutch forward at a time when using a three-point swing through gait.B.carry books and other items in a backpack to keep his hands free.C.Rest the crutch pad on the upper arm to bear his weight on the axilla crutch pad.D.use a two-point gait when no weight is allowed.

83.Which of the following would be a serious danger sign if noted in a child after head trauma?A.Memory deficit with inability to recall time or date.B.Complaint of headache along the area of trauma.C.Blood pressure moving from 120/80 mmHg to 130/50 mmHg.D.Pupils are equally and briskly reactive to light.

84.Jan, aged 13, is admitted with third degree burns over 25% of her body. Which of the following is an immediate concern in Jans plan of care?A.Liberal medication to control Jans severe painB.Arranging age-appropriate diversional activitiesC.Preventing hypovolemia and circulatory collapseD.Increasing oral intake of proteins to build tissue

85.Care of the child in coma would includeA.Encouraging parents to be positive since coma is often short term in children.B.Performing passive range of motion exercises to maintain muscle tone.C.Feeding the child with a spoon and fork to stimulate memories of normal activities.D.Maintaining the child, in a flat, supine position to simulate normal sleeping position.

86.Hypoglycemia in children may be caused byA.missing an insulin injection.B.missing a meal or a snack.C. too small an insulin dose. D. too large a meal or snack.

87.Mara, aged 6, is admitted to your unit after an automobile accident. You would suspect increased intracranial pressure if your assessment revealed which of the following?A.Bradycardia rhythmB.Decreased pulse pressureC. Hypotensive blood pressure D. Tachypnea

88.Which of the following are signs of autonomic dysreflexia?A.Bradycardia and flushed faceB.Headache and hypertensionC. Hypertension and pallor D. Pale skin and dizziness

89.Bimby, 2 years old, has been diagnosed with cerebral palsy. The nurse should explain which of the following to Bimbys parents?A.Cerebral palsy involves a progressive nerve generation.B.Contractures are unavoidable since ambulation is impossible.C.The brain damage that occurred at birth can be repaired with surgery when the child is older.D.Two children with cerebral palsy may exhibit totally different symptoms and abilities.

90.The nurse should expect which of the following findings when assessing a child with acute otitis media?A.Excessive cerumen in the outer earB.Recent respiratory infectionC.Increase mobility on the pneumatic examinationD.Copious amount of tenacious fluid

91.Because abuse involves and affects all the members of a family, the nurse should have which of the following as part of the care plan goals?A.Disrupting the dysfunctional familyB.Improving overall family functioningC.Punishing the abusive family memberD.Removing the abuse victim from the family

92.Surgery is stressful for all children, and emotional support should be included in the nurses plan of care. Which of the following is a useful intervention to prepare the child before eye surgery?A.Showing the child a doll with patched over both eyes.B.Restraining the child at the wrist bilaterally for 24 hoursC.Avoiding discussion of the impending surgeryD.Introducing the child to other children on the unit93.While observing a two-year old girl recently admitted to the hospital, the nurse becomes concerned by which of the following characteristics?A.The child is not yet potty trained.B.The child replies no to every position.C.The child cannot share toys.D.The child recognizes 4-6 words.

94.Nurse Olive who works in an adolescent clinic knows that obesityA.in teenagers, is commonly due to hypothyroidism, hypopituitarism, or other endocrine problem.B.is no more likely to be associated with emotional conflicts in teenagers who are not obese, than in teenagers who are obsess.C.during adolescence, is highly correlated with significant psychopathology.D.is often associated with poor recognition of either hunger of satiation.

95.An 18-month old is being admitted with a diagnosis of Wilms tumor. Which nursing intervention takes priority?A.Checking vital signs every 8 hours for incidence of hypertension.B.Placing a sign over the bed which says, Do not palpate the abdomen.C.Raising the head of the bed to ease breathing.D.Monitoring the urinary output every 2 hours.

96.Children who have brain tumor will have which of the following symptoms?A.Abdominal painB.Vomiting C. Hypotension D. Diarrhea

97.Clara is 15 years old ad is admitted to the hospital with anorexia nervosa. She is a model and often spoken as an overachiever. As the nurse interviews Clara and her family, she may discover other characteristics such asA.early development of secondary sex characteristics.B.amenorrhea.C.permissive parenting.D.hyperglycemia.

98.Mateo, a child with an IQ of 44, would be categorized as having which type of mental retardation?A.MildB.ModerateC. Severe D. Profound

99.When providing anticipatory guidance to parents of a hyperactive child, the nurse would encourage them toA.assign chores appropriate to the childs age.B.be flexible and lenient regarding limits.C.give instructions to this child in the group setting with the other siblings.D.delay punishing the child to allow the child to think about mistakes.

100.Which of the following is commonly seen in children with anorexia nervosa?A.Morbid obesityB.Ingesting copious amounts of waterC.Body mass index above 85% of expectedD.Binge eating and purging

Prepared by: Archie D. Alviz, R.N., R.M., N.C. II | manofsteel_archie@yahoo.com| facebook fan page: Sir Archie D. Alviz