Maternity And Pediatric Nursing 2nd Edition by Susan , Theresa Kyle – Test Bank A+

Description

When describing the menstrual cycle to a group of young women, the nurse explains that estrogen levels are highest during which phase of the endometrial cycle?
	A)	Menstrual
	B)	Proliferative
	C)	Secretory
	D)	Ischemic

2.	After teaching a group of adolescent girls about female reproductive development, the nurse determines that teaching was successful when the girls state that menarche is defined as a woman’s first:
	A)	Sexual experience
	B)	Full hormonal cycle
	C)	Menstrual period
	D)	Sign of breast development

3.	A client with a 28-day cycle reports that she ovulated on May 10. The nurse would expect the client’s next menses to begin on:
	A)	May 24
	B)	May 26
	C)	May 30
	D)	June 1

4.	Which female reproductive tract structure would the nurse describe to a group of young women as containing rugae that enable it to dilate during labor and birth?
	A)	Cervix
	B)	Fallopian tube
	C)	Vagina
	D)	Vulva

5.	After teaching a group of pregnant women about breast-feeding, the nurse determines that the teaching was successful when the group identifies which hormone as important for the production of breast milk after childbirth?
	A)	Placental estrogen
	B)	Progesterone
	C)	Gonadotropin-releasing hormone
	D)	Prolactin

6.	The nurse is assessing a 13-year-old girl who has had her first menses. Which of the following events would the nurse expect to have occurred first?
	A)	Evidence of pubic hair
	B)	Development of breast buds
	C)	Onset of menses
	D)	Growth spurt

7.	When describing the ovarian cycle to a group of students, which phase would the instructor include?
	A)	Luteal phase
	B)	Proliferative phase
	C)	Menstrual phase
	D)	Secretory phase

8.	The nurse is explaining the events that lead up to ovulation. Which hormone would the nurse identify as being primarily responsible for ovulation?
	A)	Estrogen
	B)	Progesterone
	C)	Follicle-stimulating hormone
	D)	Luteinizing hormone

9.	The nurse is teaching a health education class on male reproductive anatomy and asks the students to identify the site of sperm production. Which structure, if identified by the group, would indicate to the nurse that the teaching was successful?
	A)	Testes
	B)	Seminal vesicles
	C)	Scrotum
	D)	Prostate gland

10.	The nurse is creating a diagram that illustrates the components of the male reproductive system. Which structure would be inappropriate for the nurse to include as an accessory gland?
	A)	Seminal vesicles
	B)	Prostate gland
	C)	Cowper’s glands
	D)	Vas deferens

11.	The nurse is preparing an outline for a class on the physiology of the male sexual response. Which event would the nurse identify as occurring first?
	A)	Sperm emission
	B)	Penile vasodilation
	C)	Psychological release
	D)	Ejaculation

12.	A woman comes to the clinic complaining that she has little sexual desire. As part of the client’s evaluation, the nurse would anticipate the need to evaluate which hormone level?
	A)	Progesterone
	B)	Estrogen
	C)	Gonadotropin-releasing hormone
	D)	Testosterone

13.	A nurse is conducting a class for a group of teenage girls about female reproductive anatomy and physiology. Which of the following would the nurse include as an external female reproductive organ? Select all that apply.
	A)	Mons pubis
	B)	Labia
	C)	Vagina
	D)	Clitoris
	E)	Uterus

14.	When describing the hormones involved in the menstrual cycle, a nurse identifies which hormone as responsible for initiating the cycle?
	A)	Estrogen
	B)	Luteinizing hormone
	C)	Progesterone
	D)	Prolactin

15.	A nursing instructor is describing the hormones involved in the menstrual cycle to a group of nursing students. The instructor determines the teaching was successful when the students identify follicle-stimulating hormone as being secreted by which of the following?
	A)	Hypothalamus
	B)	Anterior pituitary gland
	C)	Ovaries
	D)	Corpus luteum

16.	A woman comes to the clinic for an evaluation. During the visit, the woman tells the nurse that her menstrual cycles have become irregular. “I’ve also been waking up at night feeling really hot and sweating.” The nurse interprets these findings as which of the following?
	A)	Menopause
	B)	Perimenopause
	C)	Climacteric
	D)	Menarche

17.	After teaching a group of students about female reproductive anatomy, the instructor determines that the teaching was successful when the students identify which of the following as the site of fertilization?
	A)	Vagina
	B)	Uterus
	C)	Fallopian tubes
	D)	Vestibule

18.	A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects that the client has an infection. When gathering additional information, which of the following would the nurse be least likely to identify as placing the client at risk for an infection?
	A)	Recent antibiotic therapy for an upper respiratory infection
	B)	Last menstrual period about 5 days ago.
	C)	Weekly douching
	D)	Frequent use of feminine hygiene sprays.

19.	A group of nursing students are reviewing information about the male reproductive structures. The students demonstrate understanding of the information when they identify which of the following as accessory organs? (Select all that apply.)
	A)	Testes
	B)	Vas deferens
	C)	Bulbourethral glands
	D)	Prostate gland
	E)	Penis

20.	A nurse is examining a female client and tests the client’s vaginal pH. Which finding would the nurse interpret as normal?
	A)	4.5
	B)	7
	C)	8.5
	D)	10

21.	When describing the male sexual response to a group of students, the instructor determines that the teaching was successful when they identify emission as which of the following?
	A)	Semen forced through the urethra to the outside
	B)	Movement of sperm from the testes and fluid into the urethra
	C)	Dilation of the penile arteries with increased blood flow to the tissues.
	D)	Body’s return to the physiologic nonstimulated state

22.	A nurse is describing the structure and function of the reproductive system to an adolescent health class. The nurse describes the secretion of the seminal vesicles as which of the following?
	A)	Mucus-like
	B)	Alkaline
	C)	Acidic
	D)	Semen

1.	The nurse is developing a plan of care for a client who is receiving highly active antiretroviral therapy (HAART) for treatment of HIV. The goal of this therapy is to:
	A)	Promote the progression of disease
	B)	Intervene in late-stage AIDS
	C)	Improve survival rates
	D)	Conduct additional drug research

2.	A woman who is HIV-positive is receiving HAART and is having difficulty with compliance. To promote adherence, which of the following areas would be most important to assess initially?
	A)	The woman’s beliefs and education
	B)	The woman’s financial situation and insurance
	C)	The woman’s activity level and nutrition
	D)	The woman’s family and living arrangements

3.	When developing a teaching plan for a community group about HIV infection, which group would the nurse identify as an emerging risk group for HIV infection?
	A)	Native Americans
	B)	Heterosexual women
	C)	New health care workers
	D)	Asian immigrants

4.	After teaching a group of adolescents about HIV, the nurse asks them to identify the major means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which of the following?
	A)	Sexual intercourse
	B)	Sharing needles for IV drug use
	C)	Perinatal transmission
	D)	Blood transfusion

5.	The nurse reviews the CD4 cell count of a client who is HIV-positive. A result less than which of the following would indicate to the nurse that the client has AIDS?
	A)	1,000 cells/mm3
	B)	700 cells/mm3
	C)	450 cells/mm3
	D)	200 cells/mm3

6.	When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)?
	A)	Hive-like rash for the past 2 days
	B)	Five different sexual partners
	C)	Weight gain of 5 lbs in 1 year
	D)	Clear vaginal discharge

7.	Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:
	A)	Trichomoniasis
	B)	Bacterial vaginosis
	C)	Candidiasis
	D)	Genital herpes simplex

8.	A client with trichomoniasis is to receive metronidazole (Flagyl). The nurse instructs the client to avoid which of the following while taking this drug?
	A)	Alcohol
	B)	Nicotine
	C)	Chocolate
	D)	Caffeine

9.	A woman gives birth to a healthy newborn. As part of the newborn’s care, the nurse instills erythromycin ophthalmic ointment as a preventive measure related to which STI?
	A)	Genital herpes
	B)	Hepatitis B
	C)	Syphilis
	D)	Gonorrhea

10.	Which findings would the nurse expect to find in a client with bacterial vaginosis?
	A)	Vaginal pH of 3
	B)	Fish-like odor of discharge
	C)	Yellowish-green discharge
	D)	Cervical bleeding on contact

11.	A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the:
	A)	Amniotic fluid
	B)	Placenta
	C)	Birth canal
	D)	Breast milk

12.	The nurse encourages a female client with human papillomavirus (HPV) to receive continued follow-up care because she is at risk for:
	A)	Infertility
	B)	Dyspareunia
	C)	Cervical cancer
	D)	Dysmenorrhea

13.	A client is diagnosed with pelvic inflammatory disease (PID). When reviewing the client’s medical record, which of the following would the nurse expect to find? (Select all that apply.)
	A)	Oral temperature of 100.4 degrees F
	B)	Dysmenorrhea
	C)	Dysuria
	D)	Lower abdominal tenderness
	E)	Discomfort with cervical motion
	F)	Multiparity

14.	Which instructions would the nurse include when teaching a woman with pediculosis pubis?
	A)	“Take the antibiotic until you feel better.”
	B)	“Wash your bed linens in bleach and cold water.”
	C)	“Your partner doesn’t need treatment at this time.”
	D)	“Remove the nits with a fine-toothed comb.”

15.	A client with genital herpes simplex infection asks the nurse, “Will I ever be cured of this infection?” Which response by the nurse would be most appropriate?
	A)	“There is a new vaccine available that prevents the infection from returning.”
	B)	“All you need is a dose of penicillin and the infection will be gone.”
	C)	“There is no cure, but drug therapy helps to reduce symptoms and recurrences.”
	D)	“Once you have the infection, you develop an immunity to it.”

16.	A nurse is preparing a presentation for a group of women at the clinic who have been diagnosed with genital herpes. Which of the following would the nurse expect to include as a possible precipitating factor for a recurrent outbreak? (Select all that apply.)
	A)	Exposure to ultraviolet light
	B)	Exercise
	C)	Use of corticosteroids
	D)	Emotional stress
	E)	Sexual intercourse.

17.	After teaching a class on sexually transmitted infections, the instructor determines that the teaching was successful when the class identifies which statement as true?
	A)	STIs can affect anyone if exposed to the infectious organism.
	B)	STIs have been addressed more on a global scale.
	C)	Clients readily view the diagnosis of STI openly.
	D)	Most individuals with STIs are over the age of 30.

18.	A group of students are reviewing information about STIs. The students demonstrate understanding of the information when they identify which of the following as the most common bacterial STI in the United States?
	A)	Gonorrhea
	B)	Chlamydia
	C)	Syphilis
	D)	Candidiasis

19.	A nurse is assessing a client for possible risk factors for chlamydia and gonorrhea. Which of the following would the nurse identify?
	A)	Asian American ethnicity
	B)	Age under 25 years
	C)	Married
	D)	Consistent use of barrier contraception

20.	A nurse at a local community clinic is developing a program to address STI prevention. Which of the following would the nurse least likely include in the program?
	A)	Outlining safer sexual behavior
	B)	Recommending screening for symptomatic individuals
	C)	Promoting the use of barrier contraceptives
	D)	Offering education about STI transmission

21.	After teaching a class on preventing pelvic inflammatory disease, the instructor determines that the teaching was successful when the class identifies which of the following as an effective method?
	A)	HIV
	B)	HSV
	C)	HPV
	D)	HAV
	E)	HBV

22.	A group of nursing students are reviewing information about vaccines used to prevent STIs. The students would expect to find information about which of the following?
	A)	HIV
	B)	HSV
	C)	HPV
	D)	HAV
	E)	HBV

23.	A mother brings her 12-year-old daughter in for well-visit checkup. During the visit, the nurse is discussing the use of prophylactic HPV vaccine for the daughter. The mother agrees and the daughter receives her first dose. The nurse schedules the daughter for the next dose, which would be given at which time?
	A)	In 2 month
	B)	In 2 months
	C)	In 3 months
	D)	In 4 months

24.	A woman comes to the clinic complaining of a vaginal discharge. The nurse suspects trichomoniasis based on which of the following? (Select all that apply.)
	A)	Urinary frequency
	B)	Yellow/green discharge
	C)	Joint pain
	D)	Blister-like lesions
	E)	Muscle aches

25.	A nurse is teaching a woman with genital ulcers how to care for them. Which statement by the client indicates a need for additional teaching?
	A)	“I need to wash my hands after touching any of the ulcers.”
	B)	“I need to abstain from intercourse primarily when the lesions are present.”
	C)	“I should avoid applying ice or heat to my genital area.”
	D)	“I can try lukewarm sitz baths to help ease the discomfort.”

1.	A woman is admitted for repair of cystocele and rectocele. She has nine living children. In taking her health history, which of the following would the nurse expect to find?
	A)	Sporadic vaginal bleeding accompanied by chronic pelvic pain
	B)	Heavy leukorrhea with vulvar pruritus
	C)	Menstrual irregularities and hirsutism on the chin
	D)	Stress incontinence with feeling of low abdominal pressure

2.	To assist the woman in regaining control of the urinary sphincter for urinary incontinence, the nurse should teach the client to do which of the following?
	A)	Perform Kegel exercises daily.
	B)	Void every hour while awake.
	C)	Limit her intake of fluid.
	D)	Take a laxative every night.

3.	When developing the plan of care for a woman who has had an abdominal hysterectomy, which of the following would be contraindicated?
	A)	Ambulating the client
	B)	Massaging the client’s legs
	C)	Applying elasticized stockings
	D)	Encouraging range-of-motion exercises

4.	Which of the following would the nurse include when teaching women about preventing pelvic support disorders?
	A)	Performing Kegel isometric exercises
	B)	Consuming low-fiber diets
	C)	Using hormone replacement
	D)	Voiding every 2 hours

5.	A client is diagnosed with an enterocele. The nurse interprets this condition as:
	A)	Protrusion of the posterior bladder wall downward through the anterior vaginal wall
	B)	Sagging of the rectum with pressure exerted against the posterior vaginal wall
	C)	Bulging of the small intestine through the posterior vaginal wall
	D)	Descent of the uterus through the pelvic floor into the vagina

6.	A woman is scheduled for an anterior and posterior colporrhaphy as treatment for a cystocele. When the nurse is explaining this treatment to the client, which of the following descriptions would be most appropriate to include?
	A)	“This procedure helps to tighten the vaginal wall in the front and back so that your bladder and urethra are in the proper position.”
	B)	“Your uterus will be removed through your vagina, helping to relieve the organ that is putting the pressure on your bladder.”
	C)	“This is a series of exercises that you will learn to do so that you can strengthen your bladder muscles.”
	D)	“These are plastic devices that your physician will insert into your vagina to provide support to the uterus and keep it in the proper position.”

7.	The nurse would be least likely to find which of the following in a client with uterine fibroids?
	A)	Regularly shaped, shrunken uterus
	B)	Acute pelvic pain
	C)	Menorrhagia
	D)	Complaints of bloating

8.	A client with polycystic ovary syndrome (PCOS) is receiving oral contraceptives as part of her treatment plan. The nurse understands that the rationale for this therapy is to:
	A)	Restore menstrual regularity
	B)	Induce ovulation
	C)	Improve insulin uptake
	D)	Alleviate hirsutism

9.	When teaching a woman how to perform Kegel exercises, the nurse explains that these exercises are designed to strengthen which muscles?
	A)	Gluteus
	B)	Lower abdominal
	C)	Pelvic floor
	D)	Diaphragmatic

10.	A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect?
	A)	Increased vaginal discharge
	B)	Urinary tract infection
	C)	Vaginitis
	D)	Vaginal ulceration

11.	When preparing the discharge teaching plan for the woman who had surgery to correct pelvic organ prolapse, which of the following would the nurse include?
	A)	Care of the indwelling catheter at home
	B)	Emphasis on coughing to prevent complications
	C)	Return to usual activity level in a few days
	D)	Daily douching with dilute vinegar solution

12.	A woman with polycystic ovary syndrome tells the nurse, “I hate this disease. Just look at me! I have no hair on the front of my head but I’ve got hair on my chin and upper lip. I don’t feel like a woman anymore.” Further assessment reveals breast atrophy and increased muscle mass. Which nursing diagnosis would most likely be a priority?
	A)	Situational low self-esteem related to masculinization effects of the disease
	B)	Social isolation related to feelings about appearance
	C)	Risk for suicide related to effects of condition and fluctuating hormone levels
	D)	Ineffective peripheral tissue perfusion related to effects of disease on vasculature

13.	After teaching a local woman’s group about incontinence, the nurse determines that the teaching was successful when the group identifies which of the following as characteristic of stress incontinence?
	A)	Feeling a strong need to void
	B)	Passing a large amount of urine
	C)	Most common in women after childbirth
	D)	Sneezing may be an initiating stimulus

14.	A woman is being evaluated for pelvic organ prolapse. A postvoid residual urine specimen is obtained via a catheter. Which residual volume finding would lead the nurse to suspect the need for further testing?
	A)	50 mL
	B)	75 mL
	C)	100 mL
	D)	120 mL

15.	After teaching a woman with pelvic organ prolapse about dietary and lifestyle measures, which of the following statements would indicate the need for additional teaching?
	A)	“If I wear a girdle, it will help support the muscles in the area.”
	B)	“I should take up jogging to make sure I exercise enough.”
	C)	“I will try to drink at least 64 oz of fluid each day.”
	D)	“I need to increase the amount of fiber I eat every day.”

16.	After teaching a group of students about genital fistulas, the instructor determines that the teaching was successful when the students identify which of the following as a major cause?
	A)	Radiation therapy
	B)	Congenital anomaly
	C)	Female genital cutting
	D)	Bartholin’s gland abscess

17.	A nurse is providing care to a female client receiving treatment for a Bartholin’s cyst. The client has had a small loop of plastic tubing secured in place to allow for drainage. The nurse instructs the client that she will have a follow-up appointment for removal of the plastic tubing at which time?
	A)	1 week
	B)	2 weeks
	C)	3 weeks
	D)	4 weeks

18.	After undergoing diagnostic testing, a woman is diagnosed with a corpus luteum cyst. The nurse anticipates that the woman will require:
	A)	Biopsy
	B)	No treatment
	C)	Oral contraceptives
	D)	Glucophage

19.	A nurse is teaching a client how to perform Kegel exercises. Which of the following would the nurse include? (Select all that apply.)
	A)	“Squeeze your rectal muscles as if you are trying to avoid passing flatus.”
	B)	“Tighten your pubococcygeal muscle for a count of 10.”
	C)	“Contract and relax your pubococcygeal muscle rapidly 10 times.”
	D)	“Try bearing down for about 10 seconds for no more than 5 times.”
	E)	“Do these exercises at least 5 times every hour.”

20.	After teaching a group of students about pelvic organ prolapse, the instructor determines that the teaching was successful when the group identifies leiomyomas as which of the following?
	A)	Cysts
	B)	Pelvic organ prolapse
	C)	Fistula
	D)	Fibroid

21.	A nurse is assessing a female client and suspects that the client may have endometrial polyps based on which of the following?
	A)	Bleeding after intercourse
	B)	Vaginal discharge
	C)	Bleeding between menses
	D)	Metrorrhagia

22.	After teaching a group of students about ovarian cysts, the instructor determines that the teaching was successful when the students identify which type of cyst as being associated with hydatiform mole?
	A)	Theca-lutein cyst
	B)	Corpus luteum cyst
	C)	Follicular cyst
	D)	Polycystic ovary syndrome

23.	A nurse is reading a journal article about care of the woman with pelvic organ prolapse. The nurse would expect to find information related to which of the following? (Select all that apply.)
	A)	Rectocele
	B)	Fecal incontinence
	C)	Cystocele
	D)	Urinary incontinence
	E)	Enterocele

24.	A nurse is reviewing the medical record of a client. Which of the following would lead the nurse to suspect that the client is experiencing polycystic ovary syndrome? (Select all that apply.)
	A)	Decreased androgen levels
	B)	Elevated blood insulin levels
	C)	Anovulation
	D)	Waist circumference of 32 inches
	E)	Triglyceride level of 175 mg/dL
	F)	High-density lipoprotein level of 40 mg/dL

25.	A group of students are preparing a class presentation about polyps. Which of the following would the students most likely include in the presentation?
	A)	Polyps are rarely the result of an infection.
	B)	Endocervical polyps commonly appear after menarche.
	C)	Cervical polyps are more common than endocervical polyps.
	D)	Endocervical polyps are most common in women in their 50s.

1.	The nurse is presenting a class at a local community health center on violence during pregnancy. Which of the following would the nurse include as a possible complication?
	A)	Hypertension of pregnancy
	B)	Chorioamnionitis
	C)	Placenta previa
	D)	Postterm labor

2.	Which approach would be most appropriate when counseling a woman who is a suspected victim of violence?
	A)	Offer her a pamphlet about the local battered women’s shelter.
	B)	Call her at home to ask her some questions about her marriage.
	C)	Wait until she comes in a few more times to make a better assessment.
	D)	Ask, “Have you ever been physically hurt by your partner?”

3.	When describing an episode, the victim reports that she attempted to calm her partner down to keep things from escalating. This behavior reflects which phase of the cycle of violence?
	A)	Battering
	B)	Honeymoon
	C)	Tension-building
	D)	Reconciliation

4.	A battered pregnant woman reports to the nurse that her husband has stopped hitting her and promises never to hurt her again. Which of the following is an appropriate response?
	A)	“That’s great. I wish you both the best.”
	B)	“The cycle of violence often repeats itself.”
	C)	“He probably didn’t mean to hurt you.”
	D)	“You need to consider leaving him.”

5.	Which of the following nursing actions would be least helpful for a client who is a victim of violence?
	A)	Assist the client to project her anger.
	B)	Provide information about a safe home and crisis line.
	C)	Teach her about the cycle of violence.
	D)	Discuss her legal and personal rights.

6.	When describing the cycle of violence to a community group, the nurse explains that the first phase usually is:
	A)	Somehow triggered by the victim’s behavior
	B)	Characterized by tension-building and minor battery
	C)	Associated with loss of physical and emotional control
	D)	Like a honeymoon that lulls the victim

7.	Which of the following statements would be most appropriate to empower victims of violence to take action?
	A)	“Give your partner more time to come around.”
	B)	“Remember—children do best in two-parent families.”
	C)	“Change your behavior so as not to trigger the violence.”
	D)	“You are a good person and you deserve better than this.”

8.	When a nurse suspects that a client may have been abused, the first action should be to:
	A)	Ask the client about the injuries and if they are related to abuse.
	B)	Encourage the client to leave the batterer immediately.
	C)	Set up an appointment with a domestic violence counselor.
	D)	Ask the suspected abuser about the victim’s injuries.

9.	Which of the following would the nurse describe as a characteristic of the second phase of the cycle of violence?
	A)	The batterer is contrite and attempts to apologize for the behavior.
	B)	The physical battery is abrupt and unpredictable.
	C)	Verbal assaults begin to escalate toward the victim.
	D)	The victim accepts the anger as legitimately directed at her.

10.	In addition to providing privacy, which of the following would be most appropriate initially in situations involving suspected abuse?
	A)	Allow the client to have a good cry over the situation.
	B)	Tell the client, “Injuries like these don’t usually happen by accident.”
	C)	Call the police immediately so they can question the victim.
	D)	Ask the abuser to describe his side of the story first.

11.	When the nurse is alone with a client, the client says, “It was all my fault. The house was so messy when he got home and I know he hates that.” Which response would be most appropriate?
	A)	“It is not your fault. No one deserves to be hurt. ”
	B)	“What else did you do to make him so angry with you?”
	C)	“You need to start to clean the house early in the day.”
	D)	“Remember, he works hard and you need to meet his needs.”

12.	When developing a presentation for a local community organization on violence, the nurse is planning to include statistics on intimate partner abuse and its effects on children. In what percentage of the cases in which a parent is abused are the children battered also?
	A)	50% to 75%
	B)	25% to 50%
	C)	10% to 25%
	D)	Less than 5%

13.	The primary goal when working with victims of intimate partner violence is to:
	A)	Convince them to leave the abuser soon
	B)	Help them cope with their life as it is
	C)	Empower them to regain control of their life
	D)	Arrest the abuser so he or she can’t abuse again

14.	Teaching for victims who are recovering from abusive situations must focus on ways to:
	A)	Enhance their personal appearance and hairstyle
	B)	Develop their creativity and work ethic
	C)	Improve their communication skills and assertiveness
	D)	Plan more nutritious meals to improve their own health

15.	During a follow-up visit to the clinic, a victim of sexual assault reports that she has changed her job and moved to another town. She tells the nurse, “I pretty much stay to myself at work and at home.” The nurse interprets these findings to indicate that the client is in which phase of rape recovery?
	A)	Disorganization
	B)	Denial
	C)	Reorganization
	D)	Integration

16.	A nurse is assessing a rape survivor for post-traumatic stress disorder. The nurse asks the woman, “Do you feel as though you are reliving the trauma?” The nurse is assessing for which of the following?
	A)	Physical symptoms
	B)	Intrusive thoughts
	C)	Avoidance
	D)	Hyperarousal

17.	A group of students are preparing a class discussion about rape and sexual assault. Which of the following would the students include as being most accurate? (Select all that apply.)
	A)	Most victims of rape tell someone about it.
	B)	Few women falsely cry “rape.”
	C)	Women have rape fantasies desiring to be raped.
	D)	A rape victim feels vulnerable and betrayed afterwards.
	E)	Medication and counseling can help a rape victim cope.

18.	After teaching a class on date rape, the instructor determines that the teaching was successful when the class identifies which of the following as the most common date rape drug?
	A)	Gamma hydroxybutyrate
	B)	Liquid ecstasy
	C)	Ketamine
	D)	Rohypnol

19.	A nurse is caring for a woman who was recently raped. The nurse would expect this woman to experience which of the following first?
	A)	Denial
	B)	Disorganization
	C)	Reorganization
	D)	Integration

20.	A group of nurses are researching information about risk factors for intimate partner violence in men. Which of the following would the nurses expect to find related to the individual person? (Select all that apply.)
	A)	Dysfunctional family system
	B)	Low academic achievement
	C)	Victim of childhood violence
	D)	Heavy alcohol consumption
	E)	Economic stress

21.	A nurse is working with a victim of intimate partner violence and helping her develop a safety plan. Which of the following would the nurse suggest that the woman take with her? (Select all that apply.)
	A)	Driver’s license
	B)	Social security number
	C)	Cash
	D)	Phone cards
	E)	Health insurance cards

22.	A nurse is presenting a discussion on sexual violence at a local community college. When describing the incidence of sexual violence, the nurse would identify that a woman has which chance of experiencing a sexual assault in her lifetime?
	A)	One in three
	B)	One in six
	C)	Two in 15
	D)	Three in 20

23.	After teaching a class on sexual violence, the instructor determines that the teaching was successful when the class identifies which of the following as a type of sexual violence. (Select all that apply.)
	A)	Female genital cutting
	B)	Bondage
	C)	Infanticide
	D)	Human trafficking
	E)	Rape

24.	A nurse is reading a journal article about sexual abuse. Which age range would the nurse expect to find as the peak age for such abuse?
	A)	7–10 years
	B)	8–12 years
	C)	14–18 years
	D)	18–22 years

25.	After teaching a group of students about sexual abuse and violence, the instructor determines that the teaching was successful when the students describe incest as involving which of the following?
	A)	Sexual exploitation by blood or surrogate relatives
	B)	Sexual abuse of individuals over age 18
	C)	Violent aggressive assault on a person
	D)	Consent between perpetrator and victim.

1.	During a vaginal exam, the nurse notes that the cervix has a bluish color. The nurse documents this finding as:
	A)	Hegar’s sign
	B)	Goodell’s sign
	C)	Chadwick’s sign
	D)	Ortolani’s sign

2.	The nurse teaches a primigravida client that lightening occurs about 2 weeks before the onset of labor. The mother will most likely experience which of the following at that time?
	A)	Dysuria
	B)	Dyspnea
	C)	Constipation
	D)	Urinary frequency

3.	A gravida 2 para 1 client in the 10th week of her pregnancy says to the nurse, “I’ve never urinated as often as I have for the past three weeks.” Which response would be most appropriate for the nurse to make?
	A)	“Having to urinate so often is annoying. I suggest that you watch how much fluid you are drinking and limit it.”
	B)	“You shouldn’t be urinating this frequently now; it usually stops by the time you’re eight weeks pregnant. Is there anything else bothering you?”
	C)	“By the time you are 12 weeks pregnant, this frequent urination should no longer be a problem, but it is likely to return toward the end of your pregnancy.”
	D)	“Women having their second child generally don’t have frequent urination. Are you experiencing any burning sensations?”

4.	In a client’s seventh month of pregnancy, she reports feeling “dizzy, like I’m going to pass out, when I lie down flat on my back.” The nurse integrates which of the following in to the explanation?
	A)	Pressure of the gravid uterus on the vena cava
	B)	A 50% increase in blood volume
	C)	Physiologic anemia due to hemoglobin decrease
	D)	Pressure of the presenting fetal part on the diaphragm

5.	A primiparous client is being seen in the clinic for her first prenatal visit. It is determined that she is 11 weeks pregnant. The nurse develops a teaching plan to educate the client about what she will most likely experience during this period. Which of the following would the nurse include?
	A)	Ankle edema
	B)	Urinary frequency
	C)	Backache
	D)	Hemorrhoids

6.	A pregnant client in her second trimester has a hemoglobin level of 11 g/dL. The nurse interprets this as indicating which of the following?
	A)	Iron-deficiency anemia
	B)	A multiple gestation pregnancy
	C)	Greater-than-expected weight gain
	D)	Hemodilution of pregnancy

7.	The nurse is discussing the insulin needs of a primiparous client with diabetes who has been using insulin for the past few years. The nurse informs the client that her insulin needs will increase during pregnancy based on the nurse’s understanding that the placenta produces:
	A)	hCG, which increases maternal glucose levels
	B)	hPL, which deceases the effectiveness of insulin
	C)	Estriol, which interferes with insulin crossing the placenta
	D)	Relaxin, which decreases the amount of insulin produced

8.	When teaching a pregnant client about the physiologic changes of pregnancy, the nurse reviews the effect of pregnancy on glucose metabolism. Which of the following would the nurse include as the underlying reason for the effect?
	A)	Pancreatic function is affected by pregnancy.
	B)	Glucose is utilized more rapidly during a pregnancy.
	C)	The pregnant woman increases her dietary intake.
	D)	Glucose moves through the placenta to assist the fetus.

9.	When assessing a woman in her first trimester, which emotional response would the nurse most likely expect to find?
	A)	Ambivalence
	B)	Introversion
	C)	Acceptance
	D)	Emotional lability

10.	The nurse is assessing a pregnant woman in the second trimester. Which of the following tasks would indicate to the nurse that the client is incorporating the maternal role into her personality?
	A)	The woman demonstrates concern for herself and her fetus as a unit.
	B)	The client identifies what she must give up to assume her new role.
	C)	The woman acknowledges the fetus as a separate entity within her.
	D)	The client demonstrates unconditional acceptance without rejection.

11.	A woman comes to the prenatal clinic suspecting that she is pregnant, and assessment reveals probable signs of pregnancy. Which of the following would be included as part of this assessment? (Select all that apply.
	A)	Positive pregnancy test
	B)	Ultrasound visualization of the fetus
	C)	Auscultation of a fetal heart beat
	D)	Ballottement
	E)	Absence of menstruation
	F)	Softening of the cervix

12.	The nurse is teaching a pregnant woman about recommended weight gain. The woman has a prepregnancy body mass index of 26. The nurse determines that the teaching was successful when the woman states that she should gain no more than which amount during pregnancy?
	A)	35 to 40 pounds
	B)	25 to 35 pounds
	C)	28 to 40 pounds
	D)	15 to 25 pounds

13.	A nurse strongly encourages a pregnant client to avoid eating swordfish and tilefish because these fish contain which of the following?
	A)	Excess folic acid, which could increase the risk for neural tube defects
	B)	Mercury, which could harm the developing fetus if eaten in large amounts
	C)	Lactose, which leads to abdominal discomfort, gas, and diarrhea
	D)	Low-quality protein that does not meet the woman’s requirements

14.	Which of the following changes in the musculoskeletal system would the nurse mention when teaching a group of pregnant women about the physiologic changes of pregnancy?
	A)	Ligament tightening
	B)	Decreased swayback
	C)	Increased lordosis
	D)	Joint contraction

15.	Assessment of a pregnant woman reveals a pigmented line down the middle of her abdomen. The nurse documents this as which of the following?
	A)	Linea nigra
	B)	Striae gravidarum
	C)	Melasma
	D)	Vascular spiders

16.	A nurse is assessing a pregnant woman on a routine checkup. When assessing the woman’s gastrointestinal tract, which of the following would the nurse expect to find? (Select all that apply.
	A)	Hyperemic gums
	B)	Increased peristalsis
	C)	Complaints of bloating
	D)	Heartburn
	E)	Nausea

17.	A woman suspecting she is pregnant asks the nurse about which signs would confirm her pregnancy. The nurse would explain that which of the following would confirm the pregnancy?
	A)	Absence of menstrual period
	B)	Abdominal enlargement
	C)	Palpable fetal movement
	D)	Morning sickness

18.	A nurse is developing a teaching plan about nutrition for a group of pregnant women. Which of the following would the nurse include in the discussion? (Select all that apply.
	A)	Keep weight gain to 15 lb
	B)	Eat three meals with snacking
	C)	Limit the use of salt in cooking
	D)	Avoid using diuretics
	E)	Participate in physical activity

19.	Assessment of a pregnant woman reveals that she compulsively craves ice. The nurse documents this finding as which of the following?
	A)	Quickening
	B)	Pica
	C)	Ballottement
	D)	Linea nigra

20.	A woman in her second trimester comes for a follow-up visit and says to the nurse, “I feel like I’m on an emotional roller-coaster.” Which response by the nurse would be most appropriate?
	A)	“How often has this been happening to you?”
	B)	“Maybe you need some medication to level things out.”
	C)	“Mood swings are completely normal during pregnancy.”
	D)	“Have you been experiencing any thoughts of harming yourself?”

21.	While talking with a woman in her third trimester, which behavior indicates to the nurse that the woman is learning to give of oneself?
	A)	Showing concern for self and fetus as a unit
	B)	Unconditionally accepting the pregnancy without rejection
	C)	Longing to hold infant
	D)	Questioning ability to become a good mother

22.	A group of students are reviewing the signs of pregnancy. The students demonstrate understanding of the information when they identify which as presumptive signs? (Select all that apply.
	A)	Amenorrhea
	B)	Nausea
	C)	Abdominal enlargement
	D)	Braxton-Hicks contractions
	E)	Fetal heart sounds

23.	A nursing instructor is teaching a class to a group of students about pregnancy, insulin, and glucose. Which of the following would the instructor least likely include as opposing insulin?
	A)	Prolactin
	B)	Estrogen
	C)	Progesterone
	D)	Cortisol

24.	A woman is at 20 weeks’ gestation. The nurse would expect to find the fundus at which of the following?
	A)	Just above the symphysis pubis
	B)	Mid-way between the pubis and umbilicus
	C)	At the level of the umbilicus
	D)	Mid-way between the umbilicus and xiphoid process

25.	A pregnant woman comes to the clinic and tells the nurse that she has been having a whitish vaginal discharge. The nurse suspects vulvovaginal candidiasis, based on which assessment finding?
	A)	Fever
	B)	Vaginal itching
	C)	Urinary frequency
	D)	Incontinence

1.	A woman in her 40th week of pregnancy calls the nurse at the clinic and says she’s not sure whether she is in true or false labor. Which statement by the client would lead the nurse to suspect that the woman is experiencing false labor?
	A)	“I’m feeling contractions mostly in my back.”
	B)	“My contractions are about 6 minutes apart and regular.”
	C)	“The contractions slow down when I walk around.”
	D)	“If I try to talk to my partner during a contraction, I can’t.”

2.	Which of the following would indicate to the nurse that the placenta is separating?
	A)	Uterus becomes globular
	B)	Fetal head is at vaginal opening
	C)	Umbilical cord shortens
	D)	Mucous plug is expelled

3.	When assessing cervical effacement of a client in labor, the nurse assesses which of the following characteristics?
	A)	Extent of opening to its widest diameter
	B)	Degree of thinning
	C)	Passage of the mucous plug
	D)	Fetal presenting part

4.	A woman calls the health care facility stating that she is in labor. The nurse would urge the client to come to the facility if the client reports which of the following?
	A)	Increased energy level with alternating strong and weak contractions
	B)	Moderately strong contractions every 4 minutes, lasting about 1 minute
	C)	Contractions noted in the front of abdomen that stop when she walks
	D)	Pink-tinged vaginal secretions and irregular contractions lasting about 30 seconds

5.	A woman is in the first stage of labor. The nurse would encourage her to assume which position to facilitate the progress of labor?
	A)	Supine
	B)	Lithotomy
	C)	Upright
	D)	Knee–chest

6.	A client has not received any medication during her labor. She is having frequent contractions every 1 to 2 minutes and has become irritable with her coach and no longer will allow the nurse to palpate her fundus during contractions. Her cervix is 8 cm dilated and 90% effaced. The nurse interprets these findings as indicating:
	A)	Latent phase of the first stage of labor
	B)	Active phase of the first stage of labor
	C)	Transition phase of the first stage of labor
	D)	Pelvic phase of the second stage of labor

7.	The fetus of a nulliparous woman is in a shoulder presentation. The nurse would most likely prepare the client for which type of birth?
	A)	Cesarean
	B)	Vaginal
	C)	Forceps-assisted
	D)	Vacuum extraction

8.	Assessment of a woman in labor reveals cervical dilation of 3 cm, cervical effacement of 30%, and contractions occurring every 7 to 8 minutes, lasting about 40 seconds. The nurse determines that this client is in:
	A)	Latent phase of the first stage
	B)	Active phase of the first stage
	C)	Transition phase of the first stage
	D)	Perineal phase of the second stage

9.	A client is admitted to the labor and birthing suite in early labor. On review of her medical record, the nurse determines that the client’s pelvic shape as identified in the antepartal progress notes is the most favorable one for a vaginal delivery. Which pelvic shape would the nurse have noted?
	A)	Platypelloid
	B)	Gynecoid
	C)	Android
	D)	Anthropoid

10.	A woman telephones her health care provider and reports that her “water just broke.” Which suggestion by the nurse would be most appropriate?
	A)	“Call us back when you start having contractions.”
	B)	“Come to the clinic or emergency department for an evaluation.”
	C)	“Drink 3 to 4 glasses of water and lie down.”
	D)	“Come in as soon as you feel the urge to push.”

11.	After teaching a group of students about the maternal bony pelvis, which statement by the group indicates that the teaching was successful?
	A)	The bony pelvis plays a lesser role during labor than soft tissue.
	B)	The pelvic outlet is associated with the true pelvis.
	C)	The false pelvis lies below the imaginary linea terminalis.
	D)	The false pelvis is the passageway through which the fetus travels.

12.	A fetus is assessed at 2 cm above the ischial spines. The nurse would document fetal station as:
	A)	+4
	B)	+2
	C)	0
	D)	–2

13.	Assessment of a fetus identifies the buttocks as the presenting part, with the legs extended upward. The nurse identifies this as which type of breech presentation?
	A)	Frank
	B)	Full
	C)	Complete
	D)	Footling

14.	A woman in her third trimester comes to the clinic for a prenatal visit. During assessment the woman reports that her breathing has become much easier in the last week but she has noticed increased pelvic pressure, cramping, and lower back pain. The nurse determines that which of the following has most likely occurred?
	A)	Cervical dilation
	B)	Lightening
	C)	Bloody show
	D)	Braxton-Hicks contractions

15.	After teaching a group of students about the factors affecting the labor process, the instructor determines that the teaching was successful when the group identifies which of the following as a component of the true pelvis? (Select all that apply.)
	A)	Pelvic inlet
	B)	Cervix
	C)	Mid pelvis
	D)	Pelvic outlet
	E)	Vagina
	F)	Pelvic floor muscles

16.	A nurse is documenting fetal lie of a woman in labor. Which term would the nurse most likely use?
	A)	Flexion
	B)	Extension
	C)	Longitudinal
	D)	Cephalic

17.	The nurse is reviewing the medical record of a woman in labor and notes that the fetal position is documented as LSA. The nurse interprets this information as indicating which of the following is the presenting part?
	A)	Occiput
	B)	Face
	C)	Buttocks
	D)	Shoulder

18.	A nurse is preparing a class for pregnant women about labor and birth. When describing the typical movements that the fetus goes through as it travels through the passageway, which of the following would the nurse most likely include? (Select all that apply.)
	A)	Internal rotation
	B)	Abduction
	C)	Descent
	D)	Pronation
	E)	Flexion

19.	The nurse is reviewing the monitoring strip of a woman in labor who is experiencing a contraction. The nurse notes the time the contraction takes from its onset to reach its highest intensity. The nurse interprets this time as which of the following?
	A)	Increment
	B)	Acme
	C)	Peak
	D)	Decrement

20.	A nurse is assessing a woman in labor. Which finding would the nurse identify as a cause for concern during a contraction?
	A)	Heart rate increase from 76 bpm to 90 bpm
	B)	Blood pressure rise from 110/60 mm Hg to 120/74
	C)	White blood cell count of 12,000 cells/mm3
	D)	Respiratory rate of 10 breaths /minute

21.	When describing the stages of labor to a pregnant woman, which of the following would the nurse identify as the major change occurring during the first stage?
	A)	Regular contractions
	B)	Cervical dilation
	C)	Fetal movement through the birth canal
	D)	Placental separation

22.	A nurse is caring for several women in labor. The nurse determines that which woman is in the transition phase of labor?
	A)	Contractions every 5 minutes, cervical dilation 3 cm
	B)	Contractions every 3 minutes, cervical dilation 5 cm
	C)	Contractions every 21/2 minutes, cervical dilation 7 cm
	D)	Contractions every 1 minute, cervical dilation 9 cm

23.	A nurse is preparing a presentation for a group of pregnant women about the labor experience. Which of the following would the nurse most likely include when discussing measures to promote coping for a positive labor experience? (Select all that apply.)
	A)	Presence of a support partner
	B)	View of birth as a stressor
	C)	Low anxiety level
	D)	Fear of loss of control
	E)	Participation in a pregnancy exercise program

24.	During a follow-up prenatal visit, a pregnant woman asks the nurse, “How long do you think I will be in labor?” Which response by the nurse would be most appropriate?
	A)	“It’s difficult to predict how your labor will progress, but we’ll be there for you the entire time.”
	B)	“Since this is your first pregnancy, you can estimate it will be about 10 hours.”
	C)	“It will depend on how big the baby is when you go into labor.”
	D)	“Time isn’t important; your health and the baby’s health are key.”

25.	A nurse is describing how the fetus moves through the birth canal. Which of the following would the nurse identify as being most important in allowing the fetal head to move through the pelvis?
	A)	Sutures
	B)	Fontanelles
	C)	Frontal bones
	D)	Biparietal diameter

26.	Assessment of a pregnant woman reveals that the presenting part of the fetus is at the level of the maternal ischial spines. The nurse documents this as which station?
	A)	–2
	B)	–1
	C)	0
	D)	+1