Question 1
Question:
An effective relief measure for primary dysmenorrhea would be to:
Choices:
A. Reduce physical activity level until menstruation ceases.
B. Begin taking prostaglandin synthesis inhibitors on the first day of the menstrual flow.
C. Decrease intake of salt and refined sugar about 1 week before menstruation is about to occur.
D. Use barrier methods rather than the oral contraceptive pill (OCP) for birth control.
Correct Answer:
C. Decrease intake of salt and refined sugar about 1 week before menstruation is about to occur.
Rationale:
Staying active is helpful since it facilitates menstrual flow and increases vasodilation to reduce
ischemia. Prostaglandin inhibitors should be started a few days before the onset of menstruation.
Decreasing intake of salt and refined sugar can reduce fluid retention. OCPs are beneficial in
relieving primary dysmenorrhea as a result of inhibition of ovulation and prostaglandin synthesis.
Question 2
Question:
With regard to dysfunctional uterine bleeding (DUB), the nurse should be aware that:
Choices:
A. It is most commonly caused by anovulation.
B. It most often occurs in middle age.
C. The diagnosis of DUB should be the first considered for abnormal menstrual bleeding.
D. The most effective medical treatment involves steroids.
Correct Answer:
A. It is most commonly caused by anovulation.
Rationale:
Anovulation may occur because of hypothalamic dysfunction or polycystic ovary syndrome. DUB
most often occurs when the menstrual cycle is being established or when it draws to a close at
menopause. A diagnosis of DUB is made only after all other causes of abnormal menstrual
bleeding have been ruled out. The most effective medical treatment is oral or intravenous
estrogen.
Question 3
Question:
During a client’s physical examination, the nurse notes that the lower uterine segment is soft on
palpation. The nurse would document this finding as:
Choices:
A. Hegar sign
B. McDonald sign
C. Chadwick sign
D. Goodell sign
Correct Answer:
A. Hegar sign
Rationale:
At approximately 6 weeks of gestation, softening and compressibility of the lower uterine
segment occur; this is called the Hegar sign. The McDonald sign is not related. The Chadwick
sign is a blue-violet cervix caused by increased vascularity. Softening of the cervical tip is called
the Goodell sign.
Question 4
Question:
A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of
pregnancy. The woman demonstrates an understanding of the nurse’s instructions if she states
that a positive sign of pregnancy is:
,Choices:
A. A positive pregnancy test
B. Fetal movement palpated by the nurse-midwife
C. Braxton Hicks contractions
D. Quickening
Correct Answer:
B. Fetal movement palpated by the nurse-midwife
Rationale:
A positive pregnancy test is a probable sign. Positive signs of pregnancy are those attributed to
the presence of a fetus, such as hearing the fetal heartbeat or palpating fetal movement.
Braxton Hicks contractions are probable signs. Quickening is a presumptive sign.
Question 5
Question:
When assessing the fetal heart rate (FHR) of a woman at 30 weeks of gestation, the nurse counts
a rate of 82 beats/min. Initially the nurse should:
Choices:
A. Recognize that the rate is within normal limits and record it.
B. Assess the woman’s radial pulse.
C. Notify the physician.
D. Allow the woman to hear the heartbeat.
Correct Answer:
C. Notify the physician.
Rationale:
The expected FHR is 120 to 160 beats/min. The nurse may have inadvertently counted the
uterine soufÒe, which corresponds to the mother’s heartbeat. The physician should be notified if
the FHR is confirmed to be 82 beats/min. Allow the woman to hear the heartbeat as soon as a full
assessment is made.
Question 6
Question:
The nurse caring for a laboring woman is aware that maternal cardiac output can be increased
by:
Choices:
A. Change in position
B. Oxytocin administration
C. Regional anesthesia
D. Intravenous analgesic
Correct Answer:
A. Change in position
Rationale:
Maternal supine hypotension syndrome is caused by the weight and pressure of the gravid
uterus on the ascending vena cava when the woman is in a supine position. This reduces venous
return to the woman’s heart, as well as cardiac output, and subsequently reduces her blood
pressure. The nurse can encourage the woman to change positions and avoid the supine
position. Oxytocin administration, regional anesthesia, and intravenous analgesic may reduce
maternal cardiac output.
Question 7
Question:
A nurse is reviewing information related to home pregnancy tests so as to prepare for a patient
teaching session. Which statement by the patient indicates that additional instruction is needed
following the teaching session?
Choices:
A. The patient states that she will follow directions as listed on the testing package.
B. The patient indicates that a positive result will be seen if there is a color change on the
,applicator.
C. The patient states there is no need for concern as home pregnancy test results are 100%
correct.
D. The patient can perform the test without any assistance in the home setting.
Correct Answer:
C. The patient states there is no need for concern as home pregnancy test results are 100%
correct.
Rationale:
Home pregnancy testing while reliable does not provide 100% correct results. There are other
variables such as medication history as well as timing of specimen, collection and interpretation
that may lead to inaccurate results. Following directions, noting a color change as a positive
result, and being able to perform the test without any assistance in the home setting all indicate
that the patient has an understanding of the process.
Question 8
Question:
The nurse should include which information when teaching a 15-year-old about genital tract
infection prevention? (Select all that apply.)
Choices:
A. Wear nylon undergarments.
B. Avoid tight-fitting jeans.
C. Use floral scented bath salts.
D. Decrease sugar intake.
E. Do not douche.
F. Limit time spent wearing a wet bathing suit.
Correct Answer:
B. Avoid tight-fitting jeans.
D. Decrease sugar intake.
E. Do not douche.
F. Limit time spent wearing a wet bathing suit.
Rationale:
Wearing nylon undergarments and using floral scented bath salts are not recommended.
Avoiding tight-fitting jeans, decreasing sugar intake, not douching, and limiting time in a wet
bathing suit help prevent genital tract infections.
Question 9
Question:
If exhibited by a pregnant woman, what represents a positive sign of pregnancy?
Choices:
A. Morning sickness
B. Quickening
C. Positive pregnancy test
D. Fetal heartbeat auscultated with Doppler/fetoscope
Correct Answer:
D. Fetal heartbeat auscultated with Doppler/fetoscope
Rationale:
Morning sickness and quickening, along with amenorrhea and breast tenderness, are
presumptive signs of pregnancy. A positive pregnancy test is a probable sign. Detection of a fetal
heartbeat, palpation of fetal movements and parts by an examiner, and detection of an
embryo/fetus with sonographic examination are positive signs diagnostic of pregnancy.
Question 10
Question:
A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of
gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her
gravidity and parity using the GTPAL system?
, Choices:
A. 31010
B. 3-1-0-1-0
Correct Answer:
A. 31010
Rationale:
G: Total number of times the woman has been pregnant (she is pregnant for the third time). T:
Number of pregnancies carried to term (she has one stillborn). P: Number of pregnancies that
resulted in a preterm birth (she has none). A: Abortions or miscarriages before the period of
viability (she has had one). L: Number of children born who are currently living (she has no living
children).
Question 11
Question:
A pregnant woman is the mother of two children. Her first pregnancy ended in a still birth at 32
weeks of gestation, her second pregnancy with the birth of her daughter at 36 weeks, and her
third pregnancy with the birth of her son at 41 weeks. Using the 5-digit system to describe this
woman’s current obstetric history, the nurse would record:
Choices:
A. 41202
B. 4-1-2-0-2
Correct Answer:
B. 4-1-2-0-2
Rationale:
Gravida (the first number) is 4 since this woman is now pregnant and was pregnant 3 times
before. Para (the next 4 numbers) represents the outcomes of the pregnancies: 1 term birth at
41 weeks, 2 preterm births at 32 and 36 weeks, 0 abortions, and 2 living children.
Question 12
Question:
A married woman has made the decision to use a diaphragm as her primary method of birth
control. The clinic nurse should provide which instructions regarding care of, insertion, and
removal of the diaphragm? (Select all that apply.)
Choices:
A. Remove the diaphragm by catching the rim from below the dome.
B. Avoid using mineral oil body products.
C. On insertion, direct the diaphragm down toward the space below cervix.
D. Wash diaphragm monthly with mild soap and water.
E. A dusting of cornstarch is appropriate after drying the diaphragm.
Correct Answer:
A. Remove the diaphragm by catching the rim from below the dome.
B. Avoid using mineral oil body products.
C. On insertion, direct the diaphragm down toward the space below cervix.
E. A dusting of cornstarch is appropriate after drying the diaphragm.
Rationale:
These are correct instructions for care, insertion, and removal of the diaphragm. Washing should
be done after each use, not just monthly.
Question 13
Question:
Cardiovascular system changes occur during pregnancy. Which finding would be considered
normal for a woman in her second trimester?
Choices:
A. Less audible heart sounds (S1, S2)
B. Increased pulse rate
Question:
An effective relief measure for primary dysmenorrhea would be to:
Choices:
A. Reduce physical activity level until menstruation ceases.
B. Begin taking prostaglandin synthesis inhibitors on the first day of the menstrual flow.
C. Decrease intake of salt and refined sugar about 1 week before menstruation is about to occur.
D. Use barrier methods rather than the oral contraceptive pill (OCP) for birth control.
Correct Answer:
C. Decrease intake of salt and refined sugar about 1 week before menstruation is about to occur.
Rationale:
Staying active is helpful since it facilitates menstrual flow and increases vasodilation to reduce
ischemia. Prostaglandin inhibitors should be started a few days before the onset of menstruation.
Decreasing intake of salt and refined sugar can reduce fluid retention. OCPs are beneficial in
relieving primary dysmenorrhea as a result of inhibition of ovulation and prostaglandin synthesis.
Question 2
Question:
With regard to dysfunctional uterine bleeding (DUB), the nurse should be aware that:
Choices:
A. It is most commonly caused by anovulation.
B. It most often occurs in middle age.
C. The diagnosis of DUB should be the first considered for abnormal menstrual bleeding.
D. The most effective medical treatment involves steroids.
Correct Answer:
A. It is most commonly caused by anovulation.
Rationale:
Anovulation may occur because of hypothalamic dysfunction or polycystic ovary syndrome. DUB
most often occurs when the menstrual cycle is being established or when it draws to a close at
menopause. A diagnosis of DUB is made only after all other causes of abnormal menstrual
bleeding have been ruled out. The most effective medical treatment is oral or intravenous
estrogen.
Question 3
Question:
During a client’s physical examination, the nurse notes that the lower uterine segment is soft on
palpation. The nurse would document this finding as:
Choices:
A. Hegar sign
B. McDonald sign
C. Chadwick sign
D. Goodell sign
Correct Answer:
A. Hegar sign
Rationale:
At approximately 6 weeks of gestation, softening and compressibility of the lower uterine
segment occur; this is called the Hegar sign. The McDonald sign is not related. The Chadwick
sign is a blue-violet cervix caused by increased vascularity. Softening of the cervical tip is called
the Goodell sign.
Question 4
Question:
A nurse teaches a pregnant woman about the presumptive, probable, and positive signs of
pregnancy. The woman demonstrates an understanding of the nurse’s instructions if she states
that a positive sign of pregnancy is:
,Choices:
A. A positive pregnancy test
B. Fetal movement palpated by the nurse-midwife
C. Braxton Hicks contractions
D. Quickening
Correct Answer:
B. Fetal movement palpated by the nurse-midwife
Rationale:
A positive pregnancy test is a probable sign. Positive signs of pregnancy are those attributed to
the presence of a fetus, such as hearing the fetal heartbeat or palpating fetal movement.
Braxton Hicks contractions are probable signs. Quickening is a presumptive sign.
Question 5
Question:
When assessing the fetal heart rate (FHR) of a woman at 30 weeks of gestation, the nurse counts
a rate of 82 beats/min. Initially the nurse should:
Choices:
A. Recognize that the rate is within normal limits and record it.
B. Assess the woman’s radial pulse.
C. Notify the physician.
D. Allow the woman to hear the heartbeat.
Correct Answer:
C. Notify the physician.
Rationale:
The expected FHR is 120 to 160 beats/min. The nurse may have inadvertently counted the
uterine soufÒe, which corresponds to the mother’s heartbeat. The physician should be notified if
the FHR is confirmed to be 82 beats/min. Allow the woman to hear the heartbeat as soon as a full
assessment is made.
Question 6
Question:
The nurse caring for a laboring woman is aware that maternal cardiac output can be increased
by:
Choices:
A. Change in position
B. Oxytocin administration
C. Regional anesthesia
D. Intravenous analgesic
Correct Answer:
A. Change in position
Rationale:
Maternal supine hypotension syndrome is caused by the weight and pressure of the gravid
uterus on the ascending vena cava when the woman is in a supine position. This reduces venous
return to the woman’s heart, as well as cardiac output, and subsequently reduces her blood
pressure. The nurse can encourage the woman to change positions and avoid the supine
position. Oxytocin administration, regional anesthesia, and intravenous analgesic may reduce
maternal cardiac output.
Question 7
Question:
A nurse is reviewing information related to home pregnancy tests so as to prepare for a patient
teaching session. Which statement by the patient indicates that additional instruction is needed
following the teaching session?
Choices:
A. The patient states that she will follow directions as listed on the testing package.
B. The patient indicates that a positive result will be seen if there is a color change on the
,applicator.
C. The patient states there is no need for concern as home pregnancy test results are 100%
correct.
D. The patient can perform the test without any assistance in the home setting.
Correct Answer:
C. The patient states there is no need for concern as home pregnancy test results are 100%
correct.
Rationale:
Home pregnancy testing while reliable does not provide 100% correct results. There are other
variables such as medication history as well as timing of specimen, collection and interpretation
that may lead to inaccurate results. Following directions, noting a color change as a positive
result, and being able to perform the test without any assistance in the home setting all indicate
that the patient has an understanding of the process.
Question 8
Question:
The nurse should include which information when teaching a 15-year-old about genital tract
infection prevention? (Select all that apply.)
Choices:
A. Wear nylon undergarments.
B. Avoid tight-fitting jeans.
C. Use floral scented bath salts.
D. Decrease sugar intake.
E. Do not douche.
F. Limit time spent wearing a wet bathing suit.
Correct Answer:
B. Avoid tight-fitting jeans.
D. Decrease sugar intake.
E. Do not douche.
F. Limit time spent wearing a wet bathing suit.
Rationale:
Wearing nylon undergarments and using floral scented bath salts are not recommended.
Avoiding tight-fitting jeans, decreasing sugar intake, not douching, and limiting time in a wet
bathing suit help prevent genital tract infections.
Question 9
Question:
If exhibited by a pregnant woman, what represents a positive sign of pregnancy?
Choices:
A. Morning sickness
B. Quickening
C. Positive pregnancy test
D. Fetal heartbeat auscultated with Doppler/fetoscope
Correct Answer:
D. Fetal heartbeat auscultated with Doppler/fetoscope
Rationale:
Morning sickness and quickening, along with amenorrhea and breast tenderness, are
presumptive signs of pregnancy. A positive pregnancy test is a probable sign. Detection of a fetal
heartbeat, palpation of fetal movements and parts by an examiner, and detection of an
embryo/fetus with sonographic examination are positive signs diagnostic of pregnancy.
Question 10
Question:
A woman is 6 weeks pregnant. She has had a previous spontaneous abortion at 14 weeks of
gestation and a pregnancy that ended at 38 weeks with the birth of a stillborn girl. What is her
gravidity and parity using the GTPAL system?
, Choices:
A. 31010
B. 3-1-0-1-0
Correct Answer:
A. 31010
Rationale:
G: Total number of times the woman has been pregnant (she is pregnant for the third time). T:
Number of pregnancies carried to term (she has one stillborn). P: Number of pregnancies that
resulted in a preterm birth (she has none). A: Abortions or miscarriages before the period of
viability (she has had one). L: Number of children born who are currently living (she has no living
children).
Question 11
Question:
A pregnant woman is the mother of two children. Her first pregnancy ended in a still birth at 32
weeks of gestation, her second pregnancy with the birth of her daughter at 36 weeks, and her
third pregnancy with the birth of her son at 41 weeks. Using the 5-digit system to describe this
woman’s current obstetric history, the nurse would record:
Choices:
A. 41202
B. 4-1-2-0-2
Correct Answer:
B. 4-1-2-0-2
Rationale:
Gravida (the first number) is 4 since this woman is now pregnant and was pregnant 3 times
before. Para (the next 4 numbers) represents the outcomes of the pregnancies: 1 term birth at
41 weeks, 2 preterm births at 32 and 36 weeks, 0 abortions, and 2 living children.
Question 12
Question:
A married woman has made the decision to use a diaphragm as her primary method of birth
control. The clinic nurse should provide which instructions regarding care of, insertion, and
removal of the diaphragm? (Select all that apply.)
Choices:
A. Remove the diaphragm by catching the rim from below the dome.
B. Avoid using mineral oil body products.
C. On insertion, direct the diaphragm down toward the space below cervix.
D. Wash diaphragm monthly with mild soap and water.
E. A dusting of cornstarch is appropriate after drying the diaphragm.
Correct Answer:
A. Remove the diaphragm by catching the rim from below the dome.
B. Avoid using mineral oil body products.
C. On insertion, direct the diaphragm down toward the space below cervix.
E. A dusting of cornstarch is appropriate after drying the diaphragm.
Rationale:
These are correct instructions for care, insertion, and removal of the diaphragm. Washing should
be done after each use, not just monthly.
Question 13
Question:
Cardiovascular system changes occur during pregnancy. Which finding would be considered
normal for a woman in her second trimester?
Choices:
A. Less audible heart sounds (S1, S2)
B. Increased pulse rate
